The shoulder is the meeting place of three bones: scapula (shoulder blade), humerus (arm bone) and clavicle (collar bone). The main shoulder joint, that is glenohumeral joint, is a ball-and-socket joint that is formed by the rounded shape at the top of the arm bone fitting into a cup-shaped socket (glenoid) in the shoulder blade. It is the most flexible joint, allowing you to raise, twist and bend your arm forward, to the side, and behind. This flexibility, however, makes your shoulder prone to injuries and overuse wear and tear, especially cartilage tears.
Let us understand in detail what actually involves in a shoulder cartilage injury. The ball at the top of the upper arm bone rests in a socket in the shoulder blade called the glenoid. As the head of the humerus is much larger than the he glenoid, a soft fibrous tissue rim surrounds the socket and attaches the joint to the socket. This ring of cartilage and fibrous tissue is called the labrum. The labral cartilage surrounds the ball of the upper arm bone and keeps it inside the glenoid. The cartilage tissue deepens the socket by up to 50 percent so that the head of the humerus fits better. Shoulder cartilage injuries can happen in a number of ways including trauma, repetitive motion, shoulder dislocation or wear and tear on the joint over time. If the tear is not severe, it may affect only the rim of the cartilage. However, if the tear is a major one, it may even affect the biceps tendon and there could be complete detachment of the cartilage.
What causes shoulder cartilage injuries?
Injuries to the shoulder cartilage can occur either from acute trauma or repetitive shoulder motion. Examples of trauma may include:
- Falling on an outstretched arm
- A direct blow to the shoulder
- A sudden pull, such as when trying to lift a heavy object
- A violent overhead reach, such as when trying to stop a fall or slide
- Activities where the force occurs at a distance from the shoulder, such as striking a hammer, swinging a racquet or throwing a baseball
- An abrupt pull, such as lifting a heavy object
- Overhead lifting of heavy weight repeatedly, like weight lifting, gymnastics, and construction work
People in the sporting fraternity, especially throwing athletes and weight lifters can experience shoulder cartilage injuries as a result of wear and tear over a prolonged period of time.
Are you at risk of shoulder cartilage injuries?
Predominant risks of shoulder cartilage injuries are sudden trauma, such a holding onto an object to prevent a fall or sudden pull to lift a heavy object. There is a high likelihood of causing a cartilage tear in these situations.
If your shoulder has dislocated previously and the cartilage has torn off as a result, if it has not healed back in the right location, you are at an increased risk of sustaining a cartilage tear again.
Age is another factor that plays a role in cartilage tears. As we age, cartilage becomes more brittle, making it susceptible to tear away from the shoulder joint.
Signs and symptoms of shoulder cartilage injuries:
A shoulder cartilage injury can trigger a number of symptoms. However, most of the symptoms are similar to those of other typical shoulder injuries. Symptoms may include:
- Shoulder dislocations
- Inability to perform overhead activities due to pain
- Catching of the joint. You may notice a clicking or popping sensation when you move your arm in certain ways
- Pain at night
- Loss of strength, often on one side
- A sense of instability of the shoulder joint
- Pain with activities of daily living
- Occasional pain at night
- Inability to rotate the shoulder freely
Diagnosis of shoulder cartilage injuries:
Range of motion, pain level and stability of the patient’s shoulder will be checked during the physical examination. In order to zero in on the exact diagnosis and the line of treatment, advanced medical technology and procedures may be utilized. Generally diagnostic procedures can include x-rays, CT scan, MRI, arthrography and arthroscopy. Injection of a contrast medium (commonly referred to as dye) is required in the case of CT, MRI and arthrography.
Treatment for shoulder cartilage injuries:
Until the final diagnosis is made, your doctor may prescribe anti-inflammatory medication and rest to ameliorate symptoms. Exercises that aim at making shoulder cartilage muscles stronger may also be recommended. If the injury is not severe, non-surgical measures are effective in relieving the symptoms and healing the injured structures. If the injury is beyond the scope of conservative measures, your doctor may prescribe surgery for the condition. The nature of the surgery (traditional, open or arthroscopic) depends on the extent and type of your injury.
If surgery was carried out, then you may need to keep your shoulder in a sling for three to six weeks, depending on your doctor’s recommendation. You may be asked to do gentle, passive, pain-free range-of-motion exercises that will aid strengthening the shoulder. However, if you are an athlete, you can resume your sporting exercises 12 weeks after the surgery, but keep in mind that it may take four to six months for your shoulder to heal completely.
Prevention of shoulder cartilage injuries:
Though many risk factors are beyond our control, you can help prevent shoulder cartilage injuries in the following ways:
Be prudent while doing some activities: Activities that involve repeated overhead motion or heavy overhead lifting are principal causes of cartilage injuries in the shoulder.
Be careful when you are on icy, wet or slick surfaces: Falling on an outstretched arm or taking a direct blow to the shoulder is another leading cause of shoulder cartilage injuries.
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