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Acromio-Clavicular (A-C) joint -Dislocation/Separation
This injury is very common in all contact sports and involves a fall onto the shoulder, elbow or outstretched hand. One common cause is during a hard bump in Australian Rules football. Depending on the severity the outside end of the clavicle will be pushed upwards (PICTURE).
This injury is caused by tearing of the ligaments around the A-C joint and involves partial separation (Grade I and II) or total separation (Grade III) of the joint. There is pain and tenderness around the outer end of the clavicle that is increased by movement.
This problem is commonly referred to as ‘frozen shoulder’. This is an ongoing shoulder problem which can occur in the older person as a result of any shoulder injury. It is characterised by a period of marked pain and inflammation in the shoulder closely followed by marked stiffness and loss of range of movement in the shoulder. It is due to a buildup of scar tissue and contraction of the ligaments around the shoulder following the painful inflammation.
Fractures (Clavicle, Scapula, Upper Humerous)
Clavicle injuries are very common in contact sports and cycling, skiing or horse riding. This fracture usually results from a fall onto the point of the shoulder, onto an outstretched hand (PICTURE) or from a direct blow. The clavicle will usually break in the middle third of the bone or towards the outer third. The fracture will be characterised by extreme localized tenderness and swelling, and sometimes a cracking feeling with arm movement. The bony deformity is easily felt in this case.
This injury is common in contact sports as well as cycling or horse, commonly caused by a direct blow to the back of the shoulder. Common symptoms are pain over the back of the shoulder, worsened by any arm movement.
This fracture most commonly occurs with a fall onto the outstretched hand or a direct fall onto the shoulder. Marked pain will be experienced around the shoulder with a large amount of pain when touching the area just below the shoulder joint. The arm should be immobilised in a sling and medical opinion should be sought as soon as possible.
Subluxation is caused when the shoulder is pushed or slips forward, backwards and/or downwards in the joint but does not pop out totally. Subluxation bay be due to an acute trauma or repetitive loading of the shoulder such as during heavy lifting. This injury is common in repetitive throwing sports such as baseball, contact sports or racquet sports.
This injury is characterised by pain during and after exertion, a felling of looseness or dislocation when raising the arm above 90?.In the long term this injury causes weakness of the rotator cuff muscles and therefore further instability.
Acute dislocation is common with a fall onto the outstretched hand or a direct blow to the front or back of the shoulder. Dislocation is characterised by extreme pain and spasm in the shoulder as well as visible deformity and inability to lift or move the arm. A temporary numbness and weakness of the arm is sometimes felt – a symptom commonly called ‘dead arm syndrome’.