Shoulder dislocation
Dislocated shoulder, injury of the AC joint and the instability that results from it.
Read moreSports orthopaedics in Vienna
An injury to the shoulder, elbow or hand does not only interrupt training, it affects work and everyday life too. As a specialist in orthopaedics and traumatology I establish at short notice which structure is affected, and I plan the treatment around your sport and your goals — from the first examination to the return to full load.
In short
Sports orthopaedics means assessing an injury together with the movement that caused it. My specialisation is the upper limb: shoulder, elbow, hand and wrist. Common conditions are the dislocated shoulder in contact sport, the torn pectoralis or biceps tendon in strength sport, tennis elbow from repeated striking movements, and ligament and bone injuries after a fall on the hand. I make the diagnosis through the consultation, the clinical examination and ultrasound in the practice; where needed I arrange an X-ray or an MRI. The findings decide the route: for tendon tears of the pectoralis, distal biceps or triceps, and for dislocations with persisting instability, I discuss surgery early with patients who are active in sport; afterwards, the return to sport is built up step by step.
What sports orthopaedics means for the elbow, shoulder and hand
Sports orthopaedics is less a field of its own than a way of looking at things. I always assess a finding together with the movement that led to it and with the load that should be possible again afterwards. That is why the first question is not only which structure is injured, but also what you need your elbow, shoulder and hand for.
Damage in sport arises in two ways. Either a high force acts on a joint, tendon or bone in a single moment — the fall on the outstretched hand, the tackle, the barbell that gives way. Or the same movement is repeated so often that the tendon insertion and capsule can no longer keep up; then it begins gradually with pain after training and ends with pain during it. Both routes lead back to the same questions: which structure is affected, how badly is it damaged, and what can it tolerate at present?
For the individual joints there are separate overviews — on shoulder surgery, on elbow surgery and on hand surgery.
How I make the diagnosis
At the beginning there is the detailed conversation: which movement, which load, what could be heard and felt, and what no longer worked in the days that followed? This is followed by the clinical examination in comparison with the other side — mobility, stability, strength and the specific tests for the suspected structure.
Ultrasound is available to me in the practice. It shows tendons, muscles and bursa in motion and allows an immediate comparison with the healthy side. Where needed I arrange an X-ray or an MRI; both examinations take place outside the building, and I discuss the results with you afterwards. If there is numbness or loss of strength without a clear trigger, I arrange a neurological assessment with nerve conduction studies; this takes place outside the building.
Sport
Why I ask about your sport
I was active myself for a long time in contact sport (American football), strength sport and ball sport.
That is no substitute for the findings, but it helps in the conversation: I know how a training week is structured, I know what a fixed competition date means, and I do not have to ask which movement is meant when someone talks about the bench press, a throw or a tackle.
That is why I ask early on about your sport, your training volume and your next goal. Whether a break, a change to your training or a procedure is called for can only be answered once it is clear where you want to get back to.
Typical loads by sport
Contact sport
In contact sport, external forces act on the body: tackle, fall, challenge. The shoulder is affected particularly often — it pops out of the joint, or the acromioclavicular joint (AC joint) is dislocated. At times, shoulder instability remains, noticeable with every throwing or blocking movement. Added to this are dislocation of the elbow and injuries to the hand when breaking a fall.
Strength sport
In strength sport the load is predictable but high, and it often meets the tendon in the least favourable position. If a tendon tears, it is usually close to its insertion: the pectoralis tendon rupture while lowering the barbell, the biceps tendon tear at the shoulder or elbow, and the tear of the triceps tendon at the back of the elbow. A triceps tendon tear is rare, but in strength sport it is a real issue: it occurs when pressing against high resistance or when falling onto the outstretched arm, and it is easily missed because straightening the elbow still works at first. Extensive tears I reattach to the olecranon (the tip of the elbow); small tears can more readily be treated conservatively than at the chest muscle. More common than tears are states of irritation: pain at the front of the shoulder when pressing overhead, symptoms at the tendon insertions of the elbow, pain in the wrist when supporting your weight on the hand.
Ball sport
In ball sport the same movement is repeated very often — throw, stroke, serve. That puts load on tendon insertions and the joint capsule: tennis elbow and golfer's elbow belong here just as much as rotator cuff symptoms under overhead load. Added to this are the typical fall and ball injuries of the hand and fingers, from a tear of the thumb's collateral ligament to a finger or metacarpal fracture.
Injuries
What I treat in sports orthopaedics
Each condition has its own page covering how it arises, how it is examined and how it is treated.
Pectoralis tendon rupture
Tear of the chest muscle tendon, classically during the bench press in strength sport.
Read moreBiceps tendon tear
Long head of the biceps tendon at the shoulder and distal tear at the elbow.
Read moreTennis & golfer's elbow
Irritation of the tendon insertions on the outer and inner side of the elbow.
Read moreElbow & wrist ligament injury
Instability of the elbow after dislocation, TFCC tear and SL ligament rupture at the wrist, and skier's thumb at the base of the thumb — treated arthroscopically or open.
Read moreFractures in sport
Distal radius fracture, scaphoid fracture and radial head fracture.
Distal radius fracture at a glanceTreatment: the findings decide
The findings decide which route comes first: with a tendon tear or instability after a dislocation I discuss surgery early; with bruises, strains and irritated tendon insertions I begin with relief of load and a change to your training, so that the other areas stay in motion. Physiotherapy, exercise therapy and a chiropractor are in the same building at the Orthozentrum Döbling, which keeps coordination short.
In addition, several methods are available to me in the practice: shockwave therapy in focused and radial form for symptoms at the tendon insertion, PRP therapy, the ultrasound-guided injection and magnetic field therapy. Which combination makes sense depends on the findings and the symptoms; an overview of all conservative treatments is available separately.
When an operation is necessary
In people who are active in sport, the balance between conservative and surgical treatment tips towards a procedure earlier. A tear of the pectoralis, distal biceps or triceps tendon should be reconstructed promptly, because the tendon retracts and scars — with a pectoralis tendon rupture this also applies to a partial tear. And if instability remains after a dislocation of the shoulder or elbow, I discuss stabilisation early, not only after the next dislocation. Anyone who wants to press overhead, throw or go into contact again needs a tendon that can bear load and a securely guided joint.
A complete tendon tear, recurrent instability, a displaced fracture or a joint that locks or can no longer be straightened argue for a procedure. Much of this can be treated with arthroscopic keyhole surgery: stabilisation of the shoulder, repair of the rotator cuff, refixation at the wrist and, via elbow arthroscopy, arthrolysis (the release of scarring) where movement is restricted.
I operate with an open approach where the technique calls for it — for instance for the refixation of the pectoralis tendon, for ligament reconstructions and for fractures that need a plate or screw. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. For operations, direct settlement with supplementary private insurance is possible; details are set out under procedure and billing in a private practice.
Back into sport: return to sport
The return to sport is not a date but a sequence of steps. First comes movement with little pain, then strength compared with the other side, then sport-specific movements — throwing, striking, supporting, pulling — and only at the end contact, maximum load or competition. Each step is cleared when the findings allow it.
What counts is not only what the joint can tolerate, but also whether it feels secure. A shoulder that provokes an evasive movement during the wind-up is not yet ready for contact, even if the strength values are right. Until then, an alternative form of training can almost always be built up that spares the injured region and maintains endurance and core strength.
For operated tendons and ligaments, the order also depends on the surgical findings and on how the tissue heals. I set the steps after the procedure together with you and with the physiotherapy team, and adjust them as things progress. Which route is the right one, and whether an operation comes into question at all, we decide together as soon as the findings are available.
Frequently asked
Frequently asked questions about sports orthopaedics
Quickly, if the shoulder was dislocated, if you heard a snap as it tore, if a joint is swollen after a fall and will not take load, or if strength and mobility are clearly lacking. Symptoms that persist despite a break from training should also be assessed. You will usually get an appointment within a week; for acute cases I offer times outside the regular practice hours.
No. A referral is not necessary, and you do not need to have an MRI beforehand. Please bring everything you have: your e-card, previous findings, doctors' letters as well as X-ray, CT or MRI images. Ultrasound is available to me in the practice. Whether an additional X-ray or MRI makes sense, I decide after the examination, and I then arrange it.
I specialise in injuries of the upper limb: shoulder dislocation and instability, injuries of the AC joint, rotator cuff tears, tears of the pectoralis, biceps and triceps tendons, tennis and golfer's elbow, instability and stiffness of the elbow, ligament injuries of the wrist, and fractures of the hand, wrist and elbow. Diagnosis, surgery and aftercare remain in one pair of hands.
Not every one. I treat bruises, strains and irritated tendon insertions conservatively with relief of load, physiotherapy and exercise therapy, supplemented by shockwave therapy, PRP therapy or an ultrasound-guided injection. In people active in sport, however, the balance tips towards a procedure earlier: a torn pectoralis, distal biceps or triceps tendon should be reconstructed promptly, and after a shoulder or elbow dislocation I discuss stabilisation early. Whether an operation makes sense depends on the findings and your goals; the decision is made together.
That cannot be answered in general terms, because it depends on the injury, the treatment route and how healing progresses. The build-up, however, always follows the same order: first movement with little pain, then strength, then sport-specific movements and finally contact, throwing or maximum load. Each step is cleared according to the findings, not the calendar. Until then, there is almost always an alternative form of training that spares the injured region.
Yes. What your elbow, shoulder and hand need to cope with follows from what you want to do with them again, not from your level of performance. That is why I ask about your sport, training volume, work and goals, and plan the treatment accordingly. Someone in strength sport who wants to press overhead again needs a different build-up from someone who wants to play ball without pain.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. For operations, direct settlement with supplementary private insurance is possible. Appointments are arranged by telephone from Monday to Friday between 9:00 and 16:00.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.