Common Shoulder & Elbow Conditions

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Introduction

Our feet, together with our hands, make up more than half the bones in our body. The feet’s tendons, muscles and ligaments work together to support our weight and are necessary to get us around, be it walking or running. However, we may experience foot conditions due to sports injuries or overuse.

Rotator Cuff Injury (Cuff Tear)

The rotator cuff refers to a group of muscles around the shoulder joint. Common symptoms following such injury to the rotary cuff is a dull ache around your shoulder. If left untreated, the condition may affect your daily activities, especially those that involve moving your arm away from the body. Some examples include combing your hair or getting dressed. You may also feel some weakness in your arms.

The injury may occur following an accident or fall, and also as a result of repetitive overhead activity or heavy lifting. The condition is a common cause of shoulder pain and discomfort in adults. The injury is most common in those who work construction jobs, carpentry, or house painting. Increasing age and family history are also two risk factors that increase your risk of developing the injury.

Shoulder Impingement (Bursitis)

This condition happens when the top of your shoulder blade continuously rubs against your rotator cuff. Overuse of these muscles may cause swelling, minimising the space around the muscles and shoulder bone. Left untreated, the lack of space leads to rubbing, thus causing pain and inflammation. Symptoms include pain when stretching or lifting your arms, tenderness in the front of your shoulders, pain when lying sideways, continuous dull ache at night, and arm weakness or stiffness.

Bursitis is most often found in those who often do sports that involve a lot of arm and shoulder movement such as swimming, baseball, and badminton. Similar to the cuff tear, bursitis is also commonly found in those who work construction jobs. On top of occurring progressively due to repetitive use, it may also occur suddenly following an injury.

Frozen Shoulder

Also known as adhesive capsulitis, the condition is characterised by stiffness and pain around your shoulder joints. The symptoms of a frozen shoulder tend to progress slowly over 1-3 years. The progression of these symptoms can be divided into 3 stages: freezing (the onset of pain and shoulder’s range of motion starts to decrease), frozen (shoulder becomes much stiffer and performing daily activities become difficult), and thawing (range of motion begins to improve).

The condition occurs when the connective tissue that covers your shoulder bones and muscles thickens and tightens, thus restricting the movement of the shoulder joint. The exact cause of this is often unknown, but there are known risk factors including age (being over 40 years old), prolonged immobility following a shoulder or arm injury, and certain diseases such as diabetes, thyroid conditions, cardiovascular diseases, and tuberculosis. The condition also more commonly occurs among women.

Shoulder Dislocation (Instability)

The shoulder joint works as a ball-in-socket mechanism — the most mobile type of joint that can move in all directions. While it is the most mobile, it is also less stable and is the most likely to suffer from a dislocation.

A shoulder dislocation happens when the ball at the tip of your upper arm gets displaced from the socket in the shoulder blade. This may happen due to a fall or other accidents that directly hits the shoulder. When your shoulder gets dislocated, you might experience extreme pain, swelling, bruising, numbness, muscle spasms, weakness on your shoulder and arm, difficulty in moving your arm, and the shoulder being visibly out of place. Muscles and other tissues that connect your arm to your shoulders may also suffer some injury.

Shoulder or Elbow Fractures

An accident or trauma to your shoulder may cause a fracture, which refers to a condition where parts of your bone are broken. They are described as either non-displaced (when the bones remain in their position) or displaced (when bone fragments move out of position). Most shoulder fractures are non-displaced and such cases may be treated simply with a sling to immobilise the affected arm. For displaced fractures, surgery is often required as it may cause arthritis otherwise.

Some signs and symptoms that suggest a shoulder fracture include pain, swelling, and/or tenderness around your shoulders, a “bump” at the affected area, discolouration of the upper arm, as well as pain or difficulty in moving your arm.

Shoulder Arthritis

Arthritis refers to damage of the cartilage in your joints. Cartilage functions as a form of protective tissue that allows bones to glide over one another smoothly. In the case of shoulder arthritis, the condition happens when the cartilage along the ball and socket joint gradually starts to wear down as a result of continuous use. As the cartilage thins out, your shoulders bones might end up rubbing against each other, thus causing pain and inflammation. Arthritis symptoms gradually develop over time and commonly include shoulder pain, stiffness, a feeling of your shoulder grinding, clicking, cracking, and overall reduced range of motion.

There are different types and causes of arthritis, the most common being osteoarthritis, which often naturally happens due to ageing. Another type is rheumatoid arthritis, an autoimmune disorder that occurs when your immune system attacks your own body’s cells. Other types include post-traumatic shoulder arthritis that may happen following an injury, rotator cuff tear arthropathy that may occur following a rotator cuff injury, and also due to avascular necrosis which refers to disrupted blood flow to a certain part of your body.

Tennis Elbow & Golfer’s Elbow

A tennis elbow happens when tendons around your elbow attach to a bony bump on the outside of your elbow. It happens when the tendons are overused, often caused by repetitive motions of the arm and wrist, especially those that involve straightening and raising your hands and wrist.

A similar condition, called golfer’s elbow, happens when the tendon attaches to a bony bump on the inside of your elbow. Golfer’s elbow is often caused by repetitive stress from forceful wrist and finger motions. Both conditions may cause pain that spread across the elbow, forearm and wrist.

As the name suggests, both conditions are often found in but are not limited to, athletes. Other than the sport, people also often get tennis elbow from plumbing, painting, driving screws, and cutting up ingredients (especially meat). The repetitive use of a computer mouse may also cause the condition. Golfer’s elbow, on the other hand, can come from racket sports such as tennis and badminton. Throwing sports (baseball, archery, javelin throw), improper weight training, and repetitive occupational movements involved in construction, plumbing and carpentry also often leads to the condition.

Cubital Tunnel Syndrome

This condition happens when the ulnar nerve, a nerve that runs from your neck all the way into your hand, is constricted at the inner part of the elbow. Common symptoms following the cubital tunnel syndrome include numbness and a tingling feeling in your hands and fingers, especially the ring and little finger. For more severe cases, symptoms include weakened grip, loss of finger coordination, and in the long run may cause loss of muscle mass in the hand.

The condition happens when there is increased pressure on the nerve around the elbow area as you bend your elbow. As such, bending your elbows and leaning on them for long periods of time may increase your risks of developing the condition. An injury or trauma that directly hits your elbow may also cause the condition. Other risk factors include prior elbow fractures, dislocation or other elbow injuries, arthritis, elbow joint swelling, and cysts around the elbow joint.

Conclusion

Pain in the shoulders and elbows could range from anything from a tear in the tendons to a fracture. If you suffer from chronic or acute pain, consult your orthopaedist for proper diagnosis and treatment.

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