Common Shoulder Injuries In Horse Riders

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 lawn mower 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

537158 497469613642274 1726135267 n   The shoulder is made up of two main bones: the end of upper arm bone (humerus) and the shoulder blade (scapula). It has two joints associated with it. The shoulder joint itself and the acromioclavicular joint.The head of the humerus is round, and it fits into a socket in the scapula. (shoulder blade). Engulfing the shoulder is a group of muscles and ligaments. Ligaments connect the bone to bone and tendons connect muscles to bones.

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 and 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. The most common are

This group of muscles is also used for stability in the shoulder joint. The most common is abduction, this action is the most used, this is when we take our arm away from our body sideways.  When the shoulder moves, the head of the humerus moves in the socket This is called a ball and socket joint. Very little of the surface of the bones touch each other. 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.Sometimes I see people with the shoulder sitting 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.

images 60In some people, hypermobility causes the joint to be unstable, this condition may be a normal partimages 62 of growth and development. It is common in knees, elbows and the fingers. Hypermobility is not as common in the shoulder but repetitive shoulder dislocation will result in hypermobility in the shoulder. Shoulders generally stiffen or tighten with age.  In athletes, shoulder instability is caused by activities, such as tackling or throwing or defending in Netball for example. 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 a severe pain when the injury occurs, a misshapen shoulder and decreased movement of the shoulder.

It can present in other ways though and should always be assessed by a Physiotherapist, and or X-rayed as well. Treatment for a dislocation is ice applied immediately after the injury to decrease pain, swelling and bleeding around the joint. Within 15 to 30 minutes of the injury, the joint will be painful and swollen. A dislocated shoulder needs immediate medical care. Once the x-ray confirms the joint position a Doctor uses gentle traction to pull the shoulder back into place.The shoulder must wear a sling for up to 6 weeks and follow a rehab program from a Physiotherapist. If the shoulder does not repair and it pops out of the socket repeatedly, the condition is called recurrent instability. Recurrent instability can be treated with surgery to repair the torn ligaments.This is a very painful and long rehab.

Shoulder Repetitive Strain Injuries.

images 56A 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. Again my patients say they haven't done anything. My answer is many micros makes a macro. 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 having a saying "Manage NO pain" Don't wait until you have the pain to change your management and 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. If the tendons develop small tears, pain and swelling change the way we move and without rest and time to heal these small tears grow into bigger tears. 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. 

 Treatment is rest, ice, time and correct stretches and strengthening exercises. 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 weakening can lead to a rotator cuff tear. Rotator cuff injuries occasionally occur in younger people, but most of them happen 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.

leanne liftingUsing your arm overhead puts pressure on the rotator cuff tendons. Repetitive movement or stress to these tendons can lead to impingement, in which the tissue or bone in that area becomes misaligned and rubs or chafes.  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. Symptoms of a torn rotator cuff include tenderness and soreness in the shoulder during an activity that uses the shoulder. A tendon that has ruptured may make it impossible to raise the arm. It may be difficult to sleep lying on that side, and you may feel pain when pressure is put on the shoulder.

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.

Frozen Shoulder

frozen shoulderThis 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 a 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.

The major symptom is the inability to move the shoulder in any direction without pain. Treatment can be NSAIDs, cortisone injections or physical therapy. You can reduce further injury and stiffness by stretching before starting activities. Beginning as early as age 50, some people develop osteoarthritis, which causes painful movement. This occurs as the smooth surfaces of the cartilage that line the bones of the shoulder joint are worn away, and joints begin to wear out and become larger. The most common cause of osteoarthritis is overuse. Treatments for arthritis in the shoulder depend on the severity of pain. The usual treatments are rest, NSAIDs and cortisone injections.  In some instances, a replacement of the shoulder joint is necessary.

I treat the cervical spine with great success in my patients with a frozen shoulder.

Managing Shoulder Injury In Horse Riders.

APR movement patternsWell, a horse riders' shoulder is no different to 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 repair. It is important to follow the program properly so stop the injury becoming chronic and developing into a major injury. Horse riders need to get help with the daily chores of caring for their horse. They need to accept the time frame and do the exercises. I am currently recovering from a full shoulder reconstruction so I have to practice what I preach and I do understand the constraints. Following a detailed core program is essential. I follow my own Applied Posture Riding program.

  I also recommend a posture shoulder brace for support and for training the posture muscles while your tissues heal. This is not the 3 websizenormal advice but I have had enormous success with people wearing this simple brace. To sum up, if you have shoulder pain, see a Physiotherapist and or a Doctor and follow their advice. A chronic shoulder injury is very hard to deal with as a horse rider. I am passionate about my horses and my riding.

I love seeing riders achieve their dreams and I love seeing riders return to riding after an injury or even worse from being told to give up.This usually comes from a health professional or family member who does not understand, first of all, the passion and secondly the injury and thirdly the sport itself. I have been in all three situations, injury, poor advice, and no family support, I have the experience the knowledge and the skills as well as the passion for helping you.

Look at my Applied Posture Riding Program and follow me on Facebook.