Probably due to the process of degeneration occurring within the tendon due to aging or repetitive minor overloading (tendinitis). These injuries occur suddenly with rapid overloading.

Pain over the outer part of the shoulder, usually with lifting the arm out to the side, with activity above shoulder height and while sleeping on the affected shoulder. Weakness moving the arm sideways away from the body. Tenderness over the outer aspect of the shoulder.

Normally respond well to resting from aggravating activity, stretching and physiotherapy. If not treated, scarring will develop, leading to further problems. If one of the tendons has ruptured completely, then surgery is often indicated.

Usually follows a mild injury to the shoulder. Repetitive overloading or faulty biomechanics (due to muscle imbalance) may cause local degeneration. Common in tennis and squash where an overhead activity is required.

Continuous aching both at rest and with movements. Aggravated by lying on the affected side and moving the arm sideways away from the body.

Complete rest. Anti-inflammatory medication and local electrotherapy (ultrasound) to the area of calcification. Cortico-steroid injections with local anaesthetic can help in some cases.

Repetitive overloading causes micro-tearing of the supraspinatus tendon. Faulty biomechanics or a muscle imbalance may predispose this tendon to injury. Impingement of the tendon reduces its blood supply and causes further degeneration. It is aggravated by the aging process. More common in overhead sports e.g. squash, tennis and swimming (freestyle and butterfly).

Pain over the outer aspect of the shoulder especially with movement to the side (normally in an arc between 70( and 120() and movement above shoulder height. Pain may radiate a short distance down the side of the arm. Pain while lying on the affected shoulder.

Rest from aggravating activity, application of ice and elecrotherapeutic modalities and anti-inflammatory medication. If the above treatment regime fails, cortico-steroid injections may be indicated. Acupuncture is often helpful. Prevent reoccurrence by correcting shoulder instability, muscle imbalances, soft tissue tightness, faulty biomechanics and training errors.

Most cases come from a fall on the tip of the shoulder. Severity of the injury depends on the extent of damage to the supporting structures of the joint, comprising ligaments and the capsule.

Symptoms: Acute pain following a fall on the tip of the shoulder. Pain is considerably increased by movements of the shoulder. There may be a visible deformity on the crest of the shoulder. Localised tenderness.

Icing, anti-inflammatory medication, rest and immobilisation in a sling. As pain subsides the sling should be removed and the shoulder should be mobilised in the pain-free range. Progressive muscle strengthening is essential. Surgery is usually not necessary but may be an option for aesthetic reasons.

Usually results from a fall on the outstretched hand or on the tip of the shoulder.

If you suspect that you have fractured your clavicle, you should consult a doctor immediately. The fracture must be reduced (the bone straightened) and maintained with a splint. Anti-inflammatories and analgesics will help with the swelling and pain respectively. Surgery may be needed for severe or multiple fractures.