Shoulder injuries. What is a shoulder injury? How do shoulder injuries occur? what you ll find in this brochure

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1 Shouder injuries what you find in this brochure What is a shouder injury? How do shouder injuries occur? What you shoud do if a shouder injury occurs. What rehabiitation you shoud do. Exampe of a return to pay strategy. How you can reduce the risk of re-injury. What is a shouder injury? Shouder injuries are very common in coision sports (e.g. rugby union) and in sports that use a arge range of motion of the shouder (e.g. swimming or gymnastics) The arge freedom of movement and the shaow fit between joint surfaces make the shouder prone to injury Damage to the supporting structures (igaments and musces) may ead to pain and instabiity How do shouder injuries occur? Shouder injuries occur after faing on an outstretched hand or the point of the shouder, foowing a direct bow to the shouder, or foowing overuse These forces may cause there to be a tearing or compete rupture of one or more of the igaments or musces Common Injuries SHOULDER INJURIES Page 1 /5 Te Kaporeihana Awhina Hunga Whara

2 Shouder injuries What shoud you do if a shouder injury occurs? Appy the RIC*D procedure... RIC*D procedure * You generay eevate the injured body part above the eve of the heart. The shouder is above the eve of the heart aready therefore 'eevation' has not been incuded in the steps beow. rest Rest reduces further damage - stop activity as soon as the injury occurs. Avoid as much movement of the injured part as possibe to imit further injury. Don't put any weight on the injured part of the body. ice Ice coos the tissue and reduces pain, sweing and beeding. Pace ice wrapped in a damp towe onto the injured area - don't put ice directy onto bare skin. Hod the ice pack firmy in pace with a bandage. Keep ice on the injury for 20 minutes every two hours for the first 48 hours. compression Firm bandaging heps to reduce beeding and sweing. Ensure that bandaging is not so tight that it cuts of circuation or causes tinging or pain past the bandage. Bandage the injury between ice treatments. diagnosis Consut a medica professiona (such as a doctor or physiotherapist) especiay if you are worried about the injury, or if the pain or sweing gets worse. If the pain or sweing has not gone down significanty within 48 hours, aso seek treatment. An accurate diagnosis is essentia for proper rehabiitation of moderate to severe injuries. Common Injuries SHOULDER INJURIES Page 2 /5 Te Kaporeihana Awhina Hunga Whara

3 Shouder injuries What rehabiitation shoud foow a shouder injury? The foowing recommendations serve as a guideine ony. Aways seek the advice of a medica professiona for a rehabiitation programme specific to you and your injury. Range of motion Restoring norma range of motion is essentia to aow fu functiona recovery of the shouder of the shouder Shouder movement can be improved initiay using penduum (i.e. by etting your arm genty swing forwards and backwards whie bending forward) Passive (assisted movement) and active (sef-movement) shoud be introduced as improvements aow A quick and easy way to evauate shouder range of motion is the Apey scratch test (stand in front of mirror): Reach behind your back and touch as high up your spine as possibe and then return to norma Reach up behind your head and touch as far down your back as possibe Perform each of the two movements with both arms Compare between arms Cardiovascuar fitness Keeping fit wi ensure a more comfortabe return to training and competition As most sports invove some running, activities such as power waking, running and stationary cycing are exceent methods of maintaining fitness In sports that require upper body conditioning (e.g. swimming) more specific training shoud be introduced to the upper imb as comfort permits Strength Strength in the shouder and shouder bade musces must be restored to ensure that the joint is stabe during activity Strength can first be improved by performing isometric contractions (hoding a fixed position for 10 to 20 seconds) against resistance As strength and range of motion improve, ight weights or fexibands can be used for added resistance through a greater range of motion Baance Baance and coordination need to be restored. Proprioception is the awareness of one's body position and is important in baance and coordination Injury to the shouder joint causes a reduction in proprioceptive abiity Proprioception training wi hep to re-educate the shouder musces, improve joint stabiity, and protect against future injury Push-ups and chest passing a ba against a wa wi improve strength and coordination Psychoogica status Reduced confidence foowing a shouder injury may prevent an athete from attempting stressfu movements (e.g. passing, tacking and faing on the ground) Graduay attempting more difficut agiity tasks and setting reaistic goas and time frames may hep to rebuid sporting confidence Return to competition is not advised unti an individua has 100% confidence in their paying abiity Sport-specific rehabiitation When genera function has been restored, rehabiitation shoud focus on preparing the shouder for sport-specific activity (e.g. throwing, hitting and passing actions) Sport-specific rehabiitation shoud be determined by the sporting code, the eve of sport and the position Heavy contact sports (e.g. rugby union and rugby eague) invove arge impact forces from tackes, scrums and fas. Return to competitive sport is possibe when these stresses and other sport-reated movements no onger cause discomfort, pain and/or sweing Ensure you are competey rehabiitated before returning to competition to minimise the risk of re-injury. Common Injuries SHOULDER INJURIES Page 3 /5 Te Kaporeihana Awhina Hunga Whara

4 Shouder injuries Exampe of a return to pay strategy after a grade 1 shouder injury (sprain/strain/bruise) NOTE: This is a guide ony. Timeframes for rehabiitation and return to pay vary depending on the nature and severity of the injury. Aways seek the advice of a medica professiona for a rehabiitation programme specific to you and your injury. days 1-3 post injury Have sweing and pain setted? Begin range of motion Continue RIC*D treatment Passive/active If sweing and pain movement of the persist, consut shouder a medica Begin gente strengthening professiona for further assessment and treatment days 4-6 can you: Move shouder through fu range of motion without pain? Progression Continue to improve Strengthening strength and to improve the stabiity of movement the shouder bade Increase resistance and range of movement for strengthening Fu range of motion Progression Coordination & proprioception Maintain Fitness Stationary cycing, running, ower body days 7-10 can you: Match the strength, range of motion and proprioception of the non-injured shouder? Perform press-ups without pain? Begin functiona Continue to improve Throwing agiity and sportspecific dris Swimming stroke Maintain Fitness Stationary cycing, running, ower body days Pass, throw, catch a ba without pain? Perform functiona tests adequatey? Compete a with 100% confidence? Return to training Continue to improve agiity and sportspecific dris Maintain Fitness, range of motion, strength, baance Common Injuries SHOULDER INJURIES Page 4 /5 Te Kaporeihana Awhina Hunga Whara

5 Shouder injuries How can you reduce the risk of re-injury? ALWAYS seek the advice of a medica professiona before returning to sport. Inadequate rehabiitation and a premature return to sport wi increase the risk of re-injury. Continue stretching, proprioception and strengthening as part of a norma training routine Correct tacking and faing techniques shoud be practised at a times Avoid breaking a fa with an outstretched arm (earn to ro safey) Proper warm-ups shoud aways be performed before any exposive movements or impacts Bracing and taping can assist with supporting the shouder If possibe, use braces rather than tape, as the effective support provided by taping is generay reduced after 20 minutes of pay. Ensure that the brace fits correcty, it compies with the rues of the game and it is suitabe for you and the sport If shouder pain persists, consut a medica professiona for advice on other possibe contributing factors Common Injuries SHOULDER INJURIES Page 5 /5 Te Kaporeihana Awhina Hunga Whara