I would say that shoulder injury is the second most frequent type of injury that we see as a result of a motor vehicle accident. You can imagine that when a car is jolted or hit, that individual who had their hands on the steering wheel, the shoulder takes the impact of that jolt.
When we see shoulder injuries sometimes we see subluxations, a shoulder usually comes out of socket, but oftentimes we see two very distinct types of injuries. One is called a rotator cuff injury and many people have heard of the term rotator cuff. Essentially what that means is that the humorous, has to fit into the shoulder socket and because it has to fit into the shoulder socket it becomes generally unstable.
There are a series of four muscles and four tendons which hold everything in that place. There is one of those tendons and muscle groups that gets injured in these types of accidents and it’s called the supraspinatus tendon and the supraspinatus tendon is the tendon that attaches at the part by the arm down by the bicep. We see injuries in this area quite often. Oftentimes people who have a supraspinatus injury will have difficulty raising their hands up to the side. So activity below shoulder height is OK. They have weakness coming down in a hand if their arm is pushed in a certain way. Aswell as have difficulty putting their arm behind their back.
What happens then is we do what most of the orthopedic spine surgeons in western New York has to deal with, upper extremity injuries. Those injuries to this area are not picked up by X-ray. It is something that has to be looked through an MRI so if a medical doctor thinks it’s appropriate and the person has symptoms, orthopedic symptoms consistent with a rotator cuff tear they will take an MRI and we’ll determine whether there is an injury there.
The other type of injury that we look at in terms of shoulder is called the labrum and in the area where this arm fits into the shoulder socket. This labrum is almost like a Teflon coating and this Teflon coating allows everything to move freely.
Oftentimes what we will see in these types of injuries is damage to that Teflon coating and because the Teflon coating is damaged as the arm moves, it creates problems, consistent with weakness or motion loss. That can be picked up by an MRI arthrogram and from those we can determine what the extension of injuries are and whether or not surgical intervention is necessary. Then we monitor to make sure that the insurance companies are aware of the nature and severity of those injuries.