Shoulder Sprain

Definition

A shoulder sprain is stretching or tearing of the ligaments that stabilize the shoulder. Ligaments are strong bands of tissue that cross joints and connect bones to each other.

Capsule of Glenohumeral Joint

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Causes

Shoulder sprains may be caused by:

• Falling on an outstretched arm
• Forced twisting of the arm
• A blow to the shoulder
• Overuse or repetitive movement of the shoulder joint

Risk Factors

Factors that may increase your risk of a shoulder sprain include:

• Playing sports, such as swimming, volleyball, baseball, gymnastics, and tennis
• Occupations that involve:
  • Repetitive shoulder movements, including heavy lifting
  • Lifting at or above the height of your shoulder
  • Vibration of the shoulder
  • Irregular posture or movements
• Poor coordination
• Poor balance
• Inadequate flexibility and strength in muscles and ligaments
• Loose joints or connective tissue disorders

Symptoms

Shoulder sprain may cause:

• Pain, tenderness, and swelling around the shoulder
• Redness, warmth, or bruising around the shoulder
• Limited ability to move the shoulder and increased pain with movement

Diagnosis

You will be asked about your symptoms and how you injured your shoulder. The stability of your shoulder joint and the severity of the injury will be assessed.

Tests may include:

• X-rays
• MRI scan
• Arthrogram

Shoulder sprains are graded according to their severity:

• Grade 1—Some stretching with micro-tearing of ligament tissue
• Grade 2—Partial tearing of ligament tissue
• Grade 3—Complete tearing of ligament tissue

Treatment

Treatment includes:

Acute Care

Rest

The shoulder will need time to heal. Activities that cause pain or put extra stress on the shoulder should be avoided.

Cold

Ice may help decrease swelling and pain in the first few days after the injury.

Pain Relief Medications

To manage pain, your doctor may advise:

• Over-the-counter pain relievers, such as ibuprofen
• Topical pain medication—creams or patches that are applied to the skin
• Prescription pain relievers

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Recovery

Extra support may be needed to help protect, support, and keep the shoulder in line while it heals. Supportive steps may include:

• Brace or sling—A brace may be needed to keep the shoulder still as it heals. Do not return to activities or sports until your doctor gives you permission to do so.
• Rehabilitation exercises—Begin exercises to restore flexibility, range of motion, and strength in your shoulder as recommended by your doctor or physical therapist.
• Surgery—Surgery is rarely needed to repair a mild shoulder sprain without instability or dysfunction. However, in athletes earlier surgery may be considered to avoid recurrent injury.

Prevention

Shoulder sprains may not always be preventable. There are steps you can take to reduce your chance of getting a shoulder sprain. These include:

• Wearing protective equipment and using proper technique while playing sports
• Keeping shoulders, back, and chest strong with regular exercises to absorb the energy of sudden physical stress