Shoulder damage accounts for 24% of sports injuries

Football and wrestling are among the sports which require complex movements of the shoulder girdle and increase the potential for injury. It’s important to be aware that rest, stretching and strengthening play a part in preventing damage Umesh Isalkar & Swati Shinde | TNN

Pune: Slap tear and shoulder dislocation are emerging as prominent injuries among sportspersons. While statistics about the exact prevalence of slap tear or shoulder dislocation is not available, sports medicine experts in the city estimate that the percentage must be between one and five per cent.

“Certain sportspersons, especially athletes, cricketers, volleyball players, javelin players etc, who do lots of throwing activity usually encounter slap tear (slap stands for superior labrum anterior to posterior) and shoulder dislocation,” said consultant shoulder and joint replacement surgeon Ashish Babhulkar who is also executive member of the education commission of Asian Federation of Sports Medicine. The most commonly injured parts of the body among sportspersons are the shoulder (24% of all injuries), he added.

While a dislocated shoulder is an obvious injury involving much pain, slap tears are more innocuous as they are very easy to miss and unless a specialist is examining the injury, it can be overlooked, said Babhulkar.

R D Dixit, president of the Sports Medicine Association, Pune branch said, “The shoulder joint has three components. It is one joint in the body which has maximum range of movement. Unlike a hip joint which is fixed in a socket, a shoulder joint is a relatively unstable joint. Hence it is more vulnerable to various injuries including shoulder dislocation. That’s the reason why shoulder dislocation is commonly seen among sports injuries, especially among rugby players, football players, wrestlers, cricketers etc.” Similarly, sports that involve jerky movements like weight-lifting, javelin throw etc. usually have to deal with slap tear as health problem, added Dixit.

“The most common wrestling movement resulting in some kind of shoulder injury is the take-down procedure. Around 68% of all injuries result from this manoeuvre among wrestlers,” said Dixit.

Elaborating on the prevailing misconceptions among sportsperson about both conditions, Babhulkar said, “Recurrent shoulder dislocations are usually considered as “almost” normal by sportspersons in between episodes of dislocation. Hence they can be quite blasé about their condition. But the fact must be underlined here that each dislocation rips out more of the ligament and damages the round head of the humerus, a long bone in the arm or forelimb that runs from the shoulder to the elbow.”

Having good flexibility is important. Sportspersons with greater ligamentous flexibility suffer from fewer shoulder injuries. “Sportsperson should work very hard to improve dynamic strength in their shoulder and knee areas, since these appear to be the two most common sites of injury in any sports (accounting for almost half of all problems). Having good flexibility also appears to be a positive, especially with regard to shoulder injury, the most common sports malady,” said Sharangpani.

For both shoulder dislocation as well as slap tear, surgery has proved to have good results. “In the modern era and with the advent of arthroscopy - a minimally invasive procedure is used and has proven acceptable to today’s patient as he can go home the next day and resume work in five days,” said Babhulkar.

Slaps tears are graded from type I to VII. “Type I tears can be treated with rehabilitation. Such patients can be put on exercises with therabands for two weeks followed by a four-week programme at home. They can then usually resume sporting activity from a period of 6 weeks to 24 weeks, depending on their UCLA score and restoration of normal biomechanics,” said Babhulkar.

Initially, patients

are apprehensive that they will get stiffness and not regain their full range of movement. “That used to be partly true when older style ‘Putti Platt’ surgery was done or open repair was performed with several sutures. With the arthroscopic repair, in my experience, 95% of my patients regain their full stability and strength and feel vividly safe after surgery,” said Babhulkar.

“When patients were asked in a questionnaire about their experience and whether they would go in for arthroscopic surgery again, 91% replied yes. In fact almost 35 to 38 patients have undergone bilateral shoulder arthroscopy at different time intervals,” said Babhulkar.

ROAD TO RECOVERY

ADWAIT MANOHAR, FORMER RANJI PLAYER

n I was trying to field a ball while playing cricket when the shoulder snapped. I still tried to continue and bowled the next over, but my shoulder totally gave up. The doctors told me that it was a ligament tear in the arm and I got it operated on. Six months later, I was back in the field, although I had recovered by 80 per cent only. Since I had left competitive cricket by the time I recovered, it did not matter so much. I still play, but at a local level.

PARAG BINIWALE, FORMER BADMINTON PLAYER

n I was injured after a fall in 1997 and decided to get my shoulder operated on in 2002. I was asked to take complete rest for three weeks and six months later I was back in action. The injury definitely put me out of action for quite some time as I could not play at all. But, once I got my shoulder treated, it did not trouble me.

ADITYA KELKAR, MALKHAMB COACH

n I was suffering from an elbow injury and could not lift weights. It was suggested that I have some physiotherapy. I did regular exercises and so did not have to go in for surgery. Now, I am an active coach and take time off from my profession as a doctor to coach malkhamb players.