Because we have ACC in New Zealand many shoulder conditions are lodged with ACC as being the result of an injury. Although the shoulder is very vulnerable to injury and many conditions are the result of trauma, the tissues in the shoulder are also susceptible to normal intrinsic and age-related degeneration which occurs throughout life. As we get older many injuries really just serve to render this underlying damage symptomatic, rather than by causing it (refer pdf on ACC).
Some of the common shoulder injuries include:
Sprains and strains: A sprain is the stretching of ligaments around a joint (tissues that connect adjacent bones in a joint). It is a common injury and usually occurs when you fall or suddenly twist your arm.
A strain is the stretching of a muscle or tendon (tissues that connect muscle to bone). Strains are usually caused by twisting or pulling of the tendons.
A sprain or strain is what is commonly registered on an ACC injury claim form. It simply delineates that an injury of some sort has occurred, and the diagnosis is updated once a proper assessment and diagnosis has been made. Generally, sprains and strains do not result in structural damage, and are generally believed to gradually resolve through the normal process of healing over about a 6-week period.
Dislocation or subluxation : A dislocation or subluxation is an injury that occurs when the ends of the bones in a joint are forced out of position. It is often caused by a fall or direct blow to the joint, and can occur at the shoulder joint, the acromioclavicular (AC) joint, or the sternoclavicular (SC) joint.
Tendinitis: Inflammation of a tendon, a tissue that connects muscles to bone. It may occur because of injury or overuse.
Bursitis: An inflammation of the fluid-filled sac called the bursa that protects and cushions your joints and/or tendons. Bursitis can be caused by chronic overuse, injury, arthritis, gout or infection. Occasionally in younger patients it may be the result of trauma.
Rotator cuff injury: The rotator cuff consists of tendons and muscles that hold the bones of the shoulder joint together. Rotator cuff muscles help to control and co-ordinate shoulder movement but also provide strength in their own right. These rotator cuff tendons are vulnerable to injury, especially as we age. Common injuries include a fall or severe wrench of the shoulder, and typically there will be immediate pain and functional disability if a rotator cuff tear occurs with trauma. Tear of the rotator cuff can also occur with age, and this may not be related to trauma.
Fractures: A fracture is a break in the bone that commonly occurs because of injuries, such as a fall or a direct blow to the shoulder. Fractures around the shoulder, especially to the clavicle and humerus bone, are not uncommon. These often will heal without the need for an operation, but if badly displaced surgery may be required.