Shoulder Injuries and Conditions: A Comprehensive Guide

Shoulder Injuries and Conditions

Glenohumeral Subluxation

Excessive translation of the humeral head without complete separation from the joint. May occur anteriorly, posteriorly, or inferiorly (most common is anterior).
Mechanism of Injury (MOI): Forced abduction and external rotation; direct blow to shoulder

Anterior Glenohumeral Dislocation

Head of humerus is forced out of its articular capsule past the glenoid and downward to rest under the coracoid process.
Injuries: Torn capsular and ligamentous tissue, possible rotator cuff and/or long head biceps tendon avulsion, possible injury to brachial plexus, possible tear (almost always a labral tear).
MOI: Direct impact to posterior shoulder, forced abduction and external rotation

Bankart Lesion

Detachment of the anterior/inferior labrum. Lesion creates a pocket which, in the position of shoulder adduction and external rotation, allows abnormal displacement of the humeral head on the glenoid.

Hill-Sachs Lesion

Bony depression fracture in the humeral head. Occurs at the time of shoulder dislocation; may contribute to shoulder instability if the defect is large.

SLAP Lesion

Defect in the Superior Labrum that begins Posteriorly and extends Anteriorly and affects the long head biceps tendon.

Chronic Recurrent Instabilities

Increased mobility of the humeral head in the glenoid fossa due to laxity in supporting tendinous, capsule, and ligamentous structures.

Rotator Cuff Strain

Most often supraspinatus near insertion on greater tuberosity.
MOI: Acute trauma (fall on outstretched hand); impingement—overhead work; weak external rotators
Signs & Symptoms (S&S): Diffuse pain around acromion (anterior shoulder), increased pain with overhead activities, weak external rotators, tightness in posterior capsule

Rotator Cuff Tendinopathy

Supraspinatus is most often involved.
MOI: Impingement and repetitive overhead activity

Shoulder Bursitis

Fibrous buildup and fluid accumulation of the subacromial bursa.
MOI: Direct impact, falling on the tip of shoulder, overuse, impingement

Biceps Tendinopathy

Irritation of the long head biceps tendon and its synovial sheath as it passes under the transverse humeral ligament in the bicipital groove.
MOI: Repetitive overhead activity

Shoulder Impingement Syndrome

Mechanical compression of the supraspinatus tendon, subacromial bursa, long head biceps tendon due to decreased space under the coracoacromial arch.
MOI: 1) Repetitive overhead activities 2) Irregularly (hooked) shaped acromion