Shoulder ligament stretching is a tear of shoulder ligaments, the tough bands of fibrous tissue that connect bones to one another inside or around the shoulder joint. The ligamentous apparatus that secures the shoulder joint is subjected to high demands to ensure the excellent mobility of this joint.
The shoulder is the most flexible joint in the human body. It can be moved in all directions and can also perform combination movements. This high degree of mobility is made possible by the fact that the head of the humerus is enormous to the glenoid cavity and projects beyond its edges. This ratio can quickly cause the head of the humerus to slip out of the socket (dislocation), or it can cause the head to slide too far in one direction during rapid, jerky movements.
To prevent this, the shoulder joint is surrounded by many muscles and ligaments that provide stability. During extreme movements, they become tense and block further movement in this direction. But if a movement is performed with so much momentum that the ligaments cannot withstand this tension, the ligaments stretch, or in the more extreme case, the ligaments tear. A ligament elongation is, therefore, also called a first-degree ligament injury.
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Causes of shoulder ligament stretching
Ligament stretching can occur during sports as well as during everyday activities. Ligament stretching in the shoulder is caused by a movement that is performed beyond the natural range of motion. This is often the case with unplanned, uncontrolled movements, such as those usually performed during sports. But also a support during a fall with unfavorable force effects on the shoulder joint can lead to an overstretching of the ligaments. Often the arm is turned unnaturally, and the shoulder joint is therefore incorrectly loaded. Besides, a blow or kick against the shoulder can cause the ligaments to stretch.
Symptoms of shoulder ligament stretching
The first sign of ligament stretching in the shoulder is a pain in the joint. This is followed by a swelling of the shoulder. The pain that occurs is particularly severe when the joint is moved or loaded. This results in a reduced development of strength and a loss of function of the shoulder or arm.
Compared to a torn ligament, both the pain and the swelling of the joint are less pronounced. Bruises (hematomas) are also usually absent when the ligament is stretched. This is because stretching the ligament does not damage the ligaments or the surrounding tissue, and therefore there is no bleeding.
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Diagnosis of shoulder ligament stretching
If acute pain occurs in the shoulder area, a doctor should be consulted. If this pain occurs after a jerky movement and is possibly associated with swelling of the joint, these are the first indications of damage to the ligamentous apparatus. Nevertheless, it is important, especially after falls, to rule out damage to the bones. The doctor then distinguishes by palpation and functional tests whether a ligament is stretched or torn. Since functional tests often do not provide clear results, a magnetic resonance tomography of the shoulder (MRI of the shoulder) is necessary in case of doubt to recognize the images whether the ligament is torn or not.
Therapy of shoulder ligament stretching
The most important thing in acute ligament stretching is to protect the joint. No large movements should be made, and no heavy loads should be lifted. If a ligament stretching has occurred during training, it should be stopped immediately. The shoulder joint should be cooled by wrapping it in cold water or ice. Care must be taken that the ice does not lie directly on the skin, as this can lead to frostbite. Cooling counteracts severe swelling of the joint.
In the acute phase, depending on the pain, it may also be necessary to take pain-relieving medication. However, the severe pain should subside after a few days, and the medication should no longer be needed.
Depending on the extent of the stretching, the doctor decides whether it is necessary for the patient to wear a splint. If the shoulder ligament is stretched, a loop is then used into which the forearm can be inserted and thus worn. The shoulder, especially the ligaments, are thus relieved, and the healing process is supported.
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If the shoulder joint is not protected enough after a ligament stretching, the symptoms may return. In the long term, this can lead to instability of the joint. If these symptoms persist over a long period, it can promote the development of arthrosis.
Ligament stretching cannot be prevented, even though many precautions are taken, especially during sports. Long warming up and stretching reduces the risk of ligament stretching, but it is often the result of sudden, extreme movement that is not anticipated. Even long stretching cannot prevent this overload.
It is important to strengthen the muscles surrounding the joint. This means that the ligaments are supported and relieved in their holding function by the muscles. In this way, the risk of injury from ligament stretching can be reduced, as the muscles can cushion the violent movements and reduce the tension on the ligaments.
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Normally, the healing process of a ligament stretching takes about one to two weeks with sufficient protection. During this time, the shoulder should be cooled regularly, and high loads, such as heavy carrying, should be avoided. Sports activities should also be avoided.
If long and heavy loads and training are avoided for a while, even after the swelling has subsided and painless, the ligament stretching of the shoulder has a good prognosis and heals without further complaints. The phase until the full load can be resumed about four to six weeks. However, the load should be increased slowly, as otherwise the complaints can recur and are often even worse than when they first appeared.
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