[Shoulder problems in leisure athletes: physical examination, diagnosis and therapy. Sensible procedures in daily practice].

At first sight the anatomy of the shoulder may seem simple (see Fig. 1). However, for the physician treating a patient suffering from shoulder pain, the scapulo-thoracal interplay of 5 joints and 19 muscles, providing a wide and varied range of motion, may constitute an obstacle difficult to overcome. In the leisure athlete acute injuries must be distinguished from degenerative disease. Contact sports in particular tend to involve risks of falling on the shoulder, injuring the shoulder girdle or the elbow and wrist, sometimes with major consequences: complex fractures, dislocations, ligament and tendon lesions or joint instabilities. Thorough, rapid and cost-effective diagnostic evaluation of the athlete, involving clinical examination (function tests), radiographic imaging (shoulder a.p., y-view) and in selected cases ultrasonography (compared with the other side) may be necessary in starting early and effective therapy.