Tuesday 21 May 2013

The Shoulder


Supraspinatus impingement, biceps tendonpathy, SLAP Lesion, Acromoclavicular Joint Sprain....to name but a few. The shoulder is an extremely complex joint, mainly because is sacrifices stability for mobility.  

A shoulder joint can move 360 degrees, in every direction possibly, as compared to a knee which can be flexed and extended.  In the last few months I have a assessed and treated a few shoulder injuries and all have had different diagnosis's.  Due to the complexity of the shoulder and all its structures involved, it is extremely important to make the correct diagnosis.  If this is not done, pain an chronic issues can develop.  If a diagnosis cannot be made by objective tests then imaging, such as, X-Rays, Ultrasounds and MRI's need to be done.

A shoulder joint cannot function without the support of the scapula or "shoulder blade", the triangular shaped bone found on your upper back.  The scapula forms a supportive role, as it stabilizes the shoulder.  Rotator cuff muscles are important stabilizing muscles of the shoulder that originate from the scapular and attach in the shoulder joint.  Thus if there is an injury in the shoulder ( muscles, ligaments, tendons, nerves, the capsule, etc) it will effect the scapula and thus the stabilization of the shoulder.  Due to this, a shoulder injury should never be treated in isolation for best results.

A cricketers shoulder is extremely important for their performance.  Every player requires a strong and flexible shoulder joint, as they need the ability to throw.  Baseball and cricket have a strong comparison and the "overuse" of a players shoulder is one reason.  Cricket does not have any shoulder injury prevention strategies set in place, due to the lack of data.  However due to the popularity of baseball in the USA, there has been numerous studies done on shoulder injuries and preventative strategies.

Throwing is very explosive, when broken down into its phases biomechanically.   Due to the stress imparted on this joint during throwing, it is important that players follow a rigorous flexibility, stabilization and strength programme.  However the most important phase of prehabilitation is an actual throwing regime'.  This is when players build throwing endurance by a progressive throwing programme.

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