Shoulder injuries are common in athletes of all ages. Instability leading to dislocation (or near dislocation, known as subluxation) typically occurs in young people and is usually following a single traumatic episode, such as being tackled during a rugby or falling on an outstretched arm. Identifying which structures are injured and quantifying the degree of injury is important as the athlete may be a candidate for surgical repair and this is most accurately done with MRI Arthrogram. If the patient is unable to undergo an MRI, then a CT arthrogram may be used in its place.
Falling onto the point of the shoulder often results in disruption of a small joint above the shoulder known as the acromioclavicular joint, or commonly referred to as the AC joint.
Overuse, or “wear and tear”, injuries in combination with advancing age predisposes the mature athlete to tears of the tendons of the shoulder that stabilises the shoulder that are collectively known as the rotator cuff. The earliest spectrum of tendon injury is degeneration, or tendinosis (previously referred to as “tendinitis”), where daily damage sustained by the tendon exceeds the ability of the tendon’s internal capacity of repair. Further overuse may then lead to the development of partial and full thickness tears which may then progress to the development of partial thickness tears.