Shoulder injury is more common than you think, especially in relation to sports. Pitching a baseball, playing volleyball, taking a hit in football, constant swimming—all can result in some sort of damage to the shoulder. Now that fall is approaching, the potential for shoulder injury increases with the return of sports.

The following are the most common types of shoulder injury, how they are caused, and the treatment of each:

Impingement Injury
Impingement injuries involve the rotator cuff, the bicep tendon (attaches the bicep muscle to the shoulder and elbow), and other structures in the affected shoulder.

Cause: It is caused by repeated overhead activities, which can overuse the shoulder. Pitching in baseball/softball, volleyball, swimming and tennis can all lead to this type of injury.

Treatment:75-80% of athletes respond well to rest and rehabilitation and are able to return to play, while the small, remaining percentage will require injections and perhaps surgery.

Instability Injury

This type of injury can be either traumatic or non-traumatic.

Cause: Non-traumatic instability injuries involve repeated overhead activities (much like impingement injury), but when examined shows signs of shoulder “instability.” Shoulder instability is when the structures surrounding the shoulder joint aren’t keeping the ball within the shoulder socket. Traumatic instability occurs from an awkward twisting motion, like one would see in football such as tackling or blocking. Athletes often report feeling a “pop” at time of injury, signaling dislocation of the shoulder joint.

Treatment: Approximately 90% of non-traumatic injuries can be rehabbed successfully, with only 10% requiring surgery. Traumatic instability often requires surgery.

Clavicle Fractures

Clavicle fractures account for 5% of all adult fractures.

Cause: A clavicle fracture is the result of a direct blow to the shoulder area or pressure on an outstretched arm, which then creates a break in the collarbone. This can be very painful, making it hard to move the arm. These fractures commonly occur in football, hockey, wrestling and lacrosse.

Treatment: Although slings used to be the recommended treatment for mild fractures, surgical intervention is now preferred due to the high incidence of re-fracture.

Nerve Injury

Commonly involving the brachial plexus (a network of nerves that sends signals from the spinal cord to the shoulder, arm and hands), this injury can also include the cervical spine (vertebrae of the portion of the spine referred to as the neck).

Cause: This type of injury is caused by sudden damage to the nerves, including stretching, compression or, in serious cases, ripping or tearing of the nerves from the spinal cord. It is often seen in the “stinger” position in football and occurs in approximately 25% of all football players annually. This injury can cause the loss of feeling or movement in the shoulder, arm or hand.

Treatment: In some cases nerve injury may heal without treatment, but more serious injury may require surgery to regain proper function of the arm or hand.

If you have suffered a shoulder injury, it is important to seek consultation and diagnosis from your primary care physician or, in more serious cases, when visiting the emergency room.