In today’s article, we will explain what are the most common injuries we can find at the level of shoulders, arms and hands and some advice on how we can avoid them to enjoy good health.
Due to the anatomical situation and its influence on the movements we make on a day-to-day basis (sports or not), the shoulder joint (and all the elements that make it up), the arm (elbow joint included) and the hand they are critical points of our anatomy and are highly exposed to trauma or affected by falls.
Before going on to point out the most common injuries in the bones of the shoulder and arm, a point to be noted in fractures in the area of the humerus is the possibility that the axillary artery or the radial nerve may be affected (the latter is a complication more frequent than we can think of when representing around 19% of cases).
Most of the clavicle fractures occur when the arms fall forward (in an instinctive gesture), which is why the pressure received by the clavicle increases or because of direct trauma to the clavicle. If we suffer a fracture of this type, the most important thing is the immediate immobilization of the area and going to a hospital .
Depending on the type of fracture in question, the treatment may vary, but the use of antibiotics and subsequent immobilization with the placement of a sling. If the fracture was severe or it was an open fracture, surgery is mandatory, and usually a plate with screws is usually placed to secure the area.
It occurs when the head of the flue “leaves” the glenoid fossa , either forward or backward. The most common causes that cause a shoulder to be pronounced can be: a fall with the arm stretched , a strong blow to the back (causing a previous dislocation) or a frontal blow (causing a posterior dislocation), a strong arm pull (especially in young children), laxity of the tissues that surround the glenohumeral joint (producing instability in it), sudden movements above our head or strong and repeated movements.
Fracture of the head of the humerus
Mainly originated by a strong traumatism in the area . Being in the same proximal head, the recovery is a little more expensive than if it had produced in the body of the bone, since during the process of welding the bone can cause small calluses that later rub and generate new discomfort and pain.
Here, it is important to know if it is a clean fracture or if there has been displacement of some fragment of the head of the humerus, as this could hinder the repair and subsequent rehabilitation of the lesion .
Fracture of the diaphysis (body) of the humerus
Produced by trauma, by a torsion force or by an increase in pressure on the areathat causes the rupture in the weakest part of the bone (both epiphyses have greater density and hardness than the diaphysis, so they can resist more).
A problem that we can find in this type of fracture is the vascularization of the area and that it is “wrapped” by the muscles of the arm, so the effects of a fracture in this area can be important. However, this vascularization and presence of muscles also act in our favor making ” compressive bandage ” in the consolidation phase of the fracture.
Fracture in the distal epiphysis
The distal humerus fractures are the most difficult to treat because of the anatomical shape of the distal part of the bone, formed by medial epicondyle, epicondyle and humeral trochlea humeral condyle. It can occur very similar to fractures in the diaphysis, with the difference that the fracture occurs almost at the height of the distal epiphysis.
The basic classification of this type of fracture is structured in:
- Extra-articular fracture : those that occur just above the distal head of the humerus. They represent around 10% of humerus fractures and may have associated damage to the median nerve and the brachial artery.
- Partial articular fracture : can be external or internal in the sagittal or frontal plane in the coronal plane. They represent approximately 5% of the fractures and take place in the lateral or medial column of the bone.
- Complete joint fracture : they represent around 60% of fractures of the humerus and often affect the soft parts that surround it.
By having much more stability than the shoulder , it is very difficult for an elbow to be dislodged by a strong pull, so that the vast majority of elbow dislocations are caused by trauma or falls, causing a misalignment between the radius and ulna and the humerus .
In most dislocations the reduction of it is done manually , although sometimes surgical intervention may be necessary, which would mean that there has been damage to the ligaments in the area.
It is the most common fracture produced by falls with the hand located in a forced dorsal position, and one of its main symptoms is the inability to grasp objects.
Dislocation of a finger
It is the loss of alignment of the phalanges and their lateral deviation . They are usually caused by injuries (such as those that occur when playing basketball or volleyball) or by falls to the ground. As a general rule, the reduction of a dislocation of a finger should not require surgical treatment unless there is some type of complication.
Main injuries of the muscles, tendons and ligaments of the shoulder and arm
They are injuries produced when the muscle or one of the fibers that compose it make a high intensity effort or perform an inappropriate movement. These lesions may appear during the course of the effort or afterwards.
To avoid this type of injury , the most important thing is to perform a good warm-up prior to the exercise, but although this does not ensure 100% that we will not suffer a contracture, it reduces the risks.
Tendinitis itself is the inflammation of a tendon , and can be caused by a blow, excessive effort of the joint or by the continuous rubbing of the tendon (usually against a bone, as for example is the case of tendinitis of the supraspinatus).
As preventive measures to avoid the appearance of this pathology , it is recommended to avoid excessively repetitive movements and also avoid making more intense movements of the due (work in the gym with excessively high loads can also cause tendonitis). As for its treatment, rest, the application of ice and the use of anti-inflammatory are the most used measures for this.
The definition of muscle rupture is the partial or total rupture of the fibers that make up the muscle . As a general rule, people think of a break as something “big” in terms of muscle size, and the reality is that the well-known laces are already included in the first group of muscle breaks ( the laces at the end of the day they are micro-fractures of muscle fibers ).
As most common causes at the origin of a muscle break we can find some of the following: direct trauma in the affected area (here we could talk about the typical “sandwich” that occurs when we play football or a blow received in the back because of of a fall or a traffic accident), extreme fatigue of the muscle during the performance of a physical effort (even when that muscle is properly prepared for that effort), prolonged sedentary life (which makes any “non-typical” action may lead to a muscular break due to lack of habit), malnutrition or some diseases such as diabetes.
The classification of muscle breaks is as follows:
a) Minor or Grade I breakage: it is produced by the breakage of some muscle fiber or by micro-tears as in the case of shoelaces. It is characterized by a slight sensation of discomfort in the affected area, maintaining the complete mobility of it.
b) Moderate or Grade II break: there is swelling in the area and there is already a slight loss of mobility in the area. There is a moderate breakage of the muscle and / or tendon fibers. Almost certainly a bruise will also be seen in the affected area.
c) severe Breakage or Grade III : already produces a complete breakdown of muscle belly or tendon. Characterized by a greater loss of mobility and a painful palpation and in which there is a certain deformity in the area.
Needless to say, in the event of a muscular break, rest will be fundamental in the recovery of it, whether surgical treatment is necessary or not.
Rotator cuff injuries
The first thing to say about this type of injuries is that due to the anatomical area and the number of movements we make in our day to day, it is a very sensitive area and whose rehabilitation is sometimes , difficult and quite slow .
The rotator cuff is a set of muscles, tendons and ligaments located in the shoulder joint and whose main function is to provide stability to it . The most common injuries that can be found in this area are tendinitis (inflammation of the tendons, being the supraspinatus one of the most common ), bursitis or tears (in the image you can see the comparison of when I injured my right shoulder, below, with the left shoulder that was healthy, above).
Carpal tunnel syndrome
The excessive pressure received by the median nerve (responsible for the sensitivity and movement of some parts of the hand), can cause numbness, weakness, tingling or even, in the most severe cases, muscle damage in the hand and fingers. One of the most common causes is inflammation of this nerve(median nerve tendinitis). Because the area through which the median nerve “runs” is known as the carpal tunnel, this pathology is called carpal tunnel syndrome.
How can we avoid these injuries?
Unfortunately, being 100% safe from an injury is something impossible to achieve, but if we want to minimize the chances of suffering any of these injuries, here are some tips we should follow :
- Doing a good job of joint mobility will help our joints maintain an optimal range of motion and we will avoid forcing them. This will influence the tension and work that the tendons and ligaments hold and will keep them in good condition for physical efforts.
- Strengthening our muscles and maintaining good muscle tone will cause the muscles that line the bones to form a much stronger and more compact protection against possible direct trauma.
- Maintaining a good diet and a healthy lifestyle will prevent us from suffering bone problems such as osteoporosis, which could lead to bone fractures at the slightest incident.
- When your body sends a signal of pain, keep it in mind , as it may be the first and only warning before suffering a more serious injury. For example, if we ignore the cramps that our body sends us during sports, we may end up suffering a muscle breakdown.
- If we avoid repetitive movements as much as possible , we will be reducing the chances of suffering from tendinitis, for example, in the rotator cuff of the shoulder (a fairly slow injury to recover).