Shoulder injuries are very common in the martial arts community. Every day stresses, wear and tear and commonly encountered trauma will take its' toll on joint integrity, cartilage and ligaments. The unusual stresses that are added by some forms of the martial arts will accelerate the deterioration of the shoulder as well as other joints.
The most common injuries involve the tendons in the front and behind the shoulders, resulting in pain with rotation of the shoulder, pain in the front of the shoulder capsule, behind the shoulder capsule and sometimes, into the anterior chest. Referred pain can be expected to occur in the area behind the shoulder blade and numbness to the hand.
Due to tendinitis of the Biceps and Triceps, Flexor Digitorum Longus, the sufferer can anticipate pain with internal rotation, that is, putting on a jacket, but pain can result from activities such as leaning on the elbow.
Difficulty will be encountered with reaching over head, to the side and with lifting.
Inappropriate stretch of the shoulder, and many of the stretch exercises that are routine in martial arts warm-up will actually worsen the condition.
Treatment must be focused on the tendons of the shoulder capsule, maintenance of flexibility, and reduction in inflammation.
Treatment of this problem consists of a combination of oral anti-inflammatory, oral anti-convulsants, and topical anti-inflammatory medicines.
The topical anti-inflammatory of choice may be a combination of flurbiprofen and ketoprofen in an isopropyl alcohol with NDMS enhancement. This is a compounded product, available by prescription.
An alternative that is available without prescription is 'kink-ease,' which is a high potency MSM salve. In either case, the topical should be used first thing in the morning, last thing at night and once or twice during the day.
The Keto/flurbo compounded mixture must be ordered by your physician. It costs about $40 per ounce.
More will be written on this in my 'Health Article Series.' When it is finished, I will come back to this post and insert the appropriate link.
David S. Klein, MD, FACA, FACPM
Pain Center of Orlando, Inc.