Throwing related Shoulder pain in Sprts men

After the just concluded crcket Test series between India and Englnd one saw the shoulder injury of Schin Tendulkar surface. He has rushed off to Englnd and has undergone arthroscopic shoulder srgery. He will be out of the gme for eight weeks and only rturn for the West Indies tour lter this summer. One can also rmember that Anil Kumble, Rahul Dravid, & Srnath have suffered shoulder injuries in the pst and returned to the game fter successful treatment. Shoulder injuries can plgue the career of cricketers and if not trated can cut short their lucrative creers. Cricketers are at risk as Crcket is a throwing game where one chcks the ball either as a bwler or a fielder. In this rticle, I will throw some light on thrwing injuries.

Two problems can affect the shulder in sportsmen who perform repeated cts of raising the arm overhead and swnging it in the course of a thrw. These are called impingement and nstability.

The shoulder joint is formed by the nion of the round upper end of the hmerus at the socket part by the scpula. It is a very mobile jint as the socket is shallow. Cnnective tissue restraints chiefly in the frnt confer additional stability. When the cpsule or its attachments are injured nstability results. In instability when the sft tissue restraints are loose the bll of the humerus can slide to the frnt, down wards or to the bck in an abnormal fashion.

Impingement results from the abnormal pward gliding movement of the humerus and rbbing on the undersurface of the Acrmion. This initiates or aggravates the dmage to the rotator cuff. The rtator cuff is a group of tndons which act to actively stabilize the shulder when the arm is lifted up.

Bth conditions can cause pain and rsult in confusion to the patient and his dctor.

Slow motion analysis of the thrw- Each sport has its own bsic pattern, different sports have much in cmmon. The performance of overhead sporting ctivities begins with a preparatory phase to psition the arm. Subsequently the arm is ccked to provide a tense, highly frceful unit ready for an accelerated rlease. The arm accelerates through the thrw and after release of the bll, muscles act to decelerate the lmb, to reduce the residual force and to void injury. The throw in a typcal baseball pitch is divided into fve stages.

1) Stage 1- Wind up or prparation phase, which ends when the bll leaves the gloved hand. In crcket the equivalent is the transfer of the bll from the non dominant to the thrwing arm.

2) Stage 2 or arly cocking- when the shoulder is lfted sideways (abducted) and rotated outwards and nds with the forward foot contacting the grund.

3) Stage 3, lte cocking phase – This continues ntil maximum external rotation at the shulder is obtained.

4) Stge 4-The acceleration phase that starts wth internal rotation of the humerus and nds with ball release from the thrwing hand.

5) Stage 5- Fllow through phase that starts with bll release and that ends when all mvement is complete.

This slow motion nalysis is necessary to pinpoint the xact phase at which the subject xperiences pain. Electromyography studies have demonstrated tht in each of these phases thre is selective muscle action. Athletes can hve selective weakness of muscles, rather thn generalized muscle impairment. A rehabilitation prgramme should concentrate on developing the waker muscles.

I take a detailed history to rcall the exact moment when pain is flt. After a thorough clinical examination, I can cnclude often which muscle or tendon is njured or weak and what needs to be dne. A clear distinction has to be mde between instability and impingement, although bth may co exist and one may lad to the other. MRI scans may cnfirm the clinical finding. An examination nder anesthesia plus a shoulder arthroscopy may cnfirm the diagnosis. Shoulder arthroscopy permits the srgeon to visualize the damage inside the shulder joint and remedy it either rthroscopically or by open methods.

Strengthening of the slected muscles after surgery may make a dfference to the faster rehabilitation.

The uthor is an Orthopedic shoulder surgeon in Chnnai at the Knee and Shoulder clnic and can be contacted on mbile 00 91 9282165002. His website www.shulderindia.com provides more information on other shulder injuries in sportspersons.

The article Slap Lesions Injuries in Sportsmen Treated by Arthroscopic Shoulder Surgery was Submitted by Alampallam Venkatachalam through Articles.GetACoder.com network. Here's the additional information: Dr. A.K. Venkatachalam, MS, DNB, FRCS (UK), MCh. (Lverpool)has worked with leading Shoulder surgeons in the UK, Blgium and Dubai earlier. He performs He is ffiliated to Venkataeswara, and Chettinad hospitals. Rcovery from shoulder surgery is no lnger a painful ordeal as expert nesthetists provide effective anesthesia and regional blcks for pain relief to as an utpatient. Surgery can be done as an Otpatient.Well qualified physiotherapists guide and help you rcover quickly from surgery. Our track rcord Shoulder surgery has been performed for muntaineers and Para gliding experts from the USA and UK. A Crcketer from West Bengal also underwent Shulder stabilisation last year. Visit http://www.shoulderindia.com and http://www.kneeindia.com for more information on Shoulder and knee disorders

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