Your shoulder is made up of three bones: your upper arm bone, the humerus, your shoulder blade (scapula), and your collarbone (clavicle). The shoulder joint is held in place by muscles, tendons, and ligaments. Tendons connect shoulder muscles to the bones and help to move the muscles in the shoulder and provide some dynamic stability to the shoulder. Along with the muscles, the ligaments connect bone to bone and provide stability to the shoulder joints.
Overhead activities such as swimming or throwing a ball can cause a pinching of the rotator cuff or biceps tendons. Poor posture can cause shoulder pain due to the increased stress on the shoulder. Trauma such as a fall or car accident can also injure the shoulder.
Rotator cuff injury and inflammation are some of the most common causes of shoulder pain. The rotator cuff is a group of four muscles that help to support and move the shoulder. Their primary role is to hold the ball of the arm bone in the socket while the arm is moved. If the tendons get pinched, they can become inflamed causing shoulder pain. Here are the three common conditions that can affect the rotator cuff:
Frozen shoulder is a shoulder condition where the shoulder becomes painful and starts to lose motion gradually. Loss of motion can cause significant shoulder pain and lead to functional loss. Frozen shoulder can also occur when there is a significant injury further down the limb in which the entire arm’s function is limited and not functioning to its full potential. An early recognition and comprehensive rehabilitation approach from a certified hand therapist can help.
The elbow is a joint in which 3 bones come together: the larger upper arm bone (humerus) and the two forearm bones (radius and ulna). All in all, the elbow is a fairly stable joint with deep bone cavities and stout ligaments to provide the joint its stability. At times these stability forces are disrupted by trauma or injury causing pain, instability, lack of range of motion and decreased strength which impacts overall limb function.
Tendinitis – both Golfer’s elbow and Tennis Elbow involve the muscle-tendon attachment of a group of forearm muscles. Golfer’s elbow affects the inside of the elbow and tennis elbow is on the outside of the elbow. Both conditions can be related to the event that they are named after, but more commonly these tendonitis conditions occur during overuse activity requiring repetitive gripping over a long duration.
Ligament sprain or tear – can occur as a stand alone condition usually occurring at the inside of the elbow more than the outside. Repetitive motions which place a lot of stress on the inner elbow can cause damage to the ligament. For example, throwers (track and field and ball sports such as baseball) are prone to this injury, especially if throwing technique is poor.
Elbow dislocation – not as common as a shoulder dislocation, but it still can occur. An elbow dislocation can result from a trauma or accident in which someone falls on an extended arm, great force is applied laterally to the elbow or the arm is twisted in an awkward manner. The ligaments providing stability are then stressed and either tearing the tout ligament or stretching the ligament causing a significant sprain.
Carpal Tunnel Syndrome—carpal tunnel syndrome occurs when your median nerve gets compressed at the wrist due to swelling. Swelling may be caused by repetitive movements with your wrist such as typing, sewing or hand tool use. Symptoms may include aching, burning, numbness or tingling in palm, wrist, thumb or fingers. The thumb muscle may become weak, making it difficult to grasp things or often people will describe their hand as being clumsy. At times the pain may run up the arm towards the elbow.
Wrist Injury—wrist injuries often occur when you fall forward onto your outstretched hand—a sudden impact injury. Wrist pain may be a sign of an injury which can include the following common wrist injuries:
Think of your ligaments as the main stabilizers in your hand joints. As a ligament is stretched due to impact, usually a reflexive act to protect yourself from landing face first on the ground, joint stability is lost. Loss of stability is then related to reduced strength, reduced grasp and reduced function in the hand.
Traumatic fractures of the hand and fingers can be difficult to manage. Fractures can cause significant impact on the hand by having a finger rotate or deviate. This limits motion which in return limits strength for grasp and dexterity with the fingers.
The small joints in the fingers are usually one of the first affected by osteoarthritis. One of the more debilitating injuries is when arthritis occurs in the base of the thumb joint, call CMC arthritis. Pain starting at the base of the thumb increases when performing repetitive pinch or any pinching to the side of the index finger. This pain progresses and bony changes are noticed as the base of the thumb loses movement making grasping difficult and reducing the ability to perform one-handed work.
Whether you suffer from a shoulder, elbow, wrist, hand or finger injury, there are hand therapy options to assist you in your recovery. Primarily hand therapists will work in phases starting with activities and exercise to assist in pain and inflammation reduction. Our therapists will then work with you in strategies and exercises to restore your range of motion, muscle strength, and coordination to get your back to doing things you love – free of discomfort.
A unique aspect of the Hand & Upper Extremity Center is manufacturing custom splints & braces for patients with fractures, dislocations, arthritis, tendonitis, carpal tunnel syndrome, and most post-operative upper extremity conditions. We fabricate over 2000 splints and braces per year and pride ourselves on excellent quality and same-day service (with appropriate authorization from the insurance carrier) to keep you protected and supported while maintaining as much function as possible. We also fit quality pre-fabricated splints to assist in sprain/strain management and other conditions that might benefit from a short term, cost efficient splinting option.