Millions of people in the United States break a bone each year, about half of which affect the arm. At the same time, approximately two million people visit their doctors for a rotator cuff problem, and osteoarthritis is the most frequent cause of disability in the nation.
Matthew Meunier, MD, sees it all. He’s an orthopedic surgeon at UC San Diego Health and associate team physician for the San Diego Padres, specializing in hand, upper extremity and microvascular surgery. In this Q&A, Meunier discusses the types of issues he treats, and how people can prevent and seek help for these conditions.
What are some common arm or shoulder issues you see in your practice?
In caring for several local teams, I treat a lot of sports-related injuries. The biggest difference I see is between baseball and football players. Football is high impact, so we see more traumatic injuries. In baseball, a new injury doesn’t usually pop up in a single game, it’s more often an injury that develops over a longer time period, due to overuse. There are a lot of games in professional baseball — 162 games over six months, which can just wear a person out.
I also see other types of active lifestyle-related injuries, such as people who fell off a bike or while skiing. Lately, as app-based rentals have become more common, we’ve also been seeing more and more scooter injuries, and they’re often pretty bad — lots of fractures and dislocations of the hands, arms and shoulders.
In the general community, I see rotator cuff tears and shoulder arthritis. Injuries to the rotator cuff — the muscles and tendons that hold the head of the upper arm bone in the shoulder socket — are usually the result of overuse, whether it’s a professional baseball player or an active older person. The human body just isn’t adapted to spending that much time using the rotator cuff, as we do in a number of sports and activities.
How can people prevent arm and shoulder issues?
The most beneficial thing a person can do is limit the amount of force they are experiencing across the shoulders. Improving shoulder flexibility and toning helps, too, as does general body fitness — losing weight can take a load off your joints.
And limiting injury now may decrease your risk of arthritis later. Half of all people in this country will experience shoulder issues at some point in their lives, even if simply due to wear and tear. But if you dislocated your shoulder, fractured a joint or tore your rotator cuff in the past that may further increase your incidence of arthritis in the future.
Is surgery the only treatment option?
What I tell friends is this: if you shop around long enough, you’ll find a surgeon who will offer you an operation. The question is, is that surgeon doing surgery to the patient instead of for them? At UC San Diego Health, having a conversation with a surgeon about options doesn’t mean you’ll have surgery. We pride ourselves on working with patients to come up with the best answer for them. Sometimes that’s surgical, but not always. We take X-rays and we talk to your referring physician, as well as our athletic trainers, physical therapists, sports medicine specialists and others, to personalize your treatment options.
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