Fractures and tendon injuries of the athletic shoulder

Athletic injuries in the shoulder range from a routine strain or sprain to a potentially disabling fracture or tendon rupture. The level of sports participation plays an important role in diagnosis and treatment. The nonprofessional athlete may be more likely to sustain injuries secondary to under-training or improper technique. The professional athlete may be capable of play tinder much higher velocities and applied loads and, therefore, may be subject to higher energy trauma than the amateur athlete. In addition to standard treatment considerations, return to play time must also be decided. Decisions regarding definitive treatment may be modulated depending on an athlete's desire to return to his or her previous level of competition. Many sports-related injuries are the result of repetitive actions that might arise in swimming or pitching. Such repetitive microtrauma leads to overuse syndromes with degenerative, time-related problems. These types of injuries are not the subject of this review. Instead, this article focuses on diagnosis and management of acute tendon injuries and fractures involving the adult athletic shoulder.