Traumatic shoulder injuries are common. They can range from soft tissue tears to dislocations and fractures. The scenarios for such traumatic injuries can vary from a collision on the football field—which may dislocate the collar bone—to a high-speed car accident that can fracture the ball or the shoulder joint socket.
While a shoulder doctor can treat most injuries conservatively with positive long-term results, some high-impact trauma fractures are unlikely to heal by themselves. They are better treated with surgery because they carry a high risk of shoulder arthritis if left unattended.
This blog article covers different types of shoulder injuries, their causes, and shoulder pain treatments that can help you heal.
Anatomy of the Shoulder
The shoulder is a highly mobile and powerful joint made up of the scapula (shoulder blade), clavicle (collar bone), and humerus (arm bone) joined together by ligaments, tendons, and muscles that help the arm function properly with speed and precision.
Layers of soft tissue cover the bones of the shoulder, the top layer being the deltoid muscle, which helps extend your arms overhead, and underneath that is a fluid-filled sac called the subdeltoid bursa.
Your shoulder has three ligaments:
Most shoulder injuries affect your glenohumeral ligament. It is comprised of a ball (humerus) on a ball-shaped joint (glenoid).
Fractures of the shoulder typically involve issues with the clavicle, top of the upper arm bone, or shoulder blade. Upper arm or clavicle fractures are usually caused by a direct blow to the area from an accidental fall, impact, or vehicular accident.
Shoulder blade fractures are uncommon because shoulder blades have good protection from your chest and surrounding muscles. Therefore, only very high-impact trauma, like a high-speed car accident, can cause a scapula fracture.
Fractures can be displaced or non-displaced, but most shoulder fractures are generally non-displaced, which means that the broken pieces lie very near their actual anatomic position and are, therefore, easier to fix.
Bone fractures can naturally heal when immobilized in a sling in about six weeks. Shoulder fractures that are displaced do require some manipulation to restore normalcy.
When bones on opposite sides of the joint don’t align properly, dislocations occur. Shoulder dislocations can involve the collar bone joint (called a “separated shoulder”) or the connection between the collarbone and the breastbone. Finally, the ball and socket joint of the shoulder. The glenohumeral joint can be dislocated toward the front (anteriorly) or the back (posteriorly).
A fall or direct blow to the shoulder is a common cause of shoulder injuries. It can forcefully twist the arm outward (exterior rotation) and cause an anterior shoulder dislocation. Posterior dislocations of the shoulder are less common and may happen from seizures or electric shocks when the frontal muscles of the shoulder tighten and contract forcefully.
Sometimes, when the shoulder is fractured, there may also be soft-tissue injuries, such as tears of the ligaments, tendons, or muscles, rotator cuff injuries, or labral tears. These are extremely painful and can further complicate treatment.
General Symptoms of Shoulder Injuries
Signs of shoulder injuries vary based on the type and severity of the injury, but some common symptoms include:
Swelling, Tenderness, and Bruising
Inability to Move the Arm Without Feeling Pain
Signs of Deformity or Bump at the Site of the Fracture
Grinding Sensation on Any Shoulder Movement
Shoulder Fracture Symptoms
Swelling at the Site of Injury, Such as Collarbone or Shoulder
Severe Pain and Bruising
Visible Lump Under the Skin at the Fracture Location
Shoulder Range of Motion Is Very Limited
Shoulder Separation Signs
Severe Pain Over the Top of the Shoulder
A Bulge at the Top of the Shoulder
Feeling Something Sticking Up on the Shoulder
Symptoms of Shoulder Dislocation
Swelling and Lump at the Front of the Shoulder
No Arm Movement Possible
An Arm Rotated Outward
No Sensation Along the Affected Arm or Feeling of a Dead Arm
How to Treat Shoulder Injuries
Injuries to the shoulder are usually diagnosed with X-rays of the area and by physical examination. Sometimes, your shoulder doctor may use additional imaging techniques to develop a treatment plan for you.
Examples of conservative treatments that your doctor might recommend:
Immobilization in a Sling or Shoulder Immobilizer
Prescription Pain Medications Until the Injury Heals Enough to Allow Movement
NSAIDs (Advil, Aleve) for Pain Control
When Surgery Is Needed
X-rays will determine if there are additional injuries and if sufficient healing has occurred to start motion exercises.
Surgery is recommended for shoulder injuries only in the case of compound fracture, where the bone has been dislodged entirely from its place or if bone fragments have been displaced.
Surgery will typically involve fixing the fracture with plates, screws, rods, or pins in the bone. When you break the ball of your upper arm, a shoulder doctor may recommend shoulder replacement surgery.
With the guidance of an experienced orthopedic surgeon, full recovery is possible until the shoulder regains motion and function.
Following surgery for most shoulder injuries, there may be stiffness in the shoulder. Your doctor may recommend physical therapy to strengthen your muscles and help increase mobility.
Your shoulder doctor and therapist will work together to get you on the path of recovery and advise you on when to progress your activities and exercises to improve your outcome.
Trust the Shoulder Experts at IBJI
If you are experiencing shoulder pain, contact an orthopedic shoulder specialist who will evaluate your shoulder pain causes and develop a shoulder care plan to help you feel better.
This blog post is for general information and educational purposes only regarding musculoskeletal conditions. The information provided does not constitute the practice of medicine or other healthcare professional services, including giving medical advice, and no doctor-patient relationship is formed. Readers with musculoskeletal conditions should seek the advice of their healthcare professionals without delay for any condition they have. The use of the information is at the reader’s own risk. This content isn’t intended to replace the diagnosis, treatment, or medical advice from your treating healthcare professional.