Dead Arm Syndrome

2010-10-03T07:16:00.000-07:00

The Dead Arm Syndrome is a disabling sports injury amongst both recreational and elite overhead athletes (pitchers, volleyball players, quarterbacks, swimmers, and tennis players). The Dead Arm Syndrome has been defined as the inability to throw, spike or serve at pre-injury level secondary to subjective pain and instability. The athlete will often say "I just can't throw anymore, and / or the shoulder just doesn't feel right". This type of injury tends to progress gradually over time, slowly creeping up on the overhead athlete until severe pain and subjective instability limits his or her ability to perform. All to often athletes are forced to retire from competition.

Recent advances in research has given us greater insight into the Dead Arm Syndrome and has given hope to the injured athlete. The often career ending sports injury now has successful treatment options. Researchers now believe that the forces subjected to the shoulder during overhead sports can lead to scaring and tightening of the posterior shoulder capsule. These changes alter the function of the shoulder joint and are believed to be one of the primary causes underlying the pathological changes (cuff tears, labral damage, etc.) often associated with the Dead Arm Syndrome.

Internal impingement Syndrome is a medical condition that attempts to categorize the constellation of signs and symptoms often associated with the Dead Arm Syndrome. It occurs with excessive or repetitive contact of the greater tuberosity of the humeral head with the posterosuperior aspect of the glenoid rim. This occurs when the arm is placed in the extremes of abduction and external rotation.

The under surface of the rotator cuff (often the supraspinatus or anterior aspect of the infraspinatus tendon) has a tendency to become impinged in this position of extreme abduction and external rotation. This is in contrast to external or outlet impingement (subacrominal impingement syndrome) where compression of the cuff tendons occurs against the under surface of the acromion.

This condition is often seen with full thickness tears in the elderly and with repetitive overhead work such as painting or window cleaning.

Internal Impingement is characterized by posterolateral shoulder pain, subjective instability, the inability to throw or use the arm overhead, articular-sided rotator cuff tears, labral fraying or tears, anterior instability, cystic lesions in the posterior lateral humeral head, glenohumeral internal rotation deficit (GIRD), and scapular dysfunction (SICK).

Conservative / Nonoperative treatment is the first line of defense and should include a focus on normalizing range of motion and capsular tightness, improving scapular function, optimizing core stability, and correcting any sport specific technical faults that may exist.

Early stage pain management may include electro-acupuncture, Active Release Techniques, Instrument Assisted Soft Tissue Mobilizations, joint mobilizations, and relative rest.

Operative intervention are recommended for those with severe instability, large cuff tears, or those that fail to improve with conservative therapy. Proper rehabilitation is paramount after surgery if the athlete is wanting to return to a high level of competition.

Don`t dismiss the symptoms, get diagnosed and treated early and your chances of full recovery will be greatly improved.

Dr. Rene J.D. Asselin

Collingwood & Penetanguishene Sport Chiropractor

Synergy Health & Wellness Centre

Tel: (705) 446-5828 x 1
150 First Street, Unit D. Collingwood

Tel: (705) 734-4334
15 Robert Street West, Penetanguishene

www.synergywellnesscentre.com

Collingwood Sport Chiropractor

Dead Arm Syndrome