May 28

Types and Treatment of Shoulder Ligament Injuries

Ligaments hold one bone to another bone and limit the amount of motion available in the joint. This prevents excess movement or motion in directions not intended for a particular joint. The tighter the ligaments are, the less motion available. Because the shoulder is a highly mobile joint, the ligaments must be loose to allow motion in all directions. This creates some inherent instability in the joint, and an avenue to potential injury.

Anterior Ligament Sprain/Dislocation

This injury usually occurs when we raise the arm overhead or out to the side and apply a force, such as with retrieving a heavy object from an overhead shelf. If the load is too great, then the ligaments in the front of the shoulder become overloaded and can tear, causing a sprain. If the ligaments tear enough, then the bones can separate and cause a dislocated shoulder. Dislocations should get immediate medical attention in the emergency room. Treatment involves applying traction to the joint, which allows the shoulder to return to its normal position and then a period of immobilization to allow the ligaments to heal.

Unfortunately, the ligaments do not heal quite as tightly as they once were. The shoulder becomes increasingly unstable, disposing it to another dislocation. Conservative treatment following a dislocation involves strengthening of the rotator cuff, a group of four muscles that provide additional stability to the shoulder. As you move your arm through space, the rotator cuff sucks the head of the arm bone, medically termed the humerus, into the socket. After a dislocation, it is even more important to keep the rotator cuff working properly. You may be referred to a physical therapist, who can provide instruction in the proper exercises.

Should the shoulder continue to dislocate, surgical intervention may be required. This entails tightening the shoulder capsule by “pulling up the slack” in the loose ligaments and stitching them back in place. This surgery is highly successful at stopping future dislocations, but there is a period of immobilization and rehabilitation for several weeks following the surgery.

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