Sports Injuries

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I Injured my shoulder! Should I rest it?

0352bI injured my shoulder!  Should I stop working out? Should I wear a sling? Should I see an orthopaedic doctor?

Depending on the circumstances surrounding your injury or pain, these questions may be swirling about in your head, and the answer to these questions could vary.

Of course, very mild aches and pains can be a normal part of life.

Illness, exercise, sports, aging…all of these can lead to soreness, mild temporary aches, and fatigue. It would be unusual to pass an entire lifetime without any trace of discomfort in our bones and joints. These types of pains can and should certainly be tolerated and should not cause alarm. When we do experience them, it is best to stay active and not allow these symptoms to affect our active lifestyle.

However, shoulder pain that is more severe, longer-lasting, or accompanied by significant weakness or loss of motion should not be “brushed off.”

An orthopedic shoulder specialist like Johnny T. Nelson, MD is specially trained in diagnosis and treatment of any and all causes of shoulder pain.  Based on questions that he will ask you about the type of pain you have, location of the pain, how long the pain has been present, as well as findings on physical examination, x-rays, and possibly ultrasound of your shoulder, he will be able to give you direction on whether or not further treatment is necessary or if it is okay to continue with life as usual.

For example, if your pain began after a more serious accident, for example a car accident or a fall, it is very important to rule out serious problem such as broken bones or torn rotator cuff tendons.  This is usually done with a combination of x-rays and physical examination. Dr. Nelson also uses in-office ultrasound to diagnose these conditions as well without having to resort to more costly and time-consuming MRIs.

There are other conditions, such as bursitis, rotator cuff tendinitis and inflammation, and arthritis that are okay to live with, and continuing to workout is usually okay and safe.  Of course, some modifications of your workout regimen may be necessary to avoid inflaming or aggravating the shoulder further.

It is almost never necessary or advisable to wear an arm sling or shoulder immobilizer unless a physician recommends it.

Unnecessary sling use can lead to more stiffness and pain, and does not contribute much to healing. Slings are usually only used for short periods of time after either serious shoulder injuries (broken bones or dislocations) or after shoulder surgery.

Sometimes if the patient has very severe pain, it may be a good idea to stop working out for a short whi6993ble to focus on more basic exercises to rebuild shoulder health, such as strengthening the rotator cuff muscles, stretching out the shoulder blades, and working on posture and core strengthening. This also allows for time for a proper workup to rule out more serious causes of pain (for example, rotator cuff tears).

Also, as we age, some types of exercising, such as very heavy weights and plyometrics, may not be suitable for our level of conditioning and physical activity, so it may be necessary to discontinue some exercises altogether.  However, every exercise that is discontinued should be replaced by another because, as Dr. Nelson always says, if you don’t move it, you lose it!

Once a diagnosis is made, Dr. Nelson can then recommend treatment.  Very rarely, this includes surgical treatment, but more often it may include watchful waiting, oral anti-inflammatories, physical therapy, injections, a home exercise program, chiropractic care, or possibly even referral to a different physician.

Do you have shoulder pain? Are you unsure of where to go next or who to listen to? Call 919-872-5296 to make a visit with Raleigh’s Shoulder Doctor, Johnny T. Nelson MD.

dislocation

I Dislocated My Shoulder…Now What?

dislocationI Dislocated My Shoulder…Now What?

Shoulder dislocations and shoulder instability can be a very scary event.

Sometimes they occur after a bad fall, for some patients they occur while playing sports, and for other patients they can occur simply by placing your arm or shoulder in the wrong position.

Fortunately, although shoulder dislocations can be very painful and scary, they usually do not require surgical treatment, and with proper evaluation and care by an orthopedic shoulder specialist such as Dr. Nelson, they may not affect the long-term health of your shoulder.

The first thing to understand about shoulder dislocations and shoulder instability is that there are different types of them.

Some patients simply feel clicking and popping in their shoulder, and some patients do not feel anything like this but only feel scared when their arm is placed in a certain position. Depending on the patient, many of these conditions can be treated with physical therapy and some activity changes.

The other more serious variety of dislocation is where the ball-and-socket joint actually comes apart, the ball “jumps” over the edge of the socket and gets stuck there. This type of dislocation usually requires treatment either by an experienced specialist (a physical trainer, orthopedic surgeon, or doctor in the emergency department) and sometimes requires medication to make you relaxed and sleepy to do so. Once the shoulder is “back in place,” you will probably need a sling for about two weeks to allow the shoulder to heal, followed by slow return to gentle activities and motion before returning to full activity.

It is important to understand the difference between these because all of these types of shoulder dislocations and instability are treated differently.

But there are some types of dislocations that require surgical treatment.

Every time you dislocate your shoulder, it is possible and very likely that some structures are torn and damaged. Unfortunately these structures are what makes your shoulder stable, so with each dislocation, this shoulder becomes less stable. This can lead to a difficult situation where simple everyday activities of daily living can cause dislocations. For example, placing groceries in the backseat of your car can cause shoulder dislocation. If this occurs, surgical treatment is necessary to repair the damaged structures and restore stability to the shoulder to avoid repeated dislocations.

Other patients that are more likely to require surgery include young competitive athletes, especially those that play certain sports that require contact. Because of the large forces and energy of the hits involved in sports such as football and rugby, these sports are more likely to cause shoulder dislocations. If young patients with shoulder instability want to continue to play their favorite sport without dislocating the shoulder more and more, surgical treatment may be necessary.

Do have problems with shoulder instability? Have you dislocated your shoulder before and continue to have pain? Do you find that you are often scared that you will dislocate your shoulder doing very simple things? If so, Dr. Nelson is a trained shoulder specialist who understands your condition and how to treat it.

Call 919-872-5296 to schedule an appointment.

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