Upper Limb

The shoulder, elbow and wrist all work together with a common goal, to help position the hand where you need it to be. It doesn’t matter if this is going for a volley in tennis, or typing on a keyboard, the interaction between these three joints is vital in allowing us to do what we need and want to do. Due to the different requirements of each of these joints the pathologies and pain that affects them is quite variable.

The Shoulder

The shoulder is prone to both traumatic injuries (eg: sustained during sport or an accident), as well as the wear and tear problems that a lifetime of use bring. Common shoulder pathologies include:
Rotator cuff injury (a group of four muscles that help to stabilise the shoulder joint)
Bursitis (inflammation of the bursa in the shoulder, a fluid filed sack that acts as a spacer between bones and tendons)
Adhesive capsulitis: commonly called frozen shoulder, it is a complaint that takes time to develop with no strongly identifiable cause. It can be quite painful and also restrict movement.
Dislocation and Subluxation: usually the result of a significant trauma, this occurs when the joint integrity between your arm and shoulder is compromised and the arm is pulled from the shoulder joint.
Postsurgical rehabilitation: if conservative treatment is non-sufficient for the above mentioned conditions surgery may be required, as such rehabilitation post-surgery is a must for optimal shoulder function.
Referred pain from the neck can be felt in the shoulder and cause significant pain if not treated.
Scapula (shoulder blade) dysfunction that can result in subsequent problems such as postural neck pain and should injury. The dysfunction generally comes from poor positioning of the scapula, which is often a result of muscle weakness or a postural compensation method.

The Elbow

The elbow is more prone to injuries of overuse with the two most common complaints: lateral epicondylalgia (tennis elbow) and medial epicondylalgia (golfers elbow). It is important to note that you do not need to play tennis or golf to suffer from these injuries, with golfers suffering a lot more tennis elbow than golfers elbow.

The Wrist

The wrist is a very complex joint, with more than ¼ of all the bones in your body contained within your hands and wrist. Due to the complexity of the wrist joint it can be prone to multiple pathologies. The most common of these consisting of:
Fracture Rehabilitation post fall or trauma
Osteoarthritis care: the most common joint is the thumbs attachment to the palm
Carpel tunnel syndrome
de Quervain’s tenosynovitis.

Treatment and progression from an injury

With such a wide variety of potential injuries that can occur in the upper limb and such a variety of causes it is important to consider what can be done to try and prevent upper limb damage. The main points to consider involve ensuring that whatever activity you are undertaking is done safely.
Always remember to try and limit the amount of force that you will pass through any of these joints and the position that these joints are in when you are loading them. If you are lifting something try to keep your elbows bent slightly, and try to not lift anything of significant load above your head.
If you do suffer a traumatic injury to any of these joints there is a very simple process to follow:

R – rest the affect area
I – apply ice to the affected area for around 20min every hour
C – try to apply a compression bandage to the area
E – if possible elevate the are slightly to prevent blood pooling
R – refer the injury to a medical or allied health professional asap
Remember that if you are scheduled to have surgery or have just had surgery the sooner you are able to begin your rehabilitation the sooner you will be back to functional activities.
Injuries of the upper limb can affect anyone at any age, with osteoporosis and osteoarthritis exacerbating factors. If you feel you may of injured your upper limb in any way, including muscular injuries it is important to have yourself assessed by a qualified physiotherapist or medical practitioner.