Monday, November 17, 2008

That All Important Shoulder

By Richard P. Holm MD

One moment I was jetting down the ski slope unbelievably free, on the edge of control. The next moment I saw a bare spot under a bunch of trees  right where I was headed, but I thought too late and was going too fast.

When my skis hit the dirt, I went for one of those head-over-heels flips, struck my right shoulder on an icy hard spot and, finally, came to a stop, a heap of body parts just like Beetle Bailey in an old comic strip.

When accidents happen like that, I find myself wishing in vain to go back five seconds and do that one differently. But of course there was no re-doing it. I felt a burning pain coming from somewhere near my right shoulder, and it was not subsiding.

The doctor in the emergency room examined my shoulder for rotator cuff injury by testing, with resistance, three movements: 1) bring bent arm with imaginary mug of coffee to the chest, 2) rotate the arm out again, and 3) with straightened arm to the side, empty the mug away from the body. Luckily my rotator cuff was fine.

He also reviewed the X-Rays with me and pointed out a separated shoulder blade-collarbone, or AC joint, which ties the arm and shoulder to the chest.

Days later, my orthopedic partner reassured me that although I had torn the AC joint, it wasn't unstable. The only real problem was that I should expect it to hurt for maybe six months, which it did. 

The whole experience helped me appreciate the sudden and long lasting consequences of a reckless choice, helped me empathize with others in pain from any cause, and helped me learn about the value of the shoulder and all its parts.

And it helped me to avoid those bare dirt spots too.

Take home message:
1. Accidents can happen in a flash, and can result in long lasting suffering. Therefore it is wise to make good choices to avoid accidents when possible;
2. The shoulder has many important parts, and because it is so very mobile, is also more at risk for becoming unstable if injured;
3. The three movements mentioned above test the Subscapularis, the Infraspinatus with the Teres Minor, and the Supraspinatus muscles.

1 comment:

Medic61 said...

I should really listen to point 1 more often, as I'm incredibly accident-prone. Broke my thumb when my partner rolled over it with a stretcher (fully loaded with patient, whee!), and injured my foot when a stretcher (fully loaded with patient again) was dropped on it.

I should definitely learn better body placement :P

Nice to find this blog, can't wait to read more!