This week, London Shoulder Specialist Mr Andrew Wallace will be attending one of the big events in the international sports medicine calendar. This year’s International Conference on Sports Rehabilitation and Traumatology will focus on ‘The Future of Football Medicine’ and will take place between 13 and 15 May at Camp Nou, the home of FC Barcelona.

With over 2,500 attendees from 90 countries expected, Mr Wallace has been invited to give a lecture on shoulder injuries in footballers. On Sunday, he will be joining other leading sport medicine specialists on a panel focusing on the ‘Future of Sport Surgery: Sparing the Scalpel?’ and reviewing conservative versus surgical options for footballers’ shoulders.

Shoulder injuries are most commonly associated with contact sports such as rugby. However, they’re also extremely common in non-contact sports such as cricket and, as the clocks go forward and temperatures get warmer, we see the attention of sporting fans turn to the start of the domestic cricket season.

Due to the repetitive actions used in batting and bowling, professional cricketers often suffer cricket shoulder injury. In fact, it’s so common, the term ‘Thrower’s shoulder’ is often used to describe shoulder pain experienced by bowlers.

So, what type of shoulder injuries do cricketers need to worry about? Here we’ll look at the different cricket shoulder injury that can occur and whether they can be prevented.

Different types of shoulder injuries experienced by cricketers

There are a wide range of shoulder conditions which can affect professional cricketers. Below we’ll provide a general overview of the different injuries and how they typically present themselves.

1. Overstretched or torn tendons – One of the milder injuries which occurs in cricketers is an overstretched tendon, caused by repeatedly overusing the shoulder muscles. Bruising, swelling, pain and inflammation are all characteristics of this type of injury. In more severe cases, the tendon can tear, causing more of a burning pain and the inability to use the arm.
2. Joint sprain – More specifically a glenohumeral joint sprain, this occurs when the ligament starts to come away from the bone. Like an overstretched tendon, it presents itself in bruising, pain and swelling. If the ligament has torn, however, players would experience a snapping sound, along with the inability to control the arm.
3. Impingement syndrome – A more serious injury which can occur if the inflammation of milder injuries such as overstretched tendons aren’t treated. The tendon can become trapped within the subacromial space, causing significant pain and discomfort. If left untreated, it can lead to issues with the rotator cuff.
4. Rotator cuff tears – The type of rotator cuff injuries experienced by cricketers are slightly different to those experienced by contact sport athletes. Degenerative tears are the most common types experienced, which are caused by a gradual breakdown of the tendon. Again, this is caused by the repetitive motions used during the sport. They can start out as partial tears, but if left untreated can lead to a full thickness tear which would require surgery to fix.

Can cricketers prevent shoulder pain?

As much of cricket, particularly the fielding process, relies upon repetitive movements, does this mean shoulder injuries cannot be prevented? While it is impossible to completely eliminate the risks involved, there are things you can do to reduce your chances of developing a cricket-related shoulder injury.

First and foremost, it’s important to ensure you are using the correct bowling and batting techniques. It’s also helpful to build up the stability of the shoulder, through specially targeted strengthening exercises.

Finally, increasing your endurance gradually is also a good idea. This will help to specifically limit the chances of developing rotator cuff injuries.

Following the advice above can help to reduce your chances of developing shoulder injuries. However, equally as important is knowing when to seek treatment. The majority of cricketers simply play on, without seeking help for shoulder pain. This not only affects your performance, but it can also lead to more serious injuries which could have a significant, long-term impact on your career.

If you suspect you or your player is suffering a cricket shoulder injury, an orthopaedic surgeon that specialises in the shoulder can provide speedy diagnosis and effective treatment.

As avid snowboarders around the globe gear up for the Snowboarding World Championships later this month, competitors will be balancing injury prevention with maximising performance.

Snowboarding shoulder injuries are a common risk for professional snowboarders due to the way the body is positioned. In skiing, the majority of pressure is placed onto the lower body, as the knees twist and help manoeuvre the skier around the mountain. With snowboarding however, the feet are strapped onto the board, and it’s the upper body that’s largely responsible for manoeuvring around the course. Not only that, but if the snowboarder loses their balance and falls, it’s the upper body that’s going to take the full force of the fall.

Here we’ll look at the most common shoulder injuries in snowboarding and what, if anything, can be done to prevent them.

How common are shoulder related injuries in snowboarding?

It’s estimated that shoulder injuries account for between 8% to 16% of all snowboarding injuries. However, these figures are taken from the ski medical clinic so the actual rate of injury could be much higher as most snowboarders visit their local physician to report any issues. It’s also likely these figures will increase over coming years, as snowboarding is witnessing a boom in popularity, with more people taking up the sport each year.

It’s also interesting to note that beginners have a higher injury risk than the more advanced snowboarders who tend to use much riskier and more difficult manoeuvres. Approximately a quarter of injuries occur during a person’s first experience of snowboarding and that’s because of the increased risk of falls.

What shoulder injuries are most commonly experienced by snowboarders?

So, as a snowboarder which shoulder injuries are you most at risk of developing? The most common include:

Rotator cuff injuries: The rotator cuff is made up of several tendons and muscles surrounding the joint of the shoulder. Helping to keep the shoulder in place, this large group of muscles and tendons is typically the most vulnerable to injury during a snowboarding fall. Rotator cuff injuries vary significantly in severity, with most presenting as a dull ache or severe pain in the affected area.

Gleno-humeral dislocations: While dislocations aren’t as common as rotator cuff injuries, they can occur after a nasty fall. The patient may be unable to move the arm away from its current position and significant pain will usually be felt.

Clavicle fractures: This is a very common shoulder injury, involving the collarbone – one of the main bones within the shoulder. Treatment for this type of injury is usually straightforward, with the arm requiring a sling while the fracture heals. However, in some cases surgery may be required.

Acromioclavicular separations: If you fall directly onto the shoulder, there’s a risk of acromioclavicular separation. This is where the clavicle separates away from the scapula. The majority of the time this type of injury can be treated without surgery, though it depends upon its severity.

So, can these injuries be prevented? Unfortunately, due to the high risk of falls in snowboarding, it’s impossible to completely prevent shoulder injury. However, making sure you use the latest equipment and you use the proper techniques while out on the slopes, will help to reduce your chances of injury.

Overall, most importantly is that you seek help from a shoulder specialist if you suspect you’re developed a snowboarding related shoulder injury. The earlier you get it looked at, the easier it will be to treat.

A new study carried out by the Utah School of Medicine has established a link between shoulder pain and heart disease.
According to the study, those suffering with shoulder pain may be at an increased risk of heart disease. In particular, rotator cuff issues can indicate a much more serious problem and patients may need more than simple shoulder treatment to address their health.

Study intensifies heart-disease connection

Shoulder pain has already been suspected to be linked to heart disease and this latest study further strengthens the connection. It appears patients who have an increased risk of heart disease are also susceptible to musculoskeletal disorders such as tennis elbow and carpal tunnel syndrome.

Results of the study, published within the Journal of Occupational and Environmental Medicine, showed the more heart disease risks participants had, the more likely they were to suffer problems with the shoulder. This includes conditions such as high cholesterol, high blood pressure and diabetes.

A total of 36 participants experiencing the highest heart disease risk factors were shown to have a 4.6 times increased risk of developing shoulder pain. Interestingly, they were also six times more probable to suffer from a second shoulder problem known as rotator cuff tendinopathy.

Heart disease more likely than physical strain to cause shoulder issues

There are a lot of contributing factors which can lead to the development of shoulder pain. Most commonly reported is physical strain. However, the study included 1226 labourers and results showed a shoulder-straining job did not increase the risk of shoulder injuries in comparison to those with heart disease risk factors.

Of course, that isn’t to say straining jobs don’t accelerate rotator cuff injuries, but what it does show mean is they aren’t the primary cause. In patients who do present with shoulder pain, particularly rotator cuff injuries, cardiovascular health is more likely to play a role in its development.

The data collected by the study now needs to be properly analysed, which lead researcher, Dr Kurt Hegmann estimates will take around five years.

How can heart disease contribute towards shoulder pain?

Currently researchers don’t know for certainty why heart disease links to shoulder pain. However, there is a theory that it could be caused by a decreased blood supply to the shoulder, leading to weakened tendons. This would therefore increase the chances of injury.

Shoulder pain is also associated as a warning sign for a heart attack, most commonly if intense pain is felt suddenly down the left arm. This is caused by a blockage in the arteries, typically brought on by high cholesterol.

Overall, this new study is one of the most in-depth carried out to establish the link between heart disease and shoulder pain. It followed participants for a total of nine years and covered a wide range of risk factors. While it is important to note that it purely points out a link and not a cause and effect between heart disease and shoulder pain, it’s still a factor to be aware of when seeking treatment.

At the end of 2016, Mr Andrew Wallace of the London Shoulder Specialists successfully operated on Atletico Madrid goalkeeper Jan Oblak after he suffered a dislocation of the left shoulder while making a save during a game against Villarreal in December. Surgery to repair the labrum was successful but Oblak, who also plays for his national team of Slovenia, will now spend up to four months recovering.

Oblak suffered a Bankart tear to the shoulder

Twenty-three-year-old Oblak suffered a Bankart tear which is more common in younger patients. It is an injury to the labrum which occurs after a shoulder dislocation; to provide stability to the shoulder, particularly with its wide range of movement, the shoulder is supported by a cuff of cartilage called the labrum.

When the shoulder is dislocated, the shoulder pops out of its joint and the inferior glenohumeral ligament that composes part of the labrum can become torn. Oblak would have felt sensations of instability, catching and aching in the shoulder and would have likely experienced repeated dislocations in the future.

The club made the following statement after the surgery: “Jan Oblak has undergone a successful operation of the injury he suffered last Monday in the game against Villarreal. The player underwent arthroscopic surgery to the left shoulder to repair the labrum — with a positive result and stabilisation of the shoulder joint.”

Treatment was provided by Mr Andrew Wallace of the Fortius Clinic, a leading sports orthopaedic centre in London.