Sports injuries

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High impact, contact and repetitive motion sports are a common cause of injuries to the shoulder and elbow. Many different injuries can occur and the treatment may need to be tailored around a training schedule or specific sports demands.

But some of the ones we see most often in the clinic are:

  • Shoulder instability – this can occur when the head of the upper arm is forced out of the shallow shoulder socket. The shoulder can become unstable and prone to repeated dislocation and injury.
  • Shoulder biceps injuries and SLAP tears – these can be at the shoulder, for example in throwing athletes who damage the long biceps tendon in the shoulder joint (SLAP tear), or a significant tear of the tendon and muscle attached to the elbow (distal tear). A distal bices rupture may require urgent treatment to repair the tendon.
  • Shoulder fracture – there are several different types of shoulder fracture. The most common is a clavicle fracture which tends to be the result of a fall. Other fractures include scapula fractures which are far less common and are normally the result of a high impact collision or fall from a height, and proximal humerus fractures which are fractures of the upper arm that are more common in older people.
  • Rotator cuff injury – the rotator cuff is the group of muscles and tendons that surround the shoulder joint and cover the head of the humerus, helping to keep it in the shoulder socket. It can become injured through a fall or sudden load on the arm or through repetitive overhead movements.
  • ACJ injury – the acromioclavicular joint is where the collarbone meets the shoulder blade. A fall or direct impact can injure the ligaments of the ACJ and so, too, can repetitive loading such as heavy weights in the gym.
  • Shoulder impingement – this is a painful condition that develops when the tendons or bursa get pinched by the bones of the shoulder. It can be caused by repetitive overhead loading of the shoulder. It can lead to inflammation of the rotator cuff tendons and bursa. In some cases, the rotator cuff tendon may begin to tear.
  • Tennis and golfer’s elbow (epicondylitis) – these are painful conditions which can result directly from injury or from repetitive overuse and gripping.
  • Elbow impingement – repetitive sports that load the elbows, such as canoeing, can lead to thickened soft tissues or spurs around the elbow joint that can catch. This often occurs at the back of the elbow with some stiffness and catching when the arm goes straight.

Causes of shoulder and elbow sports injuries

Shoulder and elbow sports injuries are normally due either to overusing the joint by making repetitive movements or to sudden trauma, such as an accident, collision or fall. Older people can be more at risk of certain injuries due to worn tendons or weaker bones.

Symptoms of shoulder and elbow sports injuries

Depending on the nature and severity of the injury, you may experience pain ranging from mild to severe. Other common symptoms include inflammation, tenderness, stiffness, loss of movement, weakness and bruising.

Diagnosis of shoulder and elbow sports injuries

Depending on your symptoms, a range of diagnostic approaches might be used. A physical examination is the normal starting point to ascertain what is causing any pain, as well as assessing for loss of movement, weakness and swelling in the affected area. You may also be referred for diagnostic testing, such as:

  • X-rays – these are used to diagnose (or rule out) fractures as well as conditions like arthritis which can cause bony spurs to develop.
  • MRI scans – these provide a detailed picture of soft tissues (tendons, ligaments and muscles) and can show if there is tearing or a rupture. For some conditions a contrast dye might be injected into your joint in a procedure called an MRI arthrogam. This helps to show up the soft tissue structures in the joint, especially in instability.
  • CT scans – these combine X-rays with computer technology to create a detailed cross-sectional image of your body. For the shoulder and elbow this type of scan shows the shape, position and structure of bones very clearly.
  • Ultrasound scans – these use high-frequency sound waves that echo off structures in the body. They may be used to diagnose rotator cuff tears.

Treatment of shoulder and elbow sports injuries

Treatments will vary depending on the type and severity of the problem and whether it was caused by sudden trauma or as the result of wear and tear or overuse.

Fractures, dislocations and significant sudden tears are often managed through the emergency department or through urgent review and treatment.

The treatment of sports injuries may need to be tailored and timed carefully to fit with complex training regimes of certain sports.

Alongside rehabilitation, exercise programs, and sometimes surgery, specialised injections may also be helpful for conditions including tendon injuries.

  • Steroid injection – these can reduce inflammation and ease pain although repeated injections may be unhealthy for tendons.
  • PRP injection – These injections use your own blood, spun to extract the healing factors and stem cells then reinjected to promote healing.
  • Hyaluronic acid injection – This is a jelly like substance similar to that produced by your own joints, which can be injected to ease pain by lubricating damaged joint and tendon surfaces and by reducing inflammation.

Consultants

For rapid access to specialist orthopaedic consultants who can help you with a personalised treatment plan, take the first step and arrange a consultation.