Injury Guide

Shoulder Injury

Shoulder Injury

This injury guide identifies the common causes of a shoulder injury, symptoms, treatments and rehabilitation. Within this section:

Shoulder Sprains and Strains
Rotator Cuff Injury
Rotator Cuff Calcific Tendonitis
Shoulder Bursitis
Shoulder Separation

Shoulder Sprains and Strains

A shoulder sprain or strain involves an injury to the soft tissues of the shoulder. A shoulder sprain involves damage to the ligaments (the bands of tissue that connect bones together) and strains involve injuries to muscles and tendons. Injuries often happen during high-velocity or contact sports such as skiing, snowboarding, football, rugby and wrestling.

A shoulder injury usually occur around one or more of the joints that connect the four bones (the acromion, sternum, clavicle and scapula). A shoulder sprain or strain can be quite mild or at the other extreme can result in a complete tear.

Rapid and appropriate treatment is needed to ensure a quick recovery from a shoulder strain. Delayed or inappropriate management can slow down the recovery and healing process.

Physicool’s cooling and compression bandage is ideal to treat the shoulder injury and help speed up the recovery and rehabilitation process. Physicool will help reduce shoulder pain.

Causes of a shoulder sprain or shoulder strain

Most shoulder sprains and strains occur when:

  • The arm is twisted suddenly
  • There is a fall on an outstretched arm
  • There is a trauma to the arm or shoulder, particularly during contact sports

Symptoms of a shoulder sprain or shoulder strain

Symptoms of shoulder sprains and strains may include

  • Reduced mobility of the shoulder
  • Pain when trying to move the shoulder
  • Swelling around the shoulder, tenderness, redness or bruising around the shoulder

Acromioclavicular joint sprain

An acromioclavicular joint sprain is one of the most common types of shoulder injuries.

The acromioclavicular joint is supported by the acromioclavicular ligament and the coracoclavicular ligament at the outside end of the collarbone near the shoulder. They bind the shoulder blade and collarbone tightly together. It takes a lot of force to tear these ligaments. The most common causes of this type of shoulder sprain are either a strong, direct blow to the front or top part of the shoulder or trauma from a fall.

Depending on the severity of the ligament damage, acromioclavicular sprains can be classified into grades [1]:

  • Grade I — The acromioclavicular ligament is partially torn but its companion ligament, the coracoclavicular, is uninjured. There is likely to be some swelling and tenderness around the collarbone and pain when the arm is moved.
  • Grade II — The acromioclavicular ligament is completely torn and the coracoclavicular ligament is partially torn. The collarbone may appear out of place and there may be significant pain when trying to move the joint.
  • Grade III — Both the acromioclavicular ligament and the coracoclavicular ligament are completely torn, and the collarbone separation is obvious. There is likely to be considerable pain and swelling around the shoulder joint, making movement difficult.
  • Grades IV, V and VI – are potentially serious and require immediate medical assistance.

Shoulder sprain and shoulder strain treatment

Treatment for shoulder sprains and strains begins with resting the affected arm and shoulder (which may include immobilising the area with a sling or brace) and using cold therapy for the first couple of days to reduce swelling and inflammation, as well as the shoulder pain.

PRICE  (Protection, rest, ice, compression and elevation) is the most recommended approaches for the initial management of a shoulder injury. The aim is to minimise haemorrhage, swelling, inflammation and pain to help provide the best conditions for healing to take place.

The PRICE approach is recommended by NHS Choices:

  • Protection – protect the injured area from further injury – using a support bandage if appropriate.
  • Rest – stop the activity that caused the injury, and rest the injured joint or muscle. Avoid activity for the first 48 to 72 hours after injury.
  • Ice – for the first 48 to 72 hours after the injury (Pghysicool).
  • Compression – compress or bandage the injured area to limit any swelling and movement that could damage it further.
  • Elevation – keep the injured area raised and supported on a pillow to help reduce swelling.

Physicool provides the key stages of PRICE in a single reusable bandage, providing protection, cooling and compression for the shoulder injury to help the healing process. A Physicool bandage can be applied to the shoulder and the cooling effect recharged by spraying Physicool Coolant directly onto the bandage whilst it is in position.

Shoulder rehab

Following a period of rest, physical therapy exercises and rehabilitation may begin, including exercises to help build strength, flexibility and range of movement.  A healthcare professional or physiotherapist will recommend the most appropriate rehabilitation programme depending on the severity of the shoulder injury.

In severe sprains, where the shoulder is dislocated or the joint is displaced, or if a muscle strain is severe and the muscle is torn, surgery may be required.

Rotator Cuff Injury

What is rotator cuff injury?

The rotator cuff comprises a quartet of tendons and muscles that meet at the top of the humerus – the upper arm bone. Together, they form what is known as the ‘cuff’, holding the arm in place and allowing it to move freely. Despite being one of the more mobile joints, the shoulder is relatively weak – too much pressure can cause tears and swelling in the tendons of the rotator cuff.

Symptoms of rotator cuff injury

  • Mild to severe pain
  • Dull aches
  • Swelling
  • Weakness and tenderness in the shoulder
  • Difficulty performing some movement

What causes rotator cuff injury?

Sudden stress or trauma can cause a rotator cuff injury, causing the tendons to pull away from the bone or tear down the middle. Athletes susceptible to rotator cuff tears include: baseball players (especially pitchers), swimmers, tennis players, and football players.

You can get a rotator cuff tear by:

  • Falling hard on your shoulder
  • A blow to the shoulder
  • Using arms to break a fall
  • Lifting heavy weights

How to treat rotator cuff injury

  • Ice/cooling therapy (Physicool) to relieve pain and swelling
  • Painkillers and anti-inflammatories
  • Physiotherapy
  • Cortisone steroid injections

Protection, rest, ice, compression and elevation (PRICE) is one of the most recommended approaches for the management of rotator cuff injuries. The aim is to minimise haemorrhage, swelling, inflammation and pain, to provide the best conditions for healing to take place.

Physicool provides the key stages of PRICE in a single reusable bandage, providing protection, cooling and compression for the shoulder injury to help the healing process. A Physicool bandage can be applied to the shoulder and the cooling effect recharged by spraying Physicool Coolant directly onto the bandage whilst it is in position.

Rotator Cuff Calcific Tendonitis

What is rotator cuff calcific tendonitis?

Rotator cuff calcific tendonitis is the accumulation of calcium in the rotator cuff. Calcium forms in the tendon causing a build up of stress on the tendon, as well as causing irritation which leads to shoulder pain.

Symptoms of rotator cuff calcific tendonitis

Calcific tendonitis symptoms include:

  • Mild to severe pain
  • Dull aches
  • Swelling
  • Difficulty performing some movement

What causes rotator cuff calcific tendonitis?

Exactly what causes rotator cuff calcific tendonitis is not fully understood. Various theories have been put forward, including defects with blood supply and aging of the tendon – however, none of the evidence to support these theories has been proven.

How to treat rotator cuff calcific tendonitis

Treatment of calcific tendinitis involves:

  • Painkillers and anti-inflammatories
  • Physiotherapy
  • Cortisone steroid injections
  • Cooling therapy to relieve pain and swelling

Physicool provides the key stages of PRICE in a single reusable bandage, providing protection, cooling and compression for a shoulder injury to help reduce the spain and swelling. A Physicool bandage can be applied to the injury and the cooling effect recharged by spraying Physicool Coolant directly onto the bandage whilst it is in position.

Physicool is a unique cotton bandage impregnated with a patented liquid which draws heat away from the affected tissues by rapid evaporation. While the deep tissues are being cooled, the simultaneous compression effects of Physicool modify the inflammatory response to soft tissue damage which helps promote healing.

Shoulder Bursitis

What is shoulder bursitis?

Bursitis is the swelling or irritation of the bursa. The bursa is a sac comprising lubricating fluid, found between tissues such as bone, muscle, tendons and skin. The job of a bursa is to decrease rubbing, friction and irritation.

What causes shoulder bursitis?

Shoulder bursitis is commonly caused by repetitive, minor impact on the shoulder area, or from a sudden, more acute injury. Age is also a factor as tendons mature, they are not able to tolerate stress as well, have less elasticity and are prone to tearing. Overuse or injury to the joint also increases risk of bursitis.

Symptoms of shoulder bursitis

  • Pain in shoulder
  • Increased pain with movement
  • Swelling
  • Trouble sleeping

How to treat shoulder bursitis

Treatment for shoulder bursitis is relatively straightforward.

  • Ice/cold therapy (Physicool) to relieve the pain and swelling
  • Ceasing strenuous or exertive activity
  • Anti-inflammatories
  • Rest

Protection, rest, ice, compression and elevation (PRICE) is one of the most recommended approaches for the management of shoulder bursitis. The aim is to minimise haemorrhage, swelling, inflammation and pain, to provide the best conditions for healing to take place.

The PRICE approach is recommended by NHS Choices:

  • Protection – protect the injured area from further injury – using a support bandage if appropriate
  • Rest – stop the activity that caused the injury, and rest the injured joint or muscle. Avoid activity for the first 48 to 72 hours after injury
  • Ice – for the first 48 to 72 hours after the injury, apply a cooling therapy like Physicool
  • Compression – compress or bandage the injured area to limit any swelling and movement that could damage it further
  • Elevation – keep the injured area raised and supported on a pillow to help reduce swelling

Physicool provides the key stages of PRICE in a single reusable bandage, providing protection, cooling and compression for the shoulder injury to help the healing process. A Physicool bandage can be applied to the injury to reduce the pain and inflammation.
 

Shoulder Separation

What is a shoulder separation?

A shoulder separation is the partial or total separation of two parts of the shoulder: the collarbone (the clavicle) and the tip of the shoulder blade (the acromion). A shoulder separation is classified on the basis of how badly the ligaments are injured.

What causes a shoulder separation?

A forceful, direct blow to the top of the shoulder or falling onto the shoulder can cause shoulder separation.

Symptoms of shoulder separation

  • Pain at the point of injury
  • Limited movement in the shoulder area
  • Swelling
  • Bruising
  • Tenderness

How to treat shoulder separation

Treatment of a shoulder separation will depend on its severity.

  • Ice/cooling therapy (Physicool) to relieve the pain and swelling
  • Anti-inflammatories
  • Rest
  • Sling
  • Physical therapy

Protection, rest, ice, compression and elevation (PRICE) is one of the most recommended approaches for the management of a shoulder injury. The aim is to minimise haemorrhage, swelling, inflammation and pain, to provide the best conditions for healing to take place.

When to seek medical advice

If you fall on your arm or receive a blow to the shoulder that causes continual pain and swelling, or if you have pain, stiffness or limited mobility following any activity that does not improve with home treatments (rest, cooling therapy, over the counter medications), you should seek the advice of a medical professional.  If the injury is accompanied by an inability to move your arm or shoulder, or you think the shoulder is displaced, the joint feels “loose”, or a bone may be broken, you should seek immediate medical attention.