The shoulder is the most mobile joint in the body and, by design, is also the most unstable. External rotation at the shoulder, which occurs when throwing a ball, for example, is an extremely complex motion, often resulting in injury. Forced external rotation of the shoulder, often occurring in football or wrestling can also result in traumatic injury to the shoulder.
Dislocation
When the shoulder joint is forced into external rotation beyond normal limits, a shoulder dislocation can occur. When the shoulder dislocates, the patient is often left unable to move the arm and there is an obvious deformity where the shoulder should be. First time shoulder dislocations must be seen by a physician to be reduced properly and to determine if there is damage to any of the supporting ligaments, tendons and cartilage. The patient will generally be placed in a sling for two to six weeks and prescribed physical therapy to strengthen the shoulder.
Rotator Cuff Tear
According to the American Academy of Orthopaedic Surgeons, the rotator cuff functions as one of the most important components in the shoulder, giving the shoulder stability and power during external rotation. During athletic activities which involve high velocity overhead motions, such as pitching in baseball and serving in tennis, it is possible to tear the rotator cuff. In this instance, it may be difficult for the patient to regain enough strength and function to return to their sport without having surgery.
Tendinitis
Tendinitis is an inflammation of the tissue that attaches the muscle to bone. During external rotation of the shoulder, tendons may be pinched between the bones or over taxed. If this occurs repeatedly, it can result in tendinitis of the shoulder. Most tendinitis can be managed conservatively with medications, injections and exercise therapy. According to the MayoClinic.com, the patient with shoulder tendinitis usually responds well to an exercise program emphasizing balance between all of the muscles. Physical therapy for instruction in proper exercise technique is important to the success of the exercise program.
