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Liverpool’s goalkeeper Alisson sustained the shoulder injury in training ahead of the trip to Villa Park – and Klopp expects the No.1 to require further assessment beyond the international break to come.

“Yesterday an incident in training, very unlucky – two players clash with each other, one gets up, one doesn’t. The one who didn’t get up was Ali,” the boss told Sky Sports pre-match.

What type of injury could Alisson have sustained?

Acromio-clavicular Joint Injury

This is a common injury in goalkeepers as they tend to jump and land on the tip of the shoulder. This is a joint above the shoulder joint. The injury can range from a simple joint sprain involving the joint capsule to a frank dislocation of the joint.

Normal Shoulder AnatomyThe symptoms include a painful swelling of this joint with difficulty lifting the involved shoulder overhead.

In a dislocation, there could be a prominence of the distal end of the collar bone (clavicle) tenting up the skin.

The various types of ACJ injuries are classified from Type I to Type VI. The common ones are type I to III.

 

 

Rockwood Classification

Shoulder Injury TypesType I and Type II injuries are usually treated symptomatically and with physiotherapy. Surgeries are generally not needed. These injuries do take a few weeks to heal. Hence Alisson might have sustained a type I or II injury to his ACJ.

Type III injuries may require surgery to reduce the joint. In these cases, the patient may take up to 3 months to recover. Alisson is unlikely to have a Type III injury as the Boss mentioned up to 6 weeks to recover.

 

Shoulder Labral Tear

The other injury to consider is a tear of the shoulder labrum.

The shoulder joint is a ball and socket joint. The ball is large while the socket is small and shallow. This allows excellent range of motions in the shoulder joint but also pre-disposes this joint to dislocations. The rim of the shoulder socket (glenoid) has a fibro-cartilage attached to it. This is called the glenoid labrum.

The glenoid labrum is typically torn at the antero-inferior attachment of the socket in frank anterior dislocation of the shoulder joint. Anterior dislocation is the commonest type of shoulder dislocation.

In some shoulder injuries especially involving falling onto the shoulder – the labrum can tear due to transient subluxation of the shoulder joint at the time of the fall. The shoulder did not dislocate but it shifted slightly out of position and popped back in. This can result in a labral tear.

Labral TearThe labral tear can result in acute pain and instability symptoms.

It can subsequently be a source of pain during movements or loading of the shoulder joint.

An MRI scan of the shoulder joint is needed to make this diagnosis.

Some patients may require keyhole surgery to repair the torn labrum.

 

 

He will likely have gotten an MRI of his injured shoulder and the results will likely determine the course of his season. Hopefully Alisson did not sustain this injury as the layoff will be much longer.

About Dr HC Chang

Dr Chang Haw Chong has over 17 years of experience as a sports orthopaedic specialist in Singapore, and has received multiple awards and accolades in the orthopaedic field.

He specialises in sports surgeries and key-hole surgeries, and his interests include allograft anatomic anterior cruciate ligament reconstructions, robotic partial knee replacements, arthroscopic treatments of hip femoro-acetabular impingements, arthroscopic treatment of tennis elbow, arthroscopic treatments of shoulder rotator cuff tear, arthroscopic treatments of shoulder dislocations, frozen shoulder treatments, ankle ligament reconstructions, herniated slipped disc treatments, hip and knee replacements.

For more information, contact our clinic here.

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