Rosh Emergency Medicine Practice Test

What is the typical mechanism of injury for a patient who has shoulder pain after being tackled during a football throw?

1. A. Axial loading of an adducted and internally rotated arm

2. B. Blow to an abducted, externally rotated, and extended arm

3. C. Forced hyperabduction of the arm

4. D. Forceful contractions due to seizure activity

The correct answer is: B. Blow to an abducted, externally rotated, and extended arm

The mechanism of injury described in the context of shoulder pain after being tackled during a football throw typically involves a blow to an abducted, externally rotated, and extended arm. This position is commonly encountered in football when a player attempts to throw the ball, and as they are tackled, the shoulder can be subjected to significant forces. When the arm is in an abducted position, it is away from the body, and if it is also externally rotated, this increases the vulnerability of the shoulder joint, particularly the glenohumeral joint. A tackle that impacts this position can lead to injury mechanisms such as shoulder dislocation, rotator cuff tears, or labral injuries. The combination of force applied to this specific arm position during a tackle is crucial in understanding how common shoulder injuries occur in athletes. In this scenario, the engagement of the arm in an externally rotated and abducted position can place added strain on the ligaments and muscular structures supporting the shoulder. Consequently, the described mechanism aligns well with injuries sustained during sports activities, particularly in contact sports like football where such tackles are frequent.