A shoulder sprain is a term describing tear in the ligaments of the shoulder, most commonly involving the acromioclavicular joint.
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.
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].
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].
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].
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].
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.
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].
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.