Travel Planning | Outdoor Sports Injuries Prevention and Treatment

SHOULDER DISLOCATION (INSTABILITY) HOW DOES THE SHOULDER WORK The shoulder is a complex ball-and-socketlike joint consisting of three main bones -the humerus (the upper part of the upper arm bone), the clavicle (the collarbone), and the scapula (or shoulder blade, the largest bone in the chest-shoulder region). The humerus forms the ball in the ball-and-socket -like joint and is attached by ligaments-connective tissue- to the scapula. Bursas - fluid-filled sacs or saclike cavities- surround and cushion the bones and allow for movement. Muscles, including the trapezius, deltoid, pectorals, and latissimus dorsi, travel over, under, and around the shoulder joint and add stability. Tendons (also connective tissue) connect these muscles to bone. What the Shoulder Does: The shoulder allows movement of the hand and arm in space. What the Injury Is: A dislocated shoulder is a shoulder “out of joint.” It occurs when the humeral bone in the upper arm comes out of the joint and sticks out, usually on the front or top of the shoulder. In severe cases, ligaments, tendons, and other connective tissues are stretched and injure nerves and blood vessels in the shoulder region, sometimes causing numbness in the hand. Cause: The injury can be caused by a traumatic event, as in a direct blow to or a fall on the shoulder, or by a fall on your outstretched hand or arm. Susceptibility to a dislocation may also be genetic, particularly if the shoulder “goes out” or “pops out” often or easily. Members of the same family may also be afflicted. In some cases, the shoulder can dislocate while the individual is sleeping. A shoulder dislocation is common in contact sports, especially football. Other sports that may cause the injury: downhill skiing, lacrosse, hockey, volleyball, rugby, and soccer. Symptoms: Severe pain at the moment the injury occurs. Limited movement in the shoulder area. Swelling, bruising, and internal bleeding. The shoulder may look odd, with a large bump rising up under the skin. Immediate Treatment: Use an ice pack to reduce swelling. Cold treatments help stop internal bleeding and the accumulation of fluids in and around the injured area, thus decreasing swelling. Seek medical treatment at a physician’s office or hospital emergency room. (Individuals with recurring dislocations may be able to “pop” the shoulder back into place.) The shoulder may be put in a sling or wrapped to immobilize the area and aid recovery. Medication: First, follow your physician’s advice. You may be given a pain-relieving drug, such as codeine with aspirin or acetaminophen. You may also be given a nonsteroidal anti-inliammatory drug (NSAID) to reduce pain and swelling. WARNING: Do not give aspirin to children under the age of 16. If pregnant or nursing, consult with your physician first before taking any medication. Continued Care: Avoid participation in sports until the shoulder has had time to heal. The healing process may take 3 to 6 weeks, depending upon the extent of the injury. With your physician’s okay, work with a trainer or physical therapist to strengthen muscles in the shoulder region. Medication: First, follow the advice of your physician. Take aspirin, ibuprofen, or acetaminophen to help reduce pain and inflammation. NOTE: Acetaminophen may not contain as much of the anti inflammatory agents as aspirin or ibuprofen. Ask your physician or pharmacist for guidance. Long-Term Effects of Injury: With proper healing, a full range of motion should return. In some cases, surgery may be recommended to help stabilize the shoulder. The procedure may involve cutting stretched ligaments and tendons. Prevention of Recurring Injury: Avoid situations in which another injury could occur. Wear layers of clothing or padding to help cushion any fall that may be likely. Use weights and exercises advised by a trainer or physical therapist to strengthen muscles in the shoulder region. Muscle-strengthening exercises also help strengthen ligaments and tendons. Use an ice pack to reduce any swelling, then a heating pad to aid recovery. (Heat treatments help to enlarge the small blood vessels in and around the injured area, thus increasing blood circulation.) See Your Physician: The first time a dislocation occurs, for rehabilitation and treatment to prevent recurrence. 

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Travel Planning | Outdoor Sports Injuries Prevention and Treatment

WHAT IS SWIMMERS SHOULDER  HOW DOES THE SHOULDER WORK? The shoulder is a complex ball-and-socket like joint consisting of three main bones -the humerus (the upper part of the upper arm bone), the clavicle (the collarbone), and the scapula (or shoulder blade, the largest bone in the chest-shoulder region). The humerus forms the ball in the ball-and-socket-like joint and is attached by ligaments -connective tissue-to the scapula. Bursas -fluid-filled sacs or saclike cavities- surround and cushion the bones and allow for movement. Muscles, including the trapezius, deltoid, pectorals, and latissimus dorsi, travel over, under, and around the shoulder joint and add stability. Tendons (also connective tissue) connect these muscles to bone. What the Shoulder Does: The shoulder allows movement of the hand and arm in space. WHAT IS SWIMMER'S SHOULDER? Swimmer’s shoulder is a strain and, sometimes, a microtear, in the supraspinatus muscle that lies on top of the shoulder between the neck and the top of the arm. It also can be a strain or tear, called an impingement syndrome, in the rotator cuff-an intertwined unit of muscles and tendons that surrounds and gives stability to the shoulder at the ball-socket joint. When trauma occurs to the rotator cuff, it may swell and “impinge” upon or rub against bone, causing pain. Cause of Injury: The injury is usually associated with a repetitive motion over time. In swimming it also can be caused by an increase in distance or speed, or both, or by an improper swimming stroke. Other sports that can cause swimmer’s shoulder: the baseball pitch, the football pass, the tennis serve, racquetball, volleyball, basketball, golf, sailing, canoeing, kayaking, javelin throw, shot put, weight lifting, and rock climbing. Other activities that may cause swimmer’s shoulder: construction work, factory work, and other kinds of manual labor (painting, plastering, or housework); any prolonged activity in which the arm is extended above the head. Symptoms: Pain on top and in the front of the shoulder. Pain in the shoulder at night. Pain and weakness when extending the arm forward or upward. You may feel as if you have a painful “bitch” in the shoulder. Sharp pain and limitation of motion in the shoulder joint (rotator cuff). Immediate Treatment: If the arm cannot be extended above the head, if the arm cannot be moved at all (“frozen shoulder”), or if there is a sharp pain and weakness where the arm connects to the trunk of the body, see your physician to determine proper treatment. Stop the activity that is causing the pain. Place an ice pack on the shoulder as soon as possible. Cold treatments help stop internal bleeding and the accumulation of fluids in and around the injured area, thus decreasing swelling. Medication: (If you have seen your physician, follow his or her advice.) Take aspirin, ibuprofen, or acetaminophen regularly to relieve pain and inflammation. Your physician may prescribe another mild analgesic (pain reliever) to help reduce pain or a nonsteroidal anti-inflammatory drug (NSAID) to help reduce pain and swelling, In some instances, your physician may suggest a low-dose injection of a corticosteroid or “steroid” drug, such as cortisone, that will help reduce inflammation. TRAINING TIPS: Acetaminophen may not contain as much of the anti inflammatory agents as aspirin or ibuprofen. Ask your physician or pharmacist for guidance. WARNING: Do not give aspirin to children under the age of 16. If pregnant or nursing, consult with your physician first before taking any medication. Continued Care: Rest the arm for approximately 4 to 8 weeks. Use an ice pack for 2 to 4 days after ceasing the activity to reduce swelling and inflammation. Use a heating pad thereafter. Heat treatments help to enlarge the small blood vessels in and around the injured area, thus increasing blood circulation. (Blood carries vital nutrients to the injury and helps speed recovery.) TRAINING TIP: Heat should be applied only after swelling has subsided, or swelling in the injured area may increase. Do not engage in original activity until the pain has subsided. Ease into limited muscle workouts: gradually swing your arm as if throwing a ball, work with light weights, and work with a trainer or physical therapist on light shoulder exercises that use and strengthen the supraspinatus muscle. Use an ice pack to help reduce any swelling that may recur, then a heating pad to help repair the injury. Medication: Take aspirin, ibuprofen, or acetaminophen to help reduce pain and inflammation. Long-Term Effects of Injury: None, with proper treatment and rest, although some individuals may suffer recurring pain even with precautionary measures (see below). In rare cases, surgery may be recommended to remove scar tissue and bone from the rotator cuff area. Prevention of Recurring Injury: Allow plenty of time for healing. Use weights and exercises advised by a trainer or physical therapist. These measures may have to be employed throughout a lifetime to avoid or reduce pain. Obtain the advice of a swimming instructor or baseball or football coach on proper technique. Use an ice pack to reduce swelling, then a heating pad to aid recovery. See Your Physician: If pain continues, is severe, or limits motion in the shoulder.

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Italy Travel Planning | Outdoor Sports Injuries Prevention and Treatment

SHOULDER SEPARATION How Does The Shoulder Work? The shoulder is a complex ball-and-socketlike joint consisting of three main bones -the humerus (the upper part of the upper arm bone), the clavicle (the collarbone), and the scapula (or shoulder blade, the largest bone in the chest-shoulder region). The humerus forms the ball in the ball-and-socket-like joint and is attached by ligaments -connective tissue- to the scapula. Bursas -fluid-filled sacs or saclike cavities-surround and cushion the bones and allow for movement. Muscles, including the trapezius, deltoid, pectorals, and latissimus dorsi, travel over, under, and around the shoulder joint and add stability. Tendons (also connective tissue) connect these muscles to bone. What the Shoulder Does: The shoulder allows movement of the hand and arm in space. What the Injury Is: A shoulder separation occurs when ligaments that hold the collarbone to the shoulder blade are torn. The collarbone also may be pushed out of alignment. Cause: The injury occurs from a traumatic event, as in a blow to or a fall on the shoulder area. It can also result from falling on your outstretched hand or arm. It is very common in contact sports, especially football. Other sports in which the injury may occur: downhill skiing, lacrosse, hockey, volleyball, rugby, and soccer. Symptoms: Severe pain at the moment the injury occurs. Limited movement in the shoulder area. Swelling, bruising, and internal bleeding. The shoulder may look malformed. Immediate Treatment: Use an ice pack, if possible, as soon as the injury occurs. Cold treatments help stop internal bleeding and the accumulation of fluids in and around the injured area, thus decreasing swelling. Seek medical treatment at a physician’s office or hospital emergency room at once. The injury should not be treated without professional medical attention. The shoulder will be put in a sling or wrapped to immobilize the area and aid recovery. Medication: First, follow the advice of your physician. You may be given a pain-relieving drug, such as codeine with aspirin or acetaminophen. You may also be given a nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and swelling. WARNING: Do not give aspirin to children under the age of 16. If pregnant or nursing, consult with your physician first before taking any medication. Continued Care: Avoid participation in sports until the injury has healed. Depending on its severity, the injury may take 2 to 10 weeks to heal. With your physician’s okay, work with a trainer or physical therapist to strengthen muscles in the shoulder region. Medication: First, follow your physician’s advice. Take aspirin, ibuprofen, or acetaminophen to help reduce pain and inflammation. NOTE: Acetaminophen may not contain as much of the anti inflammatory agents as aspirin or ibuprofen. Ask your physician or pharmacist for guidance. Long-Term Effects of Injury: There may be no lasting effects from the injury. In some individuals, however, stiffness or limitation of motion in the shoulder area may occur. In severe cases, surgery may be necessary to remove damaged tissue and to repair ligaments. Prevention of Recurring Injury: Avoid situations in which another injury could occur. Wear layers of clothing or padding to help cushion any fall that may be likely. Use weights and exercises advised by a trainer or physical therapist to strengthen muscles in the shoulder region. Muscle-strengthening exercises also hel strengthen ligaments and tendons. Use an ice pack to reduce swelling, then a heating pad to aid recovery. (Heat treatments help to enlarge the small blood vessels in and around the injured area, thus increasing blood circulation.) See Your Physician: If pain and swelling reappear and limit motion in the shoulder.

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DEALING WITH ILLNESS AND INJURIES DURING YOUR TRAVEL

Travel is one of the great freedoms in life.  But many times simple illness or minor injury can ruin our day.  When we are in the Outdoors or in a forgein country it is important to have a better understanding of First Aid and Preventive Medicine.  Not knowing the local EMS numbers or even how to procure medicines can create havoc on our travel plans.  As well simple issues can quickly turn into major medical issues, that could have been avoided, with proper training and prep.

Basic Treatment Protocols for possible medical issues in the Outdoors

• Abdominal Illness and Injury
• Allergic and Anaphylaxis Shock
• Altitude Illnesses
• Cardic Emergencies
• Chest Injuries
• First Aid for Burns