Presentation is loading. Please wait.

Presentation is loading. Please wait.

Trauma and Overuse Syndromes of the Shoulder

Similar presentations

Presentation on theme: "Trauma and Overuse Syndromes of the Shoulder"— Presentation transcript:

1 Trauma and Overuse Syndromes of the Shoulder
You don’t 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 Abrupt Stretch or Rotational Injury
Will Easily be claimed as an Acute Event

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

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 Muscle Strain Ligament Sprain

10 These Can Occur From: OVER USE

11 UNDERUSE “Supervisor Injury” Supervisors who try to “help out”


13 II. Rotator Cuff Tears

14 Caused by: OVER USE

15 Caused by: UNDER USE

16 Caused by: FALLS

17 “Partial Thickness” Tears
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 May NOT be a result of recent “complaint”
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 Falls are most common cause

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

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 Better Outcomes Lower Impairment Rating

33 What Gets Patients Back to Work?

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

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

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

37 Thank You Samuel I. Brown MD

Download ppt "Trauma and Overuse Syndromes of the Shoulder"

Similar presentations

Ads by Google