A shoulder sprain is a term describing tear in the ligaments of the shoulder, most commonly involving the acromioclavicular joint.
Presentation
The clinical presentation depends on the extent of the injury, but sprains are characterized by a milder complaint such as pain and tenderness at the acromioclavicular joint [4]. It is necessary to rule out other accompanying injuries at the glenohumeral joint, as treatment may require more aggressive measures in that case [4]. The patients may complain of restricted joint mobility or even popping in the associated region.
Entire Body System
- Pain
Pain and tenderness in the shoulder can be reported by athletes and the diagnosis is made by a thorough physical examination that evaluates the pain-free range of joint motion. [symptoma.com]
Always seek medical advice if pain is severe or you are in any doubt. [sportsinjuryclinic.net]
Pain Relief Medicines To manage pain, your doctor may advise: Over-the-counter pain medicine, such as ibuprofen Topical pain medicine—creams or patches that are put on the skin Prescription pain medicine Note: Aspirin is not advised for children with [health.cvs.com]
You have symptoms of infection, including red, warm, painful skin or a fever over 100°F (38°C). The pain does not go away after several weeks. [mountsinai.org]
- Falling
Injury to this joint can occur from a collision, falling on an outstretched arm, falling on the tip of the shoulder or another player falling onto your shoulder. Certain types of injuries to the SC joint can be very dangerous. [web.eccrsd.us]
The cause of shoulder sprains stems from a direct blow to this part of the body, most commonly during high-contact sports such as ice hockey, rugby, or American football, while falling on the shoulder may also be a mode of injury. [symptoma.com]
A direct fall onto the shoulder is the most common cause of injury. When such a fall or direct blow to the area occurs, the ligaments that surround and help to stabilize the AC joint become injured. [angieslist.com]
It is usually caused by a fall onto an outstretched arm and can range in severity from mild to a complete tear of the ligament. [sportsinjuryclinic.net]
- Swelling
Swelling may be visible over the front of the shoulder joint. [sportsinjuryclinic.net]
Symptoms Symptoms of a sprain include: Joint pain or muscle pain Swelling Joint stiffness Discoloration of the skin, especially bruising First Aid First aid steps include: Apply ice right away to reduce swelling. Wrap the ice in cloth. [mountsinai.org]
Ice : Wrap an ice pack with a towel and apply it on your injury for 15 to 20 minutes to reduce the pain and swelling. Do this step once every hour for at least three times a day. Compression : Compressing the shoulder helps to reduce swelling. [orthopaedics.com.sg]
A sling is sometimes given to people to help take the weight off of the shoulder and a doctor may prescribe you painkillers to help with the pain and swelling. [londonorthopaedic.com]
- Weakness
Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness. [northshore.org]
If he can’t, Ray-Ray Armstrong would start at weak-side linebacker. If Bowman doesn’t play, Brock Coyle would start at middle linebacker. [sacbee.com]
Your arm or hand is weak or numb. Common Injuries Dislocation. If your shoulder is pulled back too hard or rotated too far, the top of your arm might pop out of its socket. You will feel pain and weakness in your shoulder. [webmd.com]
He will also move the injured shoulder to determine areas of pain, instability and weakness. [drjeffpadaleckimd.com]
A doctor will also perform an examination, checking for signs of neural or vascular injury such as numbness, tingling, weakness or a reduced pulse in the arm. [sportsinjuryclinic.net]
- Severe Pain
Always seek medical advice if pain is severe or you are in any doubt. [sportsinjuryclinic.net]
Depending on the severity of the injury, there may be mild to severe pain along with a notable deformity in the shoulder area. For mild to moderate cases, treatment may involve icing the area, using a sling, and resting until symptoms improve. [angieslist.com]
It can range from a mild discomfort to a very severe pain. This pain is normally located in the front of the joint, near the pectoral muscle. [londonorthopaedic.com]
Gastrointestinal
- Vomiting
Nausea or vomiting. Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. Lightheadedness or sudden weakness. A fast or irregular heartbeat. [northshore.org]
Musculoskeletal
- Shoulder Pain
Ranging from a small sprain causing minimal shoulder pain to a severe sprain causing extreme pain, instability and deformity, a shoulder sprain in the AC joint can lead to a variety of symptoms. [drjeffpadaleckimd.com]
You can usually do things to ease shoulder pain yourself. See a GP if it does not start feeling better after 2 weeks. How to ease shoulder pain yourself You usually need to do these things for 2 weeks before shoulder pain starts to ease. [nhs.uk]
Shoulder dislocations are characterised by severe shoulder pain and hospital treatment is required to restore normal shoulder anatomy. [physioroom.com]
[…] and needles Recovery from shoulder pain can normally take two to six weeks, and minor examples of shoulder pain can often be treated at home. [physicool.co.uk]
- Frozen Shoulder
A popping or clicking noise when moving the shoulder. Frozen Shoulder The signs and symptoms of a frozen shoulder include: Stiffness in the joint. Tightness. Unable to lift the arm. Fracture The signs and symptoms of a fracture include: Severe pain. [niams.nih.gov]
Frozen shoulder most often occurs as a result of immobility following a shoulder injury. [aafp.org]
COMMON SHOULDER INJURIES Some of the most common shoulder injuries our products can help you with include: Frozen shoulder Shoulder tendonitis Shoulder bursitis Shoulder impingement Recovery from shoulder surgery Shoulder strains Shoulder sprains [physicool.co.uk]
Sometimes shoulder joint tears, rotator cuff tears and frozen shoulder don’t improve with rest and medicine. Your doctor may recommend surgery. [webmd.com]
Frozen shoulder can affect people with diabetes, thyroid disease, heart disease, or Parkinson disease. It can also happen if the shoulder has been immobile for a period of time. [urmc.rochester.edu]
- Joint Dislocation
Belgian Tom Boonen crashed out of stage 1 at Paris-Nice on Monday and was diagnosed with a left acromioclavicular (AC) joint dislocation in his shoulder, after examinations were performed immediately at Centre Hospitalier in Blois. [velonews.competitor.com]
The degree of damage to the joint is classified by the joint displacement and injury to the ligaments which support the AC joint.: Grade 1 Grade 2 AC joint sprain AC joint ligaments torn only Grade 3 Grade 4 100% dislocation clavicle dislocated backwards [shoulderdoc.co.uk]
An anterior, or forward dislocation is more common, however, a posterior or backwards dislocation presents significant danger. All SC joint injuries should be evaluated by the athletic trainer and/or a physician. [web.eccrsd.us]
The shoulder dislocation (more accurately termed a glenohumeral joint dislocation ) involves separation of the humerus from the glenoid of the scapula at the glenohumeral joint. This article contains a general discussion on shoulder dislocation. [radiopaedia.org]
- Stiffness of the Shoulder
Symptoms & Types A shoulder sprain will usually lead to 1 or more of the following symptoms: Pain and stiffness in the shoulder Inability to rotate the arm in all the normal positions Lack of strength in the shoulder to carry out daily activities Presence [texaschildrens.org]
In minor cases of an AC joint sprain, patients may be able to continue activity only to experience an increase in pain, swelling and stiffness in the shoulder after activity with rest (particularly first thing in the morning). [physioadvisor.com.au]
- Contusion
Deltoid muscle strain / contusion Contusions are caused by a direct impact to the muscles, usually from a hard, blunt object such as a hard ball or an opponents elbow! [sportsinjuryclinic.net]
Millsap suffered a right shoulder contusion and mild sprain during Saturday’s game against the Nets. He will miss the next two games – versus the Suns Tuesday and at the Nets Wednesday – and will be re-evaluated. [ajc.com]
X-rays on Davis' shoulder came back negative on Saturday and the team initially listed Davis' injury as a right shoulder contusion. But Pelicans coach Monty Williams said Davis would undergo a more extensive medical evaluation on Sunday. [nola.com]
Neurologic
- Dizziness
Feeling very dizzy or lightheaded, like you may pass out. Feeling very weak or having trouble standing. Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions. [northshore.org]
BACK TO TEXT Mayo Clinic : post-concusion “a complex disorder in which various symptoms — such as headaches and dizziness — last for weeks and sometimes months after the injury that caused the concussion.In fact, the risk of post-concussion syndrome doesn't [painscience.com]
Workup
A detailed physical examination is the most important step during workup. Bedside stress testing (crossover test, acromioclavicular joint compression) evaluates passive joint movement beyond the normal range of motion, and reports of pain during the exam makes the diagnosis rather straightforward [2] [3]. Additionally, the Bell-van Riet test, which examines the ability of the patient to maintain the arm in the adduced and elevated position against resistance, was shown to be highly sensitive in the setting of acromioclavicular joint involvement [6].
Treatment
Shoulder sprain rarely requires surgical treatment and symptomatic relief consisting of ice compression, non-steroidal anti-inflammatory drugs (NSAIDs) and the use of a sling for a period of one to three weeks is usually sufficient [1]. Once the pain subsides, exercises that strengthen the shoulder joint and improve the range of motion are detrimental in the rehabilitation process [1]. Some individuals may report clicking and pain when performing specific exercises (eg. push ups), which is why a carefully-designed recovery is imperative in restoring the complete function of the shoulder [1].
Prognosis
Shoulder sprains are considered to be a mild form of injury and the number of days lost to injury was around 10 days in isolated reports [5].
Etiology
Epidemiology
Due to the anatomical structure of the glenohumeral joint, it possesses an extended range of mobility compared to other joints in the body, but it is also more prone to injury, and sprains are particularly common in the athletic population [5]. Shoulder injuries appear at a rate of 9.2 per 1000 person-years, of which 89% were sprains and a significantly higher number of injuries were encountered among male athletes compared to female [5].
Pathophysiology
Direct blow to the shoulder joint seen in high-contact sports causes injury to the ligamental structures that provide stability, resulting in tears of acromioclavicular and/or coracoclavicular ligaments (sprains).
Prevention
Use of a protective foam under the athlete's shoulder pads as a mean of attenuating impact during contact has been recommended by certain authors [3], and a similar principle may be applied in American football and other contact sports.
Summary
Sprains are defined as ligamental tears and shoulder sprain is a term denoting tears in the ligaments that provide structural stability to the shoulder joint, most commonly the acromioclavicular and coracoclavicular ligaments [1] [2]. Direct hit on the acromioclavicular joint (ACJ) or a direct blow to the shoulder in contact sports such as ice hockey, rugby, and American football are the most important causes of shoulder sprains [3] [4], with significantly higher numbers observed in male athletes compared to female [5]. The clinical presentation varies on the presence of other accompanying injuries (clavicular or humeral fracture, glenohumeral dislocation, rotator cuff tears, etc) [1], but pain and tenderness of the acromioclavicular joint is characteristic for shoulder sprain, which is considered to be a milder form of shoulder injury if encountered as an isolated finding [2] [5]. The diagnosis is made by a careful physical examination that includes bedside stress testing, whereas positive history for recent trauma to the shoulder and imaging studies such as radiography are used for confirmation [2]. Treatment depends on the extent of the injury, but shoulder sprains are effectively managed by rest, ice compression, use of slings and proper rehabilitation [1] [2].
Patient Information
Shoulder injuries are common among athletes and a shoulder sprain is a term describing a tear of ligaments, the structures that provide stability to all joints in the body, including the shoulder. The cause of shoulder sprains stems from a direct blow to this part of the body, most commonly during high-contact sports such as ice hockey, rugby, or American football, while falling on the shoulder may also be a mode of injury. Pain and tenderness in the shoulder can be reported by athletes and the diagnosis is made by a thorough physical examination that evaluates the pain-free range of joint motion. Shoulder sprains are considered to be a milder form of injury, and symptomatic relief through the use of non-steroidal anti-inflammatory drugs, bed rest, and ice compression, coupled with restriction of movement for a short duration of time using a shoulder sling is sufficient. Proper rehabilitation is necessary, however, as incompletely healed injuries may cause chronic problems.
References
- Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician. 2004;70(10):1947-1954.
- Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
- Wolfinger CR, Davenport TE. Physical Therapy Management of Ice Hockey Athletes: From the rink to the clinic and back. Int J Sports Phys Ther. 2016;11(3):482-495.
- Warth RJ, Martetschläger F, Gaskill TR, Millett PJ. Acromioclavicular joint separations. Curr Rev Musculoskelet Med. 2013;6(1):71-78.
- Pallis M, Cameron KL, Svoboda SJ, Owens BD. Epidemiology of acromioclavicular joint injury in young athletes. Am J Sports Med. 2012;40(9):2072-2077.
- Woodward TW, Best TM. Clinical evaluation of acromioclavicular joint pathology: sensitivity of a new test. J Shoulder Elbow Surg. 2011;20(1):73-76.