Shoulder Pain

What is it?

The shoulder joint is a complex joint that combines many bones, tendons and muscles in order to allow a large range of motion of the arm. The large range of motion of the shoulder makes it more susceptible to injury. Common problems of the shoulder include instability or impingement of soft tissue. Pain may be felt only with certain movements or can be constant. Many shoulder conditions are aggravated by specific actions or sports.

Shoulder pain usually involves the soft tissues of the shoulder, which include the muscles, ligaments and tendons, rather than bones. Rare causes of shoulder pain are tumors, infection or nerve-related problems.

Soft tissue injuries include:

Tendonitis: A tendon connects muscle to bone or other tissue and has a cord or band-like quality. Tendonitis is often a result of the wearing process of the tendons that takes place over a long period of time. The rotator cuff is the unit of muscles and tendons which provides shoulder motion and stability. There are several types of tendonitis:

Bursitis: Excessive use of the shoulder can lead to inflammation and swelling of a bursa - bursas are fluid-filled sacs located near friction areas in the joint. They lessen the friction caused by movement of the shoulder. Bursitis can limit the range of motion of the shoulder because of pain.

Traumatic injury/instability: Bones of the shoulder can move out of their normal position. This condition, called instability, can result in complete or partial dislocation of the shoulder. Recurring dislocations cause pain and instability when you raise your arm or move it away from your body. With overhead movement, the shoulder may feel as if it is slipping out of place. Often people will avoid shoulder movements to lessen the pain or feeling of instability. This sometimes leads to tightening or stiffening of the soft tissues of the shoulder joint.

Why come to The Children’s Hospital for treatment of this condition?

Children’s has the only sports medicine program in Colorado that is focused solely on caring for young athletes.  Our team of sports medicine experts understand the demands that sports programs place on school-aged athletes and the importance of customized, age-appropriate care. Since many young athletes are still growing, they need special kid and teen-specific treatment that takes this into consideration.

Our pediatric specialists are fellowship-trained in sports medicine, giving them the focused expertise that makes The Children's Hospital the best choice for young athletes looking to maximize performance after recovering from a sports injury.

What are the signs and symptoms?

Pain in the shoulder with certain movements, or pain in the shoulder area during or after specific activities.  

How do you diagnose it?

Determining the source of the pain in the shoulder is critical to recommending the right method of treatment. A thorough medical history is a valuable tool in finding the source of the child’s pain.

A detailed physical examination will also be performed to look for any abnormalities, swelling, deformities, tender areas and to observe the range of motion in the shoulder.

X-ray studies will most likely be obtained to identify any underlying abnormalities. Magnetic resonance imaging (MRI) maybe ordered to further evaluate the soft tissues surrounding the joint. Occasionally, arthroscopic surgery maybe needed to further evaluate the joint if the problem is not apparent with the physical examination, x-rays, and other tests.

How do we treat it?

Treatment usually involves altering activities, rest and physical therapy to help improve shoulder range of motion, strength and flexibility. Medication can also be used to reduce inflammation and pain. The majority of patients with shoulder pain will respond to these treatments, but some shoulder problems, such as recurring dislocations, may end up requiring surgery.

Who gets it, and can it be prevented?

Avoiding overexertion or over extensive activities can help to prevent shoulder pain.