What is a shoulder lesion?
The term shoulder lesion refers to various injuries or changes in the shoulder area. These can be inflammation of the tendons or bursa, but also damage to the tendons and muscles or changes to the joint structure. Pain, restricted movement, instability and loss of strength can affect daily activities as a result of a shoulder lesion. Examples of shoulder lesions are:
- Rotator cuff lesions
- Tendinitis (inflammation of the tendons)
- Bursitis in the shoulder area (inflammation of the bursae)
- Shoulder impingement syndrome
Causes and risk factors for shoulder lesions
Repetitive strain or overloading of the shoulder through certain activities or jobs can lead to lesions in the shoulder. Shoulder lesions are common in sports such as tennis, swimming or baseball, but also in occupational overhead activities such as those performed by painters or construction workers.
Degenerative changes with increasing age can also lead to lesions in the shoulder. The gradual deterioration of shoulder structures can cause pain, for example due to osteoarthritis or changes in the tendons. Anatomical abnormalities, for example of the shoulder joint capsule or the shoulder blade (scapula), can also be the cause of shoulder lesions.
Can shoulder lesions be prevented?
Specific weight training to strengthen the muscles around the shoulder, especially the rotator cuff, can improve the stability and functionality of the shoulder joint. It is also important to avoid overloading and to gradually increase the intensity and duration of certain activities. It is advisable to warm up sufficiently and carry out regular stretching exercises for the shoulder muscles before every training programme and particular stresses in everyday life. This increases the flexibility of the shoulder structures and reduces the risk of injury. An ergonomic working environment that enables good posture and low strain on the shoulder can help to prevent work-related shoulder injuries.
Signs and symptoms of shoulder lesions
Shoulder lesions can cause different signs and symptoms depending on the type and severity of the injury. These usually develop over a longer period of time. They can intensify with certain movements. A shoulder lesion can restrict the range of movement in the shoulder joint. Those affected may be unable to lift and rotate the arm, especially when moving overhead or to the side of the body.
Shoulder pain due to shoulder lesions can also lead to sleep disorders.
The most common signs and symptoms also include:
- Swelling and redness: Inflammatory reactions can lead to swelling and redness around the shoulder.
- Instability: An unstable shoulder often feels like there is too little support in the joint.
- Loss of strength: A shoulder lesion can lead to a loss of strength in the affected arm, which can make it difficult to grasp, lift or carry objects.
- Crunching or cracking: Some shoulder lesions can cause grinding, cracking noises in the shoulder joint, especially during movement.
- Numbness or tingling: In some cases, shoulder lesions can cause numbness, tingling or a ‘furry’ feeling in the arm or hands, which may indicate nerve compression or irritation.
If you notice one or more of these symptoms, you should seek medical attention to get an accurate diagnosis and appropriate treatment.
Types of shoulder lesions
Rotator cuff lesion
In contrast to a rotator cuff rupture, in which one or more tendons are torn, a lesion is a (partial) damage to the rotator cuff. The tendons may be irritated or inflamed. The rotator cuff consists of four muscles and their tendons: the supraspinatus, infraspinatus, teres minor and subscapularis. These muscles and tendons play a crucial role in stabilising and moving the shoulder joint. The most common symptoms of a rotator cuff lesion are pain, especially when lifting or moving the arm above the head, estricted movement, weakness in the affected arm and possibly crunching or cracking in the shoulder joint.
Bursitis im Schulterbereich (Schleimbeutelentzündung)
Die Bursitis ist eine Form der Schulterläsion und bezeichnet die Entzündung oder Reizung eines Schleimbeutels (Bursa) im Schulterbereich. Schleimbeutel sind mit Flüssigkeit gefüllte Säckchen, die als Gleitmittel zwischen Knochen, Sehnen und Muskeln dienen, um Reibung zu reduzieren und Druckspitzen zu vermeiden. Bei einer Bursitis liegt der Schmerz typischerweise direkt über dem betroffenen Schleimbeutel und wird oft punktuell wahrgenommen.
Tendinitis (Tendon inflammation)
In the case of tendinitis, the pain is localised along the affected tendon. Various tendons can be affected - including those of the rotator cuff.
Impingement syndrome of the shoulder
Experts speak of impingement syndrome when tendons of the rotator cuff are pinched or constricted in the narrowed area between the humeral head and the acromion. This can lead to irritation, inflammation and damage to tendons - resulting in pain and functional impairment. Restricted movement often occurs when lifting the arm.
Diagnosis of shoulder lesions
Doctors diagnose patients after a physical examination and medical history. Medical treatment recommendations are made on the basis of the exact diagnosis. The diagnosis of shoulder lesions usually requires a comprehensive assessment involving various diagnostic procedures, such as ultrasound, X-ray or magnetic resonance imaging (MRI).
Therapy of shoulder lesions
Therapy and treatment of shoulder lesions depend on the type and severity of the injury as well as the patient's individual needs and goals. Examples of common conservative and surgical treatment options:
Conservative treatment
- Rest: Temporary immobilisation can help to reduce inflammation and promote healing.
- Physiotherapy: Targeted exercises to strengthen the shoulder muscles, improve mobility and restore function are usually part of a comprehensive rehabilitation programme.
- Anti-inflammatory medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can reduce pain and inflammation.
- Injections: Cortisone injections directly into the affected shoulder can relieve pain and inflammation.
Surgical treatment
Certain shoulder lesions can be examined and treated arthroscopically in order to reconstruct the affected structures, such as the rotator cuff, tendons or ligaments.
Rehabilitation and aftercare
Appropriate rehabilitation and aftercare are essential to avoid long-term consequences such as chronic pain, instability or reduced functionality of the shoulder. This may include physiotherapy exercises, manual therapy, restoration of mobility and gradual resumption of activities.
Which doctor treats shoulder lesions?
A multidisciplinary team can help plan and implement an effective treatment strategy: Orthopaedists, trauma surgeons and sports medicine specialists specialise in the diagnosis and treatment of musculoskeletal conditions, including shoulder injuries and problems. They can prescribe conservative treatments such as medication, physiotherapy exercises and injections, but can also perform surgical procedures if necessary.
Exercises to accompany therapy for shoulder lesions
The surrounding muscles of the shoulder, including the rotator cuff, can be strengthened with targeted exercises. The surrounding muscles of the shoulder, including the rotator cuff, can be strengthened with targeted exercises.
