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Trauma and Overuse Syndromes of the Shoulder You dont have to be a Professional Athlete to be Treated Like One.

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Presentation on theme: "Trauma and Overuse Syndromes of the Shoulder You dont have to be a Professional Athlete to be Treated Like One."— Presentation transcript:

1 Trauma and Overuse Syndromes of the Shoulder You dont have to be a Professional Athlete to be Treated Like One

2 Can You Shoulder the Load?

3 Shoulder Upper Extremity Neck Injuries Are one of the most common areas of occupational injury

4 Causes Industrial setting, Manufacturing Products, Repetitive Usage, Over Usage Accidental Motion, Stretch or Rotation of Upper Extremity Falls

5 Repetitious Activity – May: Lead to Chronic Shoulder Pathology: Impingement Most Commonly Claims may arise from this – NO Acute Event

6 Will Easily be claimed as an Acute Event Abrupt Stretch or Rotational Injury

7 Number 1 cause of shoulder, upper extremity complaint and physiologic injury FALLS

8 Most Common Shoulder Injuries: Muscle Strain/Ligamentous Sprain Rotator Cuff Tears Neck/Cervical problems with referred pain to shoulder/arm/hand Others – should dislocation, labral tears, AC joint separation, fractures

9 I.Muscle Strain Ligament Sprain

10 These Can Occur From: OVER USE

11 UNDERUSE Supervisor Injury Supervisors who try to help out

12 FALLS

13 II. Rotator Cuff Tears

14 Caused by: OVER USE

15 Caused by: UNDER USE

16 Caused by: FALLS

17 TRUE FULL THICKNESS Rotator Cuff Tears Should be distinguished from Partial Thickness Tears

18 R Cuff Tears are Common The incidence and prevalence of RC tears increases with age 23% of people age have asymptomatic rotator cuff tears At least 51% of pts older than 80 have asym- tomatic RC tears Partial thickness tears are more frequent than Full thickness tears (50% higher incidence)

19 Radiologist MRI Terminology Full Thickness Tear Partial Thickness Tear

20 Full Thickness Tear May Be Acute or Chronic – Radiologist should address on MRI

21 If Chronic: May NOT be a result of recent complaint

22 Partial Thickness Tears: Associated with ongoing impingement: OFTEN not related to current complaint Which may only be muscle or ligamentous sprain – No Causation Rarely require surgery

23 Falls are most common cause III. Neck Issues

24 Cervical Spondylosis/Degenerative Disc Disease May Be Aggravated: Leading to Pain or Radiating Burning, Numbness, Tingling – Shoulder, Arm, Hand

25 Conservative Treatment Best: Anti inflammatory Meds, Physical Therapy, Short Term Use of Pain Relievers Avoid Surgery – Poor Prognosis for Return to Work…. except

26 IV. Other Diagnoses Shoulder Dislocation AC Separation Labral Tears Fractures

27 Diagnosis Specific Treatment: Adhere to conservative principles Surgery only when clear indication May be associated with impairment

28 Return to Work

29 Barriers to Recovery from Occupational Injury Anxiety about return $$$ without work FACT: Better Outcome = Lower Impairment Rating

30 Anxiety about Return….

31 $$$ Without Work

32 Lower Impairment Rating Better Outcomes

33 What Gets Patients Back to Work?

34 Correlates Best With Return to Work And Especially Early Return to Work (Job Satisfaction) I Love My Job

35 Early Return to Work = Best Outcome for ALL Patients *Not necessarily elimination of pain, just return to work

36 1)Early and accurate assessment of problem 2)Early conservative/supportive treatment 3)Avoidance of surgery when possible 4)Positive environment for work and job satisfaction (hopefully) Can You Shoulder the Load?

37 Thank You Samuel I. Brown MD


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