Shoulder Joint Tear (Glenoid Labrum Tear): Symptoms & Prevention

The shoulder joint is composed of three different types of bones: the shoulder blade, upper arm bone and collarbone. This type of joint is a ball and socket joint, allowing for extreme flexibility and wide range of motion. The upper arm bone acts like a ball and is securely inside the shoulder blade socket. For stabilization purposes, the upper arm bone is slightly larger than the socket, ensuring that the fit is tight. To further enhance the stability, there is a layer of soft tissue called the labrum. Injuries to the labrum is the cause of a shoulder joint tear. In this article, we will look at some of the symptoms and preventive measures.

Symptoms of Glenoid Labrum tears are difficult to be diagnosed. The pain is unable to be localized to the exact location and pain is severely increased when actions involving the injured shoulder is attempted. Such actions can include stretching the arm or raising a hand. As time passes, the shoulder will be weaker and instability will start to set in.

Shoulder joint tears are often caused by a sudden trauma to the shoulder blade. These can include falling on an outstretched arm or a direct blow to the shoulder. In order to prevent this, protective measures should be taken:

Warm-ups and stretching

Have you ever taken a rubber band and pulled it suddenly? The rubber band will end up breaking immediately. This is the same for our muscles and it is the reason why warm ups and stretching are extremely important. Warming up will loosen the muscles and enable the tendons and ligaments to stretch. This will allow them to function properly and hold the shoulder joint together.

Protective gears

Shoulder joint tears are also much more common in players engaging in high impact sports such as rugby and baseball. Players often wear protective paddings designed for the shoulder. These cushioning pads are able to cushion and absorb shocks to a certain extent. Some are even able to prevent fractures and dislocations.

Build strong muscles

Building up strength in the shoulders will increase the ability of tendons, ligaments and muscles to withstand the impact experienced by the shoulder. Strong muscles will hold the shoulder together and prevent any muscular tears during an impact.

Shoulder joint tears are extremely painful and affects our daily lifestyle. Players who participate in high impact or repetitive sports shoulder consider investing in good protective gears and ensure that proper warm ups are performed prior to the start of their activity.

Frozen Shoulder: Cause & Symptoms

Frozen shoulder as its name suggests is a medical condition affecting the shoulder joint where it becomes swollen and stiff as though it is frozen. Our shoulder is a ball and socket joint designed for a wide range of motion and flexibility. Frozen shoulder is a condition that happens slowly over time and will also go away after a year. It may happen after injuries or diseases such as diabetes or stroke. Patients with frozen shoulder will have the formation of scar tissues in the shoulder capsule, causing it to thicken.

There is still no full understanding as to why frozen shoulder occurs. However, there are a few possible causes that are attributed to it:

Previous injury associated with shoulder

Patients who have had past shoulder injuries or surgeries such as a fracture or shoulder replacement may experience frozen shoulder. This is largely due to the post-recovery process requiring them to have large amounts of immobilization time. As a result, the shoulder capsule tightens over time and result in it freezing.

Diabetes

Patients who suffer from diabetes are twice as likely to develop frozen shoulder though the mechanism is still unknown. It could be due to the large buildup of collagen in the shoulder joint. Diabetic patients have large amount of glucose molecules in the body and these excess glucose will attach themselves to the collagen, causing them to stiffen up.

The most common and obvious symptom of frozen shoulder is persistence pain and stiffness in the shoulder joint. Symptoms usually develop slowly over time, usually within a two year timeline.

There are three stages of frozen shoulder:

Pain stage – This is the initial stage where the shoulder will become slightly stiff and the pain increases when any movement is made on the shoulder. This will result in the reduced amount of motion in the shoulder, causing it to become worse. Pain will increase after periods of immobility such as after a sleep in the morning.

Frozen stage – This is the stage where the shoulder will become much stiffer and movement is almost impossible. Usually in this stage, pain does not increase nor go away. Patients will often feel that this is due to them getting used to the pain and they are usually resigned to a lifestyle requiring little use of their shoulder.

Thawing stage – This is the final stage where improvements are slowly seen. The pain in the shoulder will start to go away and shoulders will become less stiff. Patients will be able to move their shoulder much more than before.

Scoliosis: Symptoms & Treatments

Our spine is the structure that gives our body its shape and provide support to it. The entire spinal column consists of multiple small bones stacked together. The spine is designed to be curved naturally although it looks straight when it is viewed from the front. In fact, there are two S-curves at the spine. Scoliosis is a medical problem arising from the abnormal curvature of the spine. Patients who suffer from scoliosis have got spine that looks curved even when viewed from the front. Research has shown that scoliosis are more prevalent in females than males and affects 3 out of 1000 people.

As mentioned above, patients with scoliosis have an abnormal curvature of their spine. As such, this is the most common and obvious symptom. The curving of the spine occurs at an extremely slow pace and thus is easy to miss out until it really becomes severe. The easiest way to be spotted with it is during periodic medical examinations during primary and secondary school. In some patients, scoliosis may also cause their head to the slanted to one side or one of the shoulder to be slightly higher than the other side. In serious cases, the heart and lungs cannot work efficiently and this will lead to the shortness of breath and chest pains.

Treatment of scoliosis really depends on how severe it is towards the patient. Treatment is classified into 3 general groups: observation, bracing and surgery. In patients with mild symptom, they will only be observed for a period of time to spot any changes of the curve getting worse.

Adolescent idiopathic scoliosis is the most common form of scoliosis. If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve stays below 25 degrees, no other treatment is needed. You may return to see the doctor every three to four months to check for any worsening of the curve. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve is between 25-40 degrees and you are still growing, a brace may be recommended. Bracing is not recommended for people who have finished growing. If the curve is greater than 40 degrees, then surgery may be recommended.

Although there is currently no cure for scoliosis, there are good treatment methods that are effective. As the saying goes, prevention is always better than cure.

SLAP Tears: Cause & Symptoms

A slap tear is an injury to the shoulder. SLAP stands for “superior labrum, anterior to posterior”.  This means that the top portion of the labrum is injured from the front to the back. The labrum is a ring of tissue located around the shoulder socket and it is there to stabilize the shoulder due to the extensive amount of movement associated with it. So what exactly causes a SLAP tear and what are the symptoms? This article will help to answer some of these questions.

Our shoulder is made of a ball and socket joint consisting of three different bones. The bones are the upper arm bone, the shoulder blade and the collarbone. The head of the upper arm bone is designed to fit nicely into the socket in the shoulder blade. Each person’s ball and socket joint is unique to him only. The labrum is a thick and strong fibrous tissue that helps to deepen the socket and promote stability to the shoulder joint. It also helps to attach the ligaments and tendons in the area.

A SLAP tear will occur from the area just in front or behind the biceps tendon. SLAP injuries were first observed in baseball players due to the nature of the game. SLAP tears are often due to repeated usage of the shoulder joint. It can also be due to sudden trauma to the shoulder such as a traction force or a pull on the arm. An attempt to break a fall using the shoulder can also be responsible.

The most accurate symptom of a SLAP tear is pain. However, almost everything can cause pain! Almost every movement associated with the shoulder joint will result in pain for the patient. There will also be a decrease in shoulder strength and a feeling of instability. The range of motion will also be significantly decreased. Baseball players may also observe a decrease in the velocity of their throw after pitching.

A trained medical specialist should only diagnose SLAP tears. There are several tests such as the O’Brien’s test, Apprehension Sign and Jobe Relocation Test that are highly reliable when used together as a whole package. This can be aided by a MRI scan which will help to identify the presence of a SLAP tear and the exact location.

A SLAP tear is a challenging medical injury and the treatment must be done in a timely manner due to the many ptifalls in the diagnosis and management of such injury.

5 Most Common Sports Injuries

Sports injuries are common injuries for athletes and they can affect every part of our musculoskeletal system. There are hundreds of sports injuries out there and some can have a serious impact on the future of the athlete’s career. Read on to find out which injuries are the most common ones suffered.

Achilles Tendinitis

Achilles Tendinitis is an injury that occurs when the Achilles tendon which is located at the back of the ankle is overused. It occurs commonly in athletes who are involved in sporting activities that requires them to jump, hop or run for prolonged periods of time such as soccer, running and long jumping. Chronic Achilles Tendinitis can result in inflammation and serious pain which will result in the inability to run.

Concussion

Concussion happens when there is a direct impact to the head. This is most common in high impact sports such as rugby and soccer. Remember that incident where Petr Čech of Chelsea was knocked unconscious and had to undergo a skull fracture surgery? Concussion will result in vision disturbance and disorientation. In serious cases, they can be unconscious as seen in the case of Petr Čech. Recovery period of mild cases of concussion is often fast while serious cases can cause possible permanent damages.

Anterior Cruciate Ligament tears

One common knee injury is the Anterior Cruciate Ligament (ACL) tear. The ACL is one of the 4 major knee ligaments and it provides stability and even stresses distribution across the knee. During high impact and high speed sports, the ACL can be twisted and torn when a directional change is attempted. When a patient has a torn ACL, he will not be able to walk and will require crutches to move about. Recovery from ACL tears will take at least 6 months.

Groin strains

Groin strains occur when the adductor muscles located at the upper thigh is pulled and strained. It often happens when a sudden change in direction is attempted and the muscles have no time to respond, resulting in them being pulled. This is most common in high speed sports such as soccer, rugby, basketball and volleyball.

Shoulder injuries

Shoulder injuries include shoulder sprains, strains and dislocations. This is often seen in sports which require extensive usage of the shoulder such as swimming, badminton, volleyball and tennis. Due to overuse, the shoulder joint which is essentially a ball and socket joint becomes loose, resulting in the rotator cuff loosening. When this happens, it becomes weak and is prone to injuries and dislocations.

5 Types of Physiotherapy Exercises

Physiotherapy exercises are an integral part of the recovery process of a patient with musculoskeletal problems. There are different types of exercises targeted at different parts of the body and is often used in conjunction with other treatment methods such as surgery and medication.

Range of motion exercises

One of the most common physiotherapy exercises is the range of motion exercise. This is performed by patients suffering from joint problems including the knee joint, shoulder joint and elbow joint. Due to injury, joints are often stiff, inflamed and swollen. As a result, the ability to achieve maximum range of motion is hindered. Imagine yourself being unable to fully straighten your leg or your elbow. It is definitely going to cause a lot of discomfort. Range of motion exercises can effectively loosen tight tissues and help to slowly improve your joint flexibility.

Strengthening exercises

Strengthening exercises can be prescribed before and after any surgery. Before surgery, the muscles must be strong as patients are often required are required to rest for a certain period of time, resulting in atrophy of the muscles. Strong muscles prior to surgery can help to reduce the level of weakness and better support the injured parts. After surgery, the muscles will need to be strengthened to help better support the recovery parts and bear the weight and grunt of the body.

Soft tissue mobilisation

Soft tissue mobilisation helps to relax tense and tight muscles which would otherwise be causing a lot of discomfort and pain to the patient. It is performed by therapists doing massage on the affected area, static stretching to relax and relieve stiffness and the usage of therapeutic tapes which supposedly helps to improve blood flow.

General conditioning

General conditioning as its name suggests helps to provide conditioning of the body through various cardiovascular exercises such as walking, swimming and jogging. It helps to increase flexibility of the joints as well as improve overall health.

Balancing exercises

Due to injuries, the body’s natural ability to balance the body may be slightly off and therefore, exercises that help to restore the balance will need to be performed. Initially, the use of a parallel bar may be required to help you keep your balance but as time goes by, you can start to disregard the presence of that bar.

Physiotherapy aims to recondition your body back to its initial condition and help you achieve a better quality of life.

3 Common Procedures Performed By Orthopaedic Surgeons

Orthopaedic surgeries are surgeries that involve the musculoskeletal system including our hands, shoulders, foot and knees. It is one of the most established arm of surgery and one of the most important. At one point or another in our lives, we will definitely require orthopaedic surgery to deal with issues such as sports injuries, musculoskeletal injuries or degenerative diseases. What are some common procedures performed by orthopaedic surgeons?

Total joint replacement

Due to ageing or diseases, a healthy joint can be damaged and rendered almost useless. In order to regain the full range of motion of a good quality lifestyle, total joint replacement will need to be performed on patients using man-made materials called biomaterials. These biomaterials are biocompatible and will mimic the actions of the actual joint. However, they cannot fully replicate the functions of the original one to a full extent. Wear and tear over a period of time can cause the cartilage to wear off, causing stiffness and pain due to the lack of synovium which helps to reduce friction.

Rotator cuff repair

Rotator cuff repair is performed to repair injured or torn tendons in the shoulder. There is a group of muscles in the shoulder joint forming a cuff, resulting in the name rotator cuff. Our shoulder offers superb flexibility and range of motion but this causes the shoulder joint to be extremely unstable. A slight impact can cause the shoulder “ball” to pop out of the “socket”, resulting in a dislocation. The presence of the tendons will hold the shoulder muscles to the shoulder, preventing any accidental popping out action. Due to injuries or overuse, the tendons can become weak and will not hold as well. Surgery may be performed either as a traditional open surgery or a more modern arthroscopy depending on the extent of the tear. The surgery will fix back the tendon to the shoulder and it will be held together by self-vanishing sutures.

Anterior Cruciate Ligament reconstruction

There are 4 major ligaments in our knee and one of the most important one is the anterior cruciate ligament (ACL). The ACL is responsible for the overall stability and even surface stress distribution across the knee. It limits the rotational capability of the knee as well as prevents excessive forward motion of the tibia to the femur. The ACL is frequently torn during sporting activities involving high impact and sudden jerks. For example during rugby, the long metal studs from the boots can be still stuck in the soft grass field and an attempt to make a directional change results in the twisting of the knee, instantly tearing the ACL. ACL reconstruction is performed either by open surgery or arthroscopic.  The surgeon will remove a tendon from the hamstring and use it as a replacement for the ACL.

Above are 3 of the most common orthopaedic surgeries performed by orthopaedic surgeons worldwide. No matter what surgery you are about to undergo, we wish you a speedy recovery.

4 Habits to Help Reduce Risk of Orthopaedic Conditions

In sunny Singapore, we tend to engage in sporting activities throughout the year. As the amount of sports activities increases, the risk of orthopaedic injuries will increase likewise. Studies have concluded that 80% of orthopaedic conditions involved the upper extremities such as the arm, shoulders and elbows whereas 20% of them involved the lower extremities such as the knee and ankle. Injuries will prevent us from continuing to be involved in our favourite activity for a period of time and this can be frustrating. What are some good habits to help you reduce the risk of orthopaedic injuries? What are some precautions you should take?

Warming up

Our body is not in the most ideal state for action most of the time. If you do a sudden sprint, you can expect to pull your hamstring and cause pain and discomfort. Therefore, proper warming up is crucial to reduce the risk of injuries. You need to prepare your body for an intense activity but doing an action that is less intensive for a few minutes to allow your body to adapt. Warming up provides heat to the body which will help to loosen up the tissues in your body such as the ligaments and tendons.

Wearing protective gears

Contact sports often require the usage of protective gears to protect you. For example, soccer requires the compulsory usage of shin guards. Although shin guards can hinder running movements and cause discomfort to players, they are useful in preventing injuries to the shin. Also, rugby players wear uniform with padding at the shoulder region to prevent injuries when they are tackled down. While players are better off without these protective gears, they know that they cannot do without them.

Knowing when to stop

Knowing when to stop is the difficult thing for most athletes out there. There is only a thin line between stupidity and bravery. Some players think that they can finish the game despite being injured via the usage of pain relieving sprays. However, the exact extent of injury is unknown and it could be a serious one which will cause more serious complications if further aggravated.

Cooling down

Cooling down sessions help to decrease the heart rate in a controlled manner and relax the muscles. Exercising causes the body’s temperature to be increased and a proper cool down session will revert back to the normal body temperature down and prevent the building up of lactic acid which will cause muscle soreness.

Knowing when to stop is probably the most difficult yet important decision you should make. Observe the 4 habits mentioned above and you will definitely have your risk of injuries significantly decreased.

Stiff Neck – An Underlying Spine Disorder?

Stiff neck causes pain and discomfort when attempting to move your neck. It is often due to injury to the soft tissues and ligaments at the neck region. It is usually accompanied by pain and soreness in the neck, shoulder and arm. Symptoms can last for quite a fair bit of time and it can be relieved using medication or a warm compress. For cases whereby the symptoms go away in a couple of days, there isn’t much of an underlying issue. Stiff neck can occur when you wake up after having slept in an awkward position for a long time. Sometimes, stiff neck can be an indication of an underlying spinal disorder.

We must first know the basic anatomy of our neck. Our neck is divided into 2 regions namely the anterior and posterior. There is a part of our spine that moves through our neck and that is the cervical spine which is effectively made up of 7 vertebrae. Any slight problems in our spine can ultimately lead to neck pain since they are interlinked. There are 2 common spinal disorders which are Cervical Herniated Disc and Neck Arthritis.

Cervical herniated disc is one of the leading causes for neck pain and indicates an injury to the cervical spine. Pain in the neck is caused by the disc pinching onto the cervical nerve, causing pain to flow down the nerve pathway down to the neck. Some patients may also experience numbness at the neck region.

Another common cause is due to cervical osteoarthritis which is a degenerative joint disease or otherwise known as neck arthritis. Cervical osteoarthritis are characterised by the presence of bone spurs which may impinge onto a nerve. When impingement happens, the pain will radiate down the nerve onto the neck region, creating in neck pain similar to the cervical herniated disc.

It can also be due to cervical spondylosis which is another degenerative disease that is increased by previous injuries. Cervical spondylosis can result in neck pain and stiffness and is due to the wear and tear of the cartilage and bones of the cervical vertebrae.

There are many causes for stiff neck and it could indicate an underlying spinal disorder due to the mechanism for both neck arthritis and cervical herniated disc. The best way would be to seek a doctor immediately if you frequently encounter a stiff neck.

Exercises to Relief Mouse Shoulder

Do you have a job that requires prolonged sitting at your desk, clicking onto that dreadful mouse? Spending hours at a desk bound job without being able to walk around and stretch your muscles can cause pain in your body. Do you frequently feel a tight and burning sensation at your shoulder whenever you click on the mouse? Patients always have the wrong impression that if they sit ergonomically, they will not suffer from these injuries. However, even if the keyboard and screen are arranged in an ergonomically way, the position of the mouse can cause havoc if it is incorrectly placed.

The very first thing you should do is to eliminate the cause of the pain. And that is to reach for the power socket, remove the cable and dump the entire CPU into the nearest bin. But since you are 99.99% unable to do that, you should look at the second option and that is to perform strengthening exercises with the help of free weights.

Upper back stretch

Stretching is an excellent way to help relieve mouse shoulder. Although it cannot strengthen the back muscles, it helps to loosen the stiffness and the pressure that was built up in that area. The benefit of stretching is that it can be performed anywhere, anytime, even in the comfort or your office. You will need to lie down on your stomach preferably on a yoga mat. Slowly lift your head and legs off the mat while stretching your hands behind your back. You will be able to feel intense stretching at your back. Hold in the position for 10 seconds and repeat for 3 sets of 15. You should aim to perform this every other hour when possible.

Shoulder shrugs

Shoulder shrugs are an excellent exercise to help strengthen the upper shoulder muscles. Hold the free weights with both hands and shrug your shoulders in an upwards direction, hold for 3 seconds and return back to the starting position. Strong upper shoulder muscles can resist tearing and straining. Repeat for 3 sets of 12 repetitions.

Dumbbell rows

The main difference between a dumbbell rows from a normal row is the muscle group that it engages. Dumbbell rows actively work the upper back muscles to strengthen and tone it. Stand straight with hands legs shoulder width apart. Holding the weights in both hands, stretch your hands perpendicular to the ground out to the sides until it is 90 degrees. Repeat this exercise for 3 sets of 15s.

Mouse shoulder is extremely common to office ladies (OL) due to the long hours of being at the desk. Although the position of the monitor screen and keyboard seems alright, as long as the mouse is at a different level as the keyboard, something will go wrong.