DR HQ: Anatomy 101—Bone Spurs

In this week’s anatomy lesson, we’ll take a look at bone spurs, with a focus on elbow and shoulder spurs.

What Are Bone Spurs?

Bone spurs (medically called osteophytes) are small bony protrusions that grow on the edge of a joint, the point at which two bones meet. These bone spurs form as a result of damage to the joint area and can hinder movement and stability, often causing pain. Athletes who participate in sports that require repetitive motion tend to be slightly more at risk; a pitcher is a good example.

Bone spurs can be found in the elbow, the shoulder, the ankle and the heel.

Heel Spurs form where the plantar fascia ligament attaches to the bottom of the heel bone (a.k.a. calcaneus). The heel spur growth is made up of calcium deposits that form when the plantar fascia pulls away from the heel. Overuse or heavy stress on the plantar fascia can cause players to be at a higher risk of developing heel spurs. The area around the spur may become inflamed causing pain, as the spur digs into sensitive nerves and tissue. It is painful when standing or walking on the inflamed area. Treatment includes, rest and oral medication to help reduce the inflammation and pain. Cortisone injections can be used to help quell the pain and swelling also. Surgery is not that common but can be used as a last resort to remove the spur.


courtesy:www.webmd.com

Ankle spurs develop in various locations in the ankle joint. They are no less painful than most heel spurs, and can be just as debilitating. The same treatment regimen for heel spurs is used for ankle spurs. Ankle spurs are more common in basketball players  and are not found in baseball players nearly as much as bone spurs in the elbow.


courtesy: http://www.eorthopod.com

Elbow spurs (a.k.a. thrower’s elbow) are usually precipitated by years of overhand activities that produce swollen bone linings that have developed spurs. Extreme forces are put on the elbow during the pitcher’s throwing motion and it’s called "valgus extension overload” in biomechanical circles.

More times than not, spurs form in the back of the elbow. If near a ligament or nerve, it can cause pain, lost of function and serious damage to that structure. Left untreated, spurs in the elbow can break off, leaving loose bodies floating in the elbow joint. This can lead to the joint locking up. Players who need arthroscopic surgery usually see successful restoration of almost all motion and the surgery usually allows a return to activities after the recovery period.

Signs of a bone spur in a pitcher include inflammation in the elbow joint. If bursitis is ruled out—which may signal a spur that is irritating the tissue in the elbow joint—then it is important to find out the cause of elbow soreness and inflammation.

The recovery from elbow bone spur surgery for pitchers is almost always a success. The pitcher can return to prior levels of performance in a very high percentage of cases.


courtesy: www.ehow.com

Shoulder spurs are explained as follows by FXRX Orthopedics (www. http://fxrxinc.com): “Shoulder bone spurs are common because of the complex nature of the shoulder. It is the only joint in the human body that can move with complete range of motion in all directions. Over time, the bones, muscles, tendons, and ligaments that make up your shoulder can wear against one another.

As these tendons move through the narrow space between the top of the shoulder and the upper arm, they can rub on the bones. Bone spurs can form in this narrow area that can lead to a pinching of the rotator cuff tendons resulting in irritation, inflammation, stiffness, weakness, pain and even a tearing of the tendon."

Symptoms typically occur when the bone spur is rubbing on other bone, muscles or tendons. This can cause irritation, inflammation and pain, which can increase over time, as the protective tissues are broken down even further. A bone spur may limit the joint's functionality, causing a compression of the soft tissues within the shoulder joint known as shoulder impingement.

Return from surgery to remove a bone spur in the shoulder is much more complex, and the success percentages is less than with elbow spurs. That’s because of the various structures that a bone spur can damage, the pitcher’s inability to regain all of the strength and range of motion before the spur developed. The bottom line is pitchers who have had surgery to remove a bone spur(s) have a tougher road to recovery. The biggest name in baseball that has undergone this type of surgery is Roy Halladay of the Phillies. It occurred in May 2013 and there is a chance he could return in September, though it is much more likely he is out for the year. He also had work done to his labrum and rotator cuff, complicating matters.

While spurs are painfully injuries, they are not career-enders but they can derail a players career for a period of time.


courtesy: www.winchesterhospitalchiro.com


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  For more information about the terms used in this article, see our Glossary Primer.