Shouldering the Load
Posted Feb 27 2002 2:30PM
The Bulls' athletic trainer looks at the anatomy of the shoulder and common injuries
Shoulder injuries account for approximately one percent of the time lost to injuries in the NBA. However, since the game of basketball is predicated on upper body skill and strength, it is important to develop and maintain strength and range of motion of the shoulder region.
The shoulder complex is a series of articulations (movable joints) that allow for a great range of motion. The gleno-humeral articulation is the joint involved in shoulder dislocations. This is due to a poor bony configuration similar to a golf ball on a golf tee. The head of the humerus can readily dislocate from the glenoid fossa when the stresses exceed the soft tissue's ability to stabilize the joint.
The acromio-clavicular (A-C) joint is involved in separated shoulders. Located at the tip of the shoulder, the A-C joint is often injured when a player falls on an outstretched arm, transmitting all the force in a shearing fashion to the A-C joint. The other articulations are the sterno-clavicular(S-C) joint and the scapula rib cage articulation. These two joints are rarely mentioned when discussing the shoulder, but are nonetheless important when it comes to shoulder dysfunction.
Many muscles, tendons and ligaments are involved in the shoulder complex. The group most often mentioned is the rotator cuff muscles and tendons. They are important dynamic stabilizers of the gleno-humeral joint and also serve a function of allowing the many movements of the shoulder. They are frequently involved in overuse injuries of the shoulder. It is important to note that since the shoulder has such a great range of motion, the ligaments and capsule of the shoulder are compromised, thereby relying on the muscles and tendons for assistance with stability of the shoulder.
The range of injuries is from the traumatic dislocation to a chronic condition, like rotator cuff tendinitis. Rehabilitation from a dislocation requires careful guidance and advice from a medical professional. In many instances, first-time dislocations are subjected to a prolonged period of immobilization. After the initial phase, range of motion and strengthening exercises are utilized to restore the shoulder to its pre-injury status. Careful attention is paid to improving the function of the rotator cuff as well as the muscles that stabilize the shoulder blade on the rib cage.
Rotator cuff tendinitis is a chronic condition that requires long-term care, dedicated to improving range of motion and strength, as well as alleviating the causes of the irritation. Often in the NBA, you will have players develop tendinitis from sessions of extra shooting. The repetitive overhead movements can lead a susceptible shoulder to an inflammation in the tendons of the rotator cuff. The rehabilitation program is designed to alleviate the cause of the irritation and correct any strength and/or range of motion deficiencies.
To conclude, the shoulder is a complex joint that requires careful attention to prevent injury and to rehabilitate in the event of an injury. Please contact your local health care professional for guidance or to further assist in your care.
Fred Tedeschi is in his third year tending the Bulls' health and rehabilitation issues as the team's athletic trainer. Prior to coming to Chicago, he was the head athletic trainer at the University of California-Berkeley for four years. Tedeschi's experience also includes serving as an assistant trainer with the NFL's San Francisco 49ers. During his five years in San Francisco, the 49ers won Super Bowl XIX (1985), Super Bowl XXIII (1989) and Super Bowl XXIV (1990) . Tedeschi has both a bachelor of arts and a master of arts in physical education from the University of the Pacific.