There is a wide array of shoulder injuries. The most common are minor strains or sprains. Dr. Caveh Sajadi of Kentucky Bone and Joint. Injuries explained the difference: A strain is a minor injury to a muscle or tendon, but a sprain is a minor injury to a joint.
“As we get older, our ability to have a fall or injury without repercussions deteriorates and our bodies are not as forgiving,” Sajadi said. It is a misconception that those who are physically fit heal faster. “People that are active generally do better, but they also put more demands on their body, so they may become more limited functionally than somebody who is less active,” said Sajadi.
Those whose shoulders are in good health can reduce their chance of injury.
“Get a good independent shoulder-strengthening program,” Sajadi said. “This means isolating the rotator cuff muscles, which is usually best accomplished through high- repetition, low-weight-resistance exercises.”
The immediate advice doctors should give patients with shoulder injuries are to apply ice and get medical attention.
“Someone should come in if they cannot raise their arm above their shoulder, have failed to improve despite physical therapy or medical management or are having significant pain that keeps them up at night,” said Sajadi. The patient can expect to undergo a physical exam related to the complaint. The physician may order X-rays if they were not done previously. Doctors need to recognize when a patient needs to see a specialist.
Healing depends on the person and the problem, Sajadi said. “Non-surgical treatment requires three to six months to improve in some cases,” he said. “Most surgical problems require six months to a year to fully recover.”
If you have a patient with a shoulder injury, make sure they have appropriate expectations during recovery. The most common questions patients ask doctors are about the length of recovery and how long the patient will be immobilized, particularly if he or she has to wear a sling. Recovery time varies, based on the injury or surgery, but generally involves a period of two to six weeks. Normal life can begin anywhere from three months to a year after the injury.
The general trend is to treat these injuries as minimally invasively as possible, usually through physical therapy.
“There are advances in what can be treated non-surgically in terms of therapy, medications and surgical treatment,” Sajadi said.
It is possible to preserve the normal muscles and address the problem in a more anatomic fashion. “There are advances in imaging, predominantly MRI, that allows us to better appreciate any soft-tissue problems in the shoulder,” said Sajadi.
A great deal of research is going on in many areas related to shoulder rehab, which makes this an exciting time to practice orthopedics. It is important for doctors to stay aware of cutting-edge procedures and to continue to individualize treatment plans. For patients, the good news is that most of them can hope to resume a normal lifestyle once they have fully recovered, even though it may take some longer than others.
One of the more promising areas that is currently being researched but is not in actual practice right now involves using platelet-rich plasma. “(The plasma) is drawn from a patient themselves and (is) used to provide stem cells to potentially stimulate healing,” Sajadi said. The treatment holds great promise but is still investigational.
By Jamie Lober, Staff Writer