Snowboarding and the shoulder

Snowboarding shoulder injuriesAs avid snowboarders around the globe gear up for the Snowboarding World Championships later this month, competitors will be balancing injury prevention with maximising performance.

Snowboarding shoulder injuries are a common risk for professional snowboarders due to the way the body is positioned. In skiing, the majority of pressure is placed onto the lower body, as the knees twist and help manoeuvre the skier around the mountain. With snowboarding however, the feet are strapped onto the board, and it’s the upper body that’s largely responsible for manoeuvring around the course. Not only that, but if the snowboarder loses their balance and falls, it’s the upper body that’s going to take the full force of the fall.

Here we’ll look at the most common shoulder injuries in snowboarding and what, if anything, can be done to prevent them.

How common are shoulder related injuries in snowboarding?

It’s estimated that shoulder injuries account for between 8% to 16% of all snowboarding injuries. However, these figures are taken from the ski medical clinic so the actual rate of injury could be much higher as most snowboarders visit their local physician to report any issues. It’s also likely these figures will increase over coming years, as snowboarding is witnessing a boom in popularity, with more people taking up the sport each year.

It’s also interesting to note that beginners have a higher injury risk than the more advanced snowboarders who tend to use much riskier and more difficult manoeuvres. Approximately a quarter of injuries occur during a person’s first experience of snowboarding and that’s because of the increased risk of falls.

What shoulder injuries are most commonly experienced by snowboarders?

So, as a snowboarder which shoulder injuries are you most at risk of developing? The most common include:

Rotator cuff injuries: The rotator cuff is made up of several tendons and muscles surrounding the joint of the shoulder. Helping to keep the shoulder in place, this large group of muscles and tendons is typically the most vulnerable to injury during a snowboarding fall. Rotator cuff injuries vary significantly in severity, with most presenting as a dull ache or severe pain in the affected area.

Gleno-humeral dislocations: While dislocations aren’t as common as rotator cuff injuries, they can occur after a nasty fall. The patient may be unable to move the arm away from its current position and significant pain will usually be felt.

Clavicle fractures: This is a very common shoulder injury, involving the collarbone – one of the main bones within the shoulder. Treatment for this type of injury is usually straightforward, with the arm requiring a sling while the fracture heals. However, in some cases surgery may be required.

Acromioclavicular separations: If you fall directly onto the shoulder, there’s a risk of acromioclavicular separation. This is where the clavicle separates away from the scapula. The majority of the time this type of injury can be treated without surgery, though it depends upon its severity.

So, can these injuries be prevented? Unfortunately, due to the high risk of falls in snowboarding, it’s impossible to completely prevent shoulder injury. However, making sure you use the latest equipment and you use the proper techniques while out on the slopes, will help to reduce your chances of injury.

Overall, most importantly is that you seek help from a shoulder specialist if you suspect you’re developed a snowboarding related shoulder injury. The earlier you get it looked at, the easier it will be to treat.

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Swimmers found to be more vulnerable to developing shoulder pain

Swimmer's ShoulderSwimmers are more vulnerable to developing shoulder pain than athletes who aren’t involved in overhead sports, according to a new study published in The American Journal of Sports Medicine.

Researchers studied a cohort of competitive swimmers over the course of an intensive 12-week training season and found that swimmers experience a 15% increase in forward shoulder posture compared to an approximately 1% increase in those that participate in non-overhead sports. There was also a substantial decrease in subacromial space distance in comparison.

“Swimmers have a lot of pain during training season and this [study] validates some of where that pain is coming from,” Elizabeth E. Hibberd, assistant professor at the University of Alabama and the Director of Athletic Training Research Laboratory, explains. “Over the course of the training season, they are getting these adaptions in their physical characteristics, predisposing them to injury.”

Swimmer’s shoulder is a common injury experienced by professional swimmers, affecting both men and women alike. Here we’ll look at why swimmers are more vulnerable to developing shoulder pain and the types of injuries which can occur.

Why are swimmers more vulnerable?

Unlike other sports, swimmers require a high endurance level of the upper extremity. The upper body is responsible for approximately 90% of the propulsive force involved in swimming, with the shoulders absorbing the majority of the pressure.

Shoulder pain and injury typically develops due to a combination of the overuse of the shoulders and leaving little rest time for the muscles to recover. It’s thought that competitive swimmers can swim six to eight miles each day, sometimes up to seven days a week. The constant movement of the muscles and joint, along with the mechanical characteristics involved in swimming, put an enormous amount of pressure onto the shoulders.

The shoulder joint is also particularly prone to instability and it isn’t difficult to see why shoulder injuries are the most common orthopaedic injury reported by competitive swimmers. In a recent review of published literature on musculoskeletal injuries in swimmers, the prevalence of shoulder injuries runs from between 40% and a staggering 91%.

Injuries can occur due to one or a combination of the following:

  • Over training
  • Hypermobility
  • Tightness of the joint
  • Poor technique
  • Fatigue
  • Weakness
  • The use of hand paddles
  • Previous shoulder injury

Professional swimmers therefore, are much more likely to develop shoulder injuries due to the amount of time they spend training.

Majority of swimmers believe mild to moderate shoulder pain is normal

Due to the amount of time swimmers spend in the water, most believe mild to moderate shoulder pain is normal. However, this mindset can prevent the swimmer from seeking help quickly enough when they’ve suffered an injury.

As they don’t recognise that they do have a shoulder injury, many swimmers also try to treat the pain themselves using pain medication. The trouble with this is, as the injury is left untreated, it will become worse the longer it is left undiagnosed. This leads to more time out of the pool and can seriously damage a professional swimmer’s career.

Can swimmer’s shoulder be prevented?

Further research is required to establish which intervention methods would be most effective for swimmers. While you can never completely eliminate the risk of shoulder injury, there are ways you can reduce the risk. These include:

  • Building up the muscles of the shoulder to make the joint more stable and less prone to injury.
  • Always use the correct stroke technique.
  • Ensure you seek a diagnosis quickly if you experience any form of shoulder pain.

What is known is that it is really important to have the injury diagnosed as soon as possible. If you wait before seeking help, it’s likely inflammation will have developed and the pain will be more widespread, making it difficult to make a precise diagnosis. Inflammation masks the symptoms, making it more difficult to pinpoint the exact injury. That’s when a broad ‘swimmer’s shoulder’ diagnosis is made.

Overall, swimmers shoulder is a common injury which plagues professional swimmers. It is vital that proper techniques and training are undertaken to prevent the risk and a fast diagnosis is made if injury does occur.

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Balloon Arthroplasty for Rotator Cuff Repair

Recent studies have shown that balloon arthroplasty for rotator cuff repair could provide significant improvement in shoulder function.

Rotator cuff repairs can be notoriously painful and in more serious cases are considered irreparable. This leaves patients suffering with long-term functionality issues and often intense pain. In recent years, balloon arthroplasty has emerged as a possible solution for those diagnosed with severe, irreparable rotator cuff tears.

Understanding the balloon arthroplasty procedure

Inspace balloon arthroplastyBalloon arthroplasty is a relatively-new keyhole surgery technique which involves inserting a balloon into the shoulder to replace the irreparable rotator cuff tendon.

Prior to the introduction of this treatment, the only other option for irreparable tears was a procedure known as a reverse total shoulder replacement. This major operation involves completely repositioning the muscles so that the arm can move again, involving a long and painful recovery time. The balloon arthroplasty, on the other hand, is a much less invasive technique with reduced downtime.

Known as InSpace™, the procedure is largely beneficial for elderly patients who currently experience significant shoulder pain. The balloon comes in numerous sizes and is made from biodegradable polymer. The size used will depend upon the subacromial space available.

The balloon is inserted into the subacromial space via an arthroplasty procedure. It is then filled with a saline solution once it is in position. The surgeon then takes the joint through a range of different motions to ensure that the balloon is securely in place and isn’t likely to become dislodged.

As the procedure is performed via keyhole surgery, it can be carried out under local anaesthetic. This means patients can have the procedure and return home the same day.

What are the benefits of balloon arthroplasty?

Although balloon arthroplasty is a new procedure and isn’t yet approved by NICE, it has shown promising results in initial testing. The fact it is a fairly straightforward and non-invasive procedure compared to a reverse total shoulder replacement is a major benefit. It’s a low-risk option for patients who are reluctant to undergo major surgery.

It is worth noting that it isn’t necessarily a permanent solution. The balloon will naturally break down within six to twelve months. This means it can either be used as a temporary solution until the patient undergoes a reverse total shoulder replacement, or a new balloon can be inserted as and when it is required.

As far as scientific evidence goes, due to the infancy of the procedure, very little is known about its exact benefits and effectiveness. Some current scientific papers even suggest physiotherapy could be just as effective at helping to restore a good range of motion. However, that is based on rotator cuff tears which are reparable. It is therefore largely designed to treat irreparable injuries in older patients.

The recovery time is the most notable benefit, with patients requiring the use of a sling for around a week following the procedure. With reverse total shoulder replacement, the recovery takes an average six weeks.

Balloon arthroplasty has shown some promising early results for patients suffering with irreparable rotator cuff tears. However, further studies do need to be carried out to establish just how viable and effective the procedure is.

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Don’t let shoulder pain derail your new year resolutions

Now that the new year is upon us, you may now be determined to shape up in 2017. However, if you’re suffering with shoulder pain, your new year’s get fit resolution may seem like an impossible task.

shoulderThe shoulder is an incredibly complex joint and an injury can cause severe pain not just within the shoulder itself, but across the upper back, neck and right down the affected arm. This obviously causes issues when it comes to working out, as any movement and pressure placed upon the injury can intensify the pain significantly.

So how can you get fit if you’re suffering with shoulder pain?

Should you work out if you have shoulder pain?

There are a lot of different types of shoulder injury and some are more severe than others. If you haven’t already, you need to get the cause of the shoulder pain correctly diagnosed. Minor injuries may simply require good physiotherapy, while more severe injuries may require surgery.

In some cases, you may need to rest the shoulder and avoid working out until it has recovered and the pain has subsided. However, there may still be some exercises you can do which won’t cause further problems or worsen the pain experienced.

What exercises can you do with a shoulder injury?

While it is advisable to avoid heavy lifting and above the head exercises while you have a shoulder injury, that isn’t to say you have to stop exercising completely. It is possible to continue to work out the muscles of the back and shoulders without the risk of further injury and pain. Some of the best exercises to consider include:

  • Side lateral raises – Using dumbbells to ensure a more natural motion, side lateral raises help you to tone up the lateral deltoids in the shoulders.
  • Front raises – If you’re looking to bulk up the anterior or frontal parts of the deltoid muscles in the shoulder, front raises can help. For this exercise a plate is recommended rather than dumbbells, as it enables your shoulders to work together rather than signalling one out which could increase the risk of further injury.
  • Leaning shoulder shrugs – This one is great for the middle of the back and helps to give you a more polished look. To perform it properly, bend over a little at the hips and then do it like you would with a regular shrug. This leaned position helps to target the area and builds it up quickly.

There are also exercises you can do which can help to speed up your shoulder recovery. Internal rotations using dumbbells is a great starter exercise. Always ensure you start off with the lighter weight when you’re starting out. After working on internal rotations, you can then progress to external rotations with dumbbells. These exercises are great for the rotator cuff muscles.

Overall, there are numerous exercises you can still perform while suffering with a shoulder injury. However, it is important to seek advice from a shoulder specialist to establish the cause of the pain and the type and severity of the injury before you begin working out.

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What are my treatment options after a rotator cuff tear?

The rotator cuff tear is one of the most common reasons why patients consult their GPs about pain and disability affecting the shoulder. In fact, the first description of a rotator cuff injury can be traced back to 1600 BC, when it appeared in the Surgical Papyrus, one of the oldest known medical texts.

Injuries to the rotator cuff become more common the older you get, accounting for 5% of all GP encounters. They may occur as part of the natural ageing process of the tendon and often show no symptoms at all. It’s estimated that more than 40% of patients over 60 will have a rotator cuff tear and will not even be aware of it, instead blaming their aches and pains on just getting older.

There may not be an isolated injury or event that causes the tear; the shoulder has a relatively poor blood supply and it is also an area that sees a lot of wear over time. As the tendons start to thin, even a small amount of strain can result in a tear.

Alternatively, a rotator cuff tear can be caused by a sudden, acute injury. Often, workers engaged in heavy lifting work can suffer from these types of injuries. Injuries can also occur during simple everyday activities such as cleaning, hanging curtains or gardening.

Athletic activities that involve excessive, repetitive, overhead motion, such as swimming, tennis and weightlifting can often be a cause. Tennis player Maria Sharapova had surgery to repair two rotator cuff tears in 2008. After a long recovery she finally returned to singles after a 10-month absence, but struggled for the next two years, before returning to form.

Will I need surgery to mend a rotator cuff tear?

At your consultation with the team at London Shoulder Specialist, non-surgical methods will usually be recommended first. The exact cause of the rotator cuff tear will often dictate the treatment options we advise.

Even though most tears can’t heal on their own, satisfactory function can often be achieved without surgery, so most patients with small degenerative rotator cuff tears can be treated with a combination of anti-inflammatory medication, steroid injections and physiotherapy. These options may all be of benefit in relieving pain and restoring strength to the involved shoulder. However, if the pain and lack of mobility associated with a rotator cuff tear fail to resolve, then your surgical options will be discussed with you.

Reasons where surgery might be indicated to repair a rotator cuff tear are:

  • persistent pain or weakness in your shoulder despite non-surgical treatment
  • if you are active and use your arm for overhead work or sports
  • symptoms have lasted for nine to twelve months
  • there is marked loss of function in the shoulder
  • a large tear is detected in the tendon (usually more than 3 cm)

Rotator cuff tear surgery typically entails re-attaching the tendon to the head of the upper arm bone called the humerus. A less invasive procedure, known as debridement, can be used to repair a partial tear by trimming or smoothing the tendon. A complete tear may require the two parts of the tendon to be stitched back together.

Three techniques are used for rotator cuff repair: traditional open repair, mini-open repair, and arthroscopic repair (keyhole); your consultant will advise you as to which approach is best suited to your individual circumstances.

What is the recovery like after rotator cuff tear surgery?

Rehabilitation plays a vital role in both the non-surgical and surgical treatment of a rotator cuff tear. Initially, the tendon will need to heal and you will be advised to keep your shoulder immobile for the first month or so and we recommend wearing a sling. Once the tendon has begun to heal then you will be required to undergo a programme of physical therapy aimed at returning your shoulder to its full pre-injury strength and motion.

Complete recovery can be expected approximately six months after surgery, as long as the patient rehabilitation programme has been followed. It is important to realise that there is always a chance of the rotator cuff re-tearing and the larger the initial tear, the higher the chance of that happening.

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Could an electric shock zap shoulder arthritis pain?

An innovative approach to pain relief could provide hope for sufferers of rheumatoid arthritis.

In a limited trial at the University of Amsterdam, 17 rheumatoid arthritis sufferers were fitted with an electronic implant in the vagus nerve that controls many of the important functions of the body, including inhibiting inflammation which is the underlying cause of rheumatoid arthritis.

In this degenerative condition, the body’s immune system mistakenly attacks the joints causing swelling, stiffness and pain. The implant works by releasing an electric pulse that stimulates the vagus nerve, reducing the levels of immune cells that cause the damage.

All patients enrolled on the trial had previously failed to respond to medication and all reported a marked reduction in stiffness and discomfort. Rheumatoid arthritis is just one of many different types of arthritis that can affect any joint of the body, including the shoulder. The most common type of shoulder arthritis is osteoarthritis, which is often associated with ageing.

Understanding shoulder arthritis

Arthritis means inflammation of a joint in the body. As the shoulder is a very mobile joint it can develop wear and tear over a lifetime. The cartilage which lies on the bones of the shoulder joint becomes thinner and ultimately can be destroyed. As a result, one bone then rubs on the other causing pain, stiffness and loss of functional abilities. One option is to then consider a shoulder replacement. Whilst this type of surgery is not as common as hip or knee replacements, on average, approximately 4,500 shoulder replacement surgeries are carried out each year in the UK.

Unsurprisingly, the National Joint Registry found that osteoarthritis was indicated in 58% of shoulder replacements, but there are other types of arthritis or conditions that can affect the shoulder requiring replacement surgery. These include

Rheumatoid arthritis

Affecting the joint lining of the shoulder, rheumatoid arthritis is one of the more common types experienced by patients. The autoimmune condition can present itself in one or both shoulders, causing stiffness and pain. Over time, it can lead to deformity of the shoulder joints, as well as an erosion of the shoulder bones.

Post-traumatic arthritis

Shoulder injuries are common, particularly in young athletes. When an injury occurs, it can trigger post-traumatic arthritis. Patients who have experienced shoulder dislocation or fractures are particularly at risk of developing the condition. In this type of arthritis, fluid can build up within the joint, causing pain and swelling.

Rotator cuff tear arthropathy

Rotator cuff injuries are fairly common and they can lead to a type of arthritis known as rotator cuff tear arthropathy. It is most commonly caused by a longstanding tear of the rotator cuff tendons, which results in muscle weakness and loss of support for the shoulder. As a result, a painful arthritis then develops.

Avascular Necrosis

Avascular necrosis is a condition whereby the blood supply to the humeral head (ball) is disrupted. This then causes bone cells to die. The body attempts to regenerate itself but the process is flawed and the ball can become very irregular. Conditions that can cause avascular necrosis include sickle cell disease, high dose steroids, excessive alcohol consumption, previous fractures and radiotherapy.

What are the treatment options for shoulder arthritis?

As consultant shoulder surgeon Mr Andy Richards of the London Shoulder Specialist commented in a recent lecture on shoulder arthritis: “There is no cure for arthritis so all the surgeon can do is reduce the symptoms and pain. Range of movement and function may be increased through reducing pain.”

This new electric shock implant may prove beneficial for patients suffering with rheumatoid arthritis. It is worth noting, though, that the trial was very limited so although results are promising, more in-depth studies are required. Also other types of arthritis will require a different approach and these include a range of non-surgical and surgical options. At London Shoulder Specialists, we will first assess the type of shoulder arthritis prior to offering expert, impartial advice on the most appropriate treatment.

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New painkilling techniques trialled in shoulder surgery

New painkilling techiques are being tested in the hope of reducing the amount of medication prescribed after surgery. Opioids are a common pain relief medication but there are concerns that they are being overprescribed after surgery. They reduce the intensity of pain signals before they reach the brain and affect the areas of the brain that control emotion. They range from hydrocodone, oxycodone, morphine and codeine and differ greatly in strength.

These prescription drugs can be extremely addictive. A 2015 US study published in the Mayo Clinic Proceedings, found one in four people who have been prescribed opioids go on to develop an addition. It is a worrying pandemic that’s particularly affecting young athletes. UK data is less comprehensive than that gathered in America, but a survey released by the charity Action on Addiction last year estimated that nearly one in ten UK adults believe they could be or could have been addicted to opioid painkillers, with a quarter taking opioids for more than five years.

Doctors are hoping the new painkilling techniques being tested may be used in conjunction with or instead of opioid medication to minimise patients’ reliance on this form of pain relief.

Combination of non-addictive treatments is key

Rotator cuff surgery can involve a painful recovery process, hence strong opioid prescriptions are often required in the initial post-operative period. However, the new painkilling techniques being trialled aim to deliver the same relief without the addictive nature of opioids and the dangerous side effects.

While the techniques have been used individually to relieve pain after surgery, it’s the combination of the different methods which is key according to surgeons at NYU Langone Medical Center’s Department of Orthopaedic Surgery in New York who are aiming to greatly minimise the pain experienced after elbow or shoulder surgery and, therefore, the use of opioids. Their techniques include:

  • Non-addictive anaesthetic – including the use of injections around the nerves in the neck and shoulder
  • Catheter implant – delivering anaesthetic over a set period of time
  • Mechanical stimulation and wearable icing devices – helping to reduce swelling and pain throughout physiotherapy
  • Drug regimens – helping patients to move onto non-addictive medication like Tylenol

There are of course some potential drawbacks with these techniques. Patients have to become accustomed to having weak or numb arms for a number of days. Catheter implants can sometimes be difficult to keep in place and they can seem like an ‘intimidating’ option.

Instead, single injections can be used which would effectively block pain signals for up to 24 hours. Opioid medication can still be used for a short amount of time before transitioning patients onto other medication

Many units, including Fortius London Shoulder specialists now employ regional anaesthesia, where injections are placed about the nerves in the brachial plexus to reduce post operative pain requirements. There are some risks that come with these injections such as nerve damage and the potential for the anaesthetic to leak, though these are relatively small.

Understanding rotator cuff surgery

Rotator cuff surgery is carried out in one of two ways. It can be performed via open surgery or arthroscopically. In the open surgery method, an incision is made in the skin and the procedure is performed through a large wound – the torn tendons are reaattched to the bone.

Arthroscopic surgery is performed using an arthroscope, or mini camera, so the surgeon can view the inside of the shoulder on a monitor. Small, specially designed surgical instruments are used so less extensive incisions are required. Arthroscopic surgery typically causes less trauma to the muscles surrounding the shoulder, which in turn reduces the discomfort felt after the surgery.

A study entitled ‘Effectiveness of Open and Arthroscopic Rotator Cuff Surgery’ published in the NIHR Journals Library, provided a better understanding of each method. Interestingly, the post-operative pain management required was similar with the open and arthroscopic method. Two-thirds of participants were still taking painkillers after two weeks and after eight weeks, though painkiller use was decreased from 66% to 55%.

Overall, regardless of the type of technique used, recovery from rotator cuff surgery should not be underestimated.

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Summer of sport: spotlight on shoulder instability and the young athlete

For young athletes, summer is prime time to get out there to train, compete or even just to engage in sport for fun and relaxation with friends. However, increased sporting engagement also means a rise in shoulder instability cases.

It is recognised that a trauma to the shoulder, such as a fall, can cause shoulder instability and many people know someone who has dislocated a shoulder doctor.

However popular summer sports such as swimming, volleyball, tennis and cricket, can lead to shoulder instability, due to repetitive actions involving arm rotation. Shoulder instability can be painful and it can also put you out of action.

What is shoulder instability?

Shoulder instability presents itself in numerous ways including a full dislocation,  a partial dislocation (subluxation) and mild looseness (laxity). It occurs most dramatically when the ball (head) of the upper arm (humerus) is forced out of the socket (glenoid). In doing so, the ball can tear a ring (the labrum) that runs around the socket The problem is that once shoulder instability occurs, it is likely to recur. In repetitive sports, the injury to the labrum can be less acute and develops over a period of time.

There are a number of ways to classify shoulder instability. These include the cause of the instability – trauma, natural laxity, poor muscle patterning – the direction of the instability – anterior, posterior or multidirectional – the degree of the instabilty and the anatomic site of any injury within the shoulder.

The most common problem experienced by young athletes is anterior instability. It occurs largely in men aged between 18 and 25 and accounts for approximately 85% to 95% of shoulder instability cases. The most likely cause is trauma causing a complete dislocation, though subluxations are also common.  If there is a complete dislocation, patients can sometimes relocate the shoulder themselves, however often they need to attend hospital to have it reduced.

In the case of a subluxation, the shoulder only partially comes out and then slides back into joint by itself. This can still be painful and result in ongoing symptoms, such as pain when trying to rotate the shoulder. Very occasionally, the instability can be associated with altered sensation within the arm.

At the London Shoulder Specialists, we first assess the cause of the instability, as to whether it is the result of a trauma, natural joint looseness (hyperlaxity) or due to poor muscle control. It may be possible to utilise physiotherapy to help strengthen and coordinate your shoulder muscles and thereby reduce any instability symptoms, or the risk of a further significant event. We are often asked about the use of braces and, in certain circumstances, these can be helpful.

However, particularly in the younger population, surgery may be the best course of action to reduce the risks of further problems.

Surgery could reduce need for follow-up procedures

Research carried out by the American Orthopaedic Society for Sports Medicine, has shown first time dislocation surgery  significantly lowers the risk of re-injury and reduces the need for follow up procedures.

Within the study, 121 patients, with an average age of 19, were examined on average, 51 months after surgery. The group included 68 patients who had a first-time dislocation and 53 who had experienced several dislocations after initial non-operative treatment. Results showed that just 29% of first-time dislocation patients experienced further shoulder instability issues after arthroscopic surgery, compared to 62% in the patients who hadn’t undergone surgery.

This was a long-term, in-depth study which recorded data from 2003 to 2013. The results clearly highlight the benefits of first-time surgery for shoulder instability cases, providing hope for young athletes. It supports a number of other studies, which have shown similar findings. Indeed many of these have shown even better results for patients undergoing surgery. One area that has improved the results of surgery is better selection of patients and matching patients to the surgical options.

Most patients who suffer from first-time shoulder instability are understandably worried. This new research eases that worry and demonstrates that sometimes surgery can be the best way forward to protect their athletic career.

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Could wearable technology reduce sports injury for top-flight cricketers?

More and more sports are utilising wearable tech, to keep their players at peak fitness and reduce possibility of sports injury. Rugby has been an early adopter, with every club in the Aviva Premiership using GPS units to measure speed and distance, and now cricket is set to follow.

Researchers at a leading Australian university have developed an algorithm, employing the technology behind guided missiles, to try and reduce injury and improve performance in cricket players. This so-called ‘torpedo technology’ has now been adopted by the Australian national team in advance of their test series against Sri Lanka in July.

Currently, the amount of balls that a bowler delivers is measured but not the intensity that is employed. Using missile-guiding microtechnology, including accelerometers, magnetometers and gyroscopes implanted into wearable technology, data will be gathered for a more in-depth workload analysis.

Sports injury rates in professional cricket game

Developments in professional cricket, with the introduction of T20 just over ten years ago, has meant more varied and complex demands on the player. As the cricket calendar has become more crowded, sports injury rates have risen; a study into injury rates of the Australian team found that the annual injury prevalence rates for fast bowlers exceeded 18%, with the shoulder being particularly vulnerable to injury.

Treating top-class cricketers

The team at the London Shoulder Specialists are experts in the treatment of professional cricket players. Mr Andrew Wallace, Consultant Orthopaedic Surgeon, has treated elite athletes playing for the England and Wales national teams, as well as professional cricketers from abroad. Later this month, he will be giving a lecture on ‘Shoulder Injuries in Elite Cricketers: Prospects for Success’ at the Sports Symposium at the British Elbow and Shoulder Society. The focus of this particularly segment of the meeting, held in Dublin from 22nd to 24th June, will be on managing sports injury from the pitchside to return to play.

Mr Wallace will be focusing on SLAP tears, a shoulder injury that is common to cricketers or those that partake in overhead sports. Standing for ‘Superior Labrum Anterior and Posterior’, this is a tear to the top part of the shoulder joint, known as the labrum. It can be an incredibly painful injury and Mr Wallace employs arthroscopic surgery to visualise and successfully repair the labrum.

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Could supplements reduce shoulder fracture risk?

Shoulder fractures, particularly clavicle fractures, are a common and very painful injury suffered by athletes. Contact sports in particular carry a high risk; though they can also be caused by a bad fall or injury. Fractures can take months to heal and for keen athletes they can have a devastating impact on their career.

Recent evidence provided by an ESCEO-IOF expert panel suggests calcium and Vitamin D supplements could play a key role in minimising the risk of a fracture.

Supplements prove effective at promoting healthy musculoskeletal ageing

shoulder fracture and supplementsThe European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases (ESCEO) along with the International Foundation of Osteoporosis (IOF) recently came together to analyse the evidence that vitamin D and calcium supplements can help promote healthy musculoskeletal ageing.

They specifically wanted to address whether such supplements could reduce the risk of fractures. Using all current knowledge and evidence presented for both the benefits and adverse reactions reported, the board came to the following conclusions:

  • Fracture risk is slightly reduced – taking calcium and vitamin D supplements together do appear to slightly reduce the risk of fractures. However, calcium alone hasn’t proven to have the same effects so the supplements would need to be combined.
  • Vitamin D reduces the risks of falls – obviously not all falls can be prevented, particularly if you’re taking part in contact sports. However, studies show that vitamin D when taken alone, can reduce the likelihood of patients suffering a bad fall. This discovery was surprising given the fact that calcium is more closely linked to muscle physiology.
  • Those at risk of calcium and vitamin D insufficiency receive most benefits – in terms of fracture reduction, vitamin D and calcium supplements tend to work best for those at a high risk of vitamin insufficiency.

So, it appears supplements do have some positive effects in terms of reducing fracture risk and they’re also promoted for osteoporosis treatment. However, further in-depth studies are required to establish just how much of an effect they have on the muscular and skeletal system.

Understanding shoulder fractures

There are several types of shoulder fractures to be aware of. These include clavicle, scapula and proximal humerus fractures.

In general, clavicle fractures tend to be the most common and are typically the result of a fall. Scapula fractures are the least common and are mostly caused by high energy traumas such as a car accident or a high fall. Finally, proximal humerus fractures occur in older patients, usually over the age of 65.

Diagnosis varies depending upon the type of fracture experienced. Some require a simple X-ray, while others may need to be analysed in depth via a CT scan. If you suspect you have a fracture it’s important to seek diagnosis and treatment as soon as possible. If you take part in sports you will need to wait until the shoulder is fully healed before you can start playing again.

Overall, using supplements to reduce your fracture risk certainly won’t harm you. However, those at high risk would be much better off working to build up the shoulder muscles which help to protect the bones. Calcium and vitamin D supplements would also be better suited to older patients, particularly as traumatic clavicle fractures have been linked with a doubled mortality rate for patients over 65 years, as evidenced in a 2011 study published in the Journal of Orthopaedic Trauma.

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