Wave Your Hands in the Air for Your Shoulders, Part 2 | Torrance Memorial

Published on May 04, 2022

Wave Your Hands in the Air for Your Shoulders, Part 2

woman with shoulder pain

In this blog series we’re discussing common shoulder ailments, treatment options, recovery and preventive measures with Torrance Memorial orthopedic surgeon Dr. Brian Magovern. Part 1 explored the bane of baseball pitchers – rotator cuff tears – and we discovered that rotator cuff injuries aren’t limited to athletes: degenerative rotator cuff frays and tears can affect anyone. Fortunately, there are both surgical and non-surgical options to heal or minimize the affects of these painful conditions. In Part 2, we’re looking at other traumatic shoulder injuries: dislocations and fractures.

Unlike rotator cuff injuries, which can be either acute (caused by a sudden trauma) or degenerative (caused by wear and tear, often aggravated by a trauma), shoulder dislocations are always the result of some trauma, and are generally an injury of the young. Dislocations usually occur on the field, when an athlete experiences a sudden strong force across the shoulder that levers the ball of the humerus (upper arm bone) out of the socket on the shoulder blade.

Although shoulder dislocations don’t often cause rotator cuff tears, they can tear the labrum, a cushion of cartilage around the rim of the shoulder blade’s socket that helps cup the arm bone’s ball and hold it in place. Shoulder dislocations are immediate and painful. The ER is the first stop, where the patient’s shoulder is re-set (after the administration of a local anesthetic). Dr. Magovern sees the unfortunate athlete later, to determine whether physical therapy or surgery is the next step.

The goal of follow-on treatment for shoulder dislocations is to decrease the risk of future dislocations. “Even though younger patients involved in high-contact activities are more likely to dislocate again, it’s rare to recommend surgery for any first-time patient,” Dr. Magovern says. “Instead, we turn to physical therapy to strengthen the rotator cuff and make up for any tears in the labrum or ligaments.” When surgery is recommended – for example, if the patient has suffered previous dislocations and has shoulder instability that makes future dislocations or other complications more likely – the procedure is similar to rotator cuff repair: an outpatient surgery lasting less than an hour. As with rotator cuff tears, the post-surgical rehabilitation and physical therapy process can take several months. Surgery is less common for older patients. Our shoulders, like our other joints, stiffen as we age, Dr. Magovern explains, decreasing the risk of further shoulder dislocations. Because dislocations are so associated with athletics, Dr. Magovern says the best preventive measure is to practice good technique when playing sports.

Like dislocations, shoulder fractures are often sports related, but Dr. Magovern says he sees a lot of shoulder fractures that are the result of car accidents, on-the-job injuries and falls, as well. Fractures are an injury of the young and old: young people fracture their upper humerus, clavicle or shoulder blade through athletic activities, while older adults can fracture a shoulder bone in a fall (middle-aged adults don’t play sports as aggressively, but still have strong bones). Sports-related fractures are most commonly associated with football and lacrosse, while soccer mishaps can result in clavicle fractures, and skiing falls can fracture the upper humerus. Cycling accidents, meanwhile, are a common cause of clavicle fractures.

Because shoulder fractures result from a direct, significant collision, blow or other trauma, they’re usually diagnosed quickly: the patient visits the ER or urgent care with pain, swelling and bruising in the shoulder. The specific nature of these and other symptoms (the location and level of pain, for example) give medical staff a pretty good idea of the type of fracture; X-rays provide a definitive diagnosis, along with details of the fracture’s severity.

Most fractures can be treated without surgery, Dr. Magovern says; immobilizing the fractured bone allows it to knit back together and heal. The more displaced or separated the bone fragments are, the greater the likelihood that surgery will be necessary to reset and secure the bones with rods, pins or screws.

In our next blog, we’ll discuss two wear-and-tear conditions: frozen shoulder and arthritis.

View Part 3

To schedule an appointment with a Torrance Memorial orthopedic specialist, call 310-517-4700. To reach Dr. Magovern, call 310-316-6190.