Two Shoulders, an Ankle and a Nose (Part 1)

It’s been a busy week for injuries: Wednesday, Dancing with the Stars semifinalist, and Sex in the City hunk Gilles Marini underwent successful surgery to repair a shoulder separation he sustained during the first dance of DWTS. Boston Red Sox center fielder Jacoby Ellsbury (below) was a little luckier when he injured his right shoulder in a game Sunday against the Texas Rangers. Ellsbury slid awkwardly into second, then aggravated it making a diving catch in center field later in the game. Tests revealed that the shoulder was “structurally sound” and the injury was called an AC (acromioclavicular) joint sprain.

The shoulder is a complex of four separate joints (see diagram), together called the shoulder girdle, which gives it its amazing ability to move in so many directions. However, this freedom of movement also makes it more prone to injury. Shoulder separation occurs when the fibrous tissue (ligaments) that hold the collarbone (clavicle) to the shoulder blade (scapula) are torn, most commonly by a direct hit to the shoulder or by falling on an outstretched arm. Small tears are usually treated conservatively with immobilization and pain relief. Larger tears or completely torn ligaments may be treated surgically.

A sprain is an injury to the ligaments (thick bands of cartilage that connect bone to bone) caused by a fall or outside force that pulls the surrounding joint beyond its normal range of movement. The degree of sprain can range from a stretched ligament to a completely torn ligament. Symptoms include pain with movement, swelling, bruising, and joint instability. Mild injuries of either type are treated with RICE therapy – rest, ice, compression, and elevation. More severe injuries may require immobilization or possibly surgery to restore function.

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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