Shoulder Problems and Injuries
Shoulder Problems and Injuries
Minor shoulder problems, such as sore muscles and aches and pains,
are common. Shoulder problems develop from everyday wear and tear, overuse, or
an injury. They can also be caused by the natural process of aging.
Your shoulder joints move every time you move your arms. To better
understand shoulder problems and injuries, you may want to review the anatomy
and function of the
shoulder . The shoulder is a ball-and-socket joint with
three main bones: the upper arm bone (humerus), collarbone (clavicle), and shoulder blade (scapula). These
bones are held together by muscles,
ligaments. The shoulder joint has the greatest
range of motion of any joint in the body. Because of
this mobility, the shoulder is more likely to be injured or cause problems. The
acromioclavicular (AC) joint, which lies over the top
of the shoulder, is also easily injured.
Shoulder problems can be
minor or serious. Symptoms may include pain, swelling, numbness, tingling,
weakness, changes in temperature or color, or changes in your range of motion.
Shoulder injuries most commonly occur during sports activities, work-related
tasks, projects around the home, or falls. Home treatment often can help
relieve minor aches and pains.
Sudden (acute) injury
Injuries are the most common
cause of shoulder pain.
A sudden (acute) injury may occur from a
fall on an outstretched arm, a direct blow to the shoulder, or abnormal
twisting or bending of the shoulder. Pain may be sudden and severe. Bruising
and swelling may develop soon after the injury. If nerves or blood vessels have
been injured or pinched during the injury, the shoulder, arm, or hand may feel
numb, tingly, weak, or cold, or it may look pale or blue. Acute injuries
- Bruises (contusions ), which occur when small
blood vessels under the skin tear or rupture, often from a twist, bump, or
fall. Blood leaks into tissues under the skin and causes a black-and-blue color
that often turns purple, red, yellow, and green as the bruise
- Injuries to the tough, ropy fibers (ligaments) that
connect bone to bone and help stabilize the shoulder joints (sprains).
- Injuries to the tough, ropy
fibers that connect muscle to bone (tendons).
- Pulled muscles (strains).
- Injuries to nerves, such as
brachial plexus neuropathy.
- Separation of the shoulder, which occurs when the
outer end of the collarbone (clavicle) separates from the end (acromion) of the
shoulder blade because of torn ligaments. This injury occurs most often from a
blow to a shoulder or a fall onto a shoulder or outstretched hand or
- Damage to one or more of the four tendons that cover the
shoulder joint (torn rotator cuff), which may occur from a direct blow
to or overstretching of the tendon.
- Broken bones (fractures). A break may occur when a bone is twisted,
struck directly, or used to brace against a fall.
- Pulling or
pushing bones out of their normal relationship to the other bones that make up
the shoulder joint (subluxation or
You may not recall having a specific
injury, especially if symptoms began gradually or during everyday activities.
Overuse injuries occur when too much stress is placed on a joint or other
tissue, often by overdoing an activity or through repetition of an activity.
Overuse injuries include:
- Inflammation of the sac of fluid that cushions
and lubricates the joint area between one bone and another bone, a tendon, or
the skin (bursitis).
- Inflammation of the tough,
ropy fibers that connect muscles to bones (tendinitis).
Bicipital tendinitis is an inflammation of one of the
tendons that attach the muscle (biceps) on the front of the upper arm bone
(humerus) to the shoulder joint. The inflammation usually occurs along the
groove (bicipital groove) where the tendon passes over the humerus to attach
just above the shoulder joint.
frozen shoulder, which is a condition that limits
shoulder movement and may follow an injury.
- Overhead arm
movements, which may cause tendons to rub or scrape against a part of the
shoulder blade called the acromion. This rubbing or scraping may lead to
abrasion or inflammation of the
rotator cuff tendons (also called
Other causes of shoulder symptoms
Overuse and acute
injuries are common causes of shoulder symptoms. Less common causes of shoulder
Treatment for a shoulder injury may include
first aid measures, physical therapy, medicine, and, in some cases, surgery.
Treatment depends on:
- The location, type, and severity of the
- How long ago the injury occurred.
- Your age,
health condition, and activities, such as work, sports, or hobbies.
Check your symptoms to decide if and when
you should see a doctor.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
August 23, 2011
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