The shoulder is a very painful joint to injury and takes a long time to recover from. Shoulder injuries in horse riders are common and not well managed. The shoulder is one of the most used joints in our body. Many of my patients present with pain and say “I haven’t done anything”? The shoulder is a victim of repetitive use and with my clinical experience, I believe it is due to poor posture more so than overuse or age.
Throwing a ball, driving, typing, lifting boxes, or pushing a lawnmower all use the shoulder under a load. We rely heavily on our shoulders to perform a number of activities. The shoulder has a large range of motion, it not only rotates it moves in a full arc both above the head and to the side of our body. The shoulder with this range is the most mobile joint in the body. Because of this flexibility, however, it is not very stable and is easily injured.
Anatomy of The Shoulder
The most common muscles injured come from the rotator cuff group. This group is made up of four muscles that wrap around the head of the humerus connect to the scapular and allow us to perform many ranges of motion. This group of muscles is also used for stability in the shoulder joint. Ligaments and muscles keep the humerus from slipping out of the socket and keep the clavicle attached to the scapula.
To prevent injury it is important to understand how all of this works.
Shoulder Instability And Treatment
Shoulder instability occurs when the muscles and ligaments have been stressed or injured directly. Sometimes the shoulder feels like it might slip out of place. This is a dislocation or a subluxation of the shoulder joint. It occurs most often in young people and athletes. The shoulder becomes unstable when muscles and ligaments that hold it together are stretched beyond their normal limits.
In some people, hypermobility causes the joint to be unstable, this condition may be a normal part of growth and development. It is common in knees, elbows, and fingers. Hypermobility is not as common in the shoulder but repetitive shoulder dislocation will result in hypermobility in the shoulder. In horse riders, a fall or a severe grab at the reins and in many cases just doing jobs around the stable. It doesn’t always happen in the saddle. This puts extreme force on the shoulder.
Symptoms of shoulder instability are pain that comes on either suddenly or gradually, a feeling that the shoulder is loose, or a weakness in the arm. Dislocation is common in falls when the hand or arm is outstretched to stop the fall, or when the fall is on a hard surface. Symptoms are severe pain when the injury occurs, a misshapen shoulder, and decreased movement of the shoulder.
A dislocated shoulder needs immediate medical care and rehabilitation
Shoulder Repetitive Strain Injuries.
A strain of the Rotator Cuff is the most common injury in all people and certainly the most evident in horse riders. A partial tear progressing to a complete tear is also common and often misdiagnosed as a strain. So every time you tug and pull or use a tendon is everyday activities it is being loaded and if not in the best posture it is being micro traumatized. Soreness is often neglected until it becomes very painful.
I have a saying “Manage NO pain” Don’t wait until you have the pain to change your management and the way you do things.
Bursitis and tendonitis of the shoulder are the most used terms given to patients. The most common of these is an injury to the Supraspinatus tendon and or bursa that cushions the tendon. The bursa inflames and swells and then the shoulder becomes extremely painful and useless. The humerus can’t move as easily in the socket, making it difficult to move the arm up or away from the body.
It is important to treat the injury and then look at the cause. If you injure yourself by doing what you do, then you will keep the injury by doing what you do and it will develop into a chronic injury. It is important to follow a professional program specific to your injury. This program must respect your lifestyle as well, though.
Shoulder Pain In The Older Horse Rider
As people age and their physical activity decreases, tendons begin to lose strength this often happens to middle-aged or older adults who already have shoulder problems. This area of the body has a poor supply of blood, making it more difficult for the tendons to repair and maintain themselves. As a person ages, these tendons degenerate.
The rotator cuff tendons can be injured or torn by trying to lift a very heavy object while the arm is extended, or by trying to catch a heavy falling object.
Treatment depends on the severity of the injury. If the tear is not complete, your health care provider may recommend RICE, for rest, ice, compression, and elevation. Resting the shoulder is probably the most important part of treatment, although after the pain has eased, you should begin physical therapy to regain shoulder movement. Your doctor may prescribe a nonsteroidal anti-inflammatory drug (NSAID) for pain.
This extreme stiffness in the shoulder can occur at any age. It affects approximately 2 percent of the population, most often between 40 to 60 years of age. Although the causes are not completely understood, it can affect people with diabetes, thyroid disease, heart disease, or Parkinson’s disease. It can also occur if the shoulder has been kept immobile for a period of time. This can be after surgery of resting the joint due to injury.
It occurs when a minor shoulder injury heals with scar tissue that affects how the joint moves. This scar tissue reduces flexibility in the shoulder and makes it more prone to injury. In effect, the capsule becomes stiff and inflexible.
Managing Shoulder Injury In Horse Riders.
Well, a horse rider’s shoulder is no different from any other athlete or nonathlete. The tissue is damaged and needs time to heal. Ice, a sling, stretches and the specific rehab program is the only way a shoulder will be repaired. It is important to follow the program properly to stop the injury from becoming chronic and developing into a major injury.