Shoulder Injury

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DEFINITION

• Injuries to a bone, muscle, joint or ligament in the shoulder

Types of Shoulder Injuries

• Fractures (broken bones)
• Dislocations (bone out of joint)
• Sprains - stretches and tears of ligaments
• Strains - stretches and tears of muscles (e.g., pulled muscle)
• Muscle overuse injuries from sports or exercise (e.g., strain, bursitis, tendonitis)
• Muscle bruise from a direct blow (e.g., contusion)
• Causes extrinsic to shoulder (referred pain) - Examples include neck pain, cardiac disease, abdominal disorders, spleen injury

See More Appropriate Topic (instead of this one) If

• ANIMAL BITE to shoulder
• BURN of shoulder
• PUNCTURE WOUND to shoulder
• SKIN INJURY is main concern

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for Suspected Fracture or Dislocation of the Shoulder:

• Use a sling to support the arm. Make the sling with a triangular piece of cloth.
• Or, at the very least, the patient can support the injured arm with the other hand or a pillow.

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WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Major bleeding (actively dripping or spurting) that can't be stopped
• Amputation or bone sticking through the skin

Call Your Doctor Now (night or day) If

• You think you have a serious injury
• Injury looks like a broken bone or dislocated joint (crooked or deformed)
• Can't move injured shoulder at all
• Collar bone is painful or tender to touch
• Severe pain

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think you need to be seen
• Can't move injured shoulder normally (e.g., full range of motion, able to touch top of head)
• There is a large swelling or bruise (wider than 2 inches) at the site of the injury
• You are over age 54, have osteoporosis, or use steroid medications routinely

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Injury interferes with work or school
• Pain has not improved after 3 days
• Injury is still painful or swollen after 2 weeks

Self Care at Home If

• Minor shoulder injury and you don't think you need to be seen

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HOME CARE ADVICE FOR MINOR SHOULDER INJURY

1. Treatment of a Bruise (e.g., direct blow to shoulder):
   • Apply a cold pack or an ice pack (wrapped in a moist towel) to the area with ice for 20 minutes each hour for 4 consecutive hours (i.e., 20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).
   • Rest the injured part as much as possible for 48 hours.
   • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
2. Treatment of Sprains and Strains:
   • FIRST AID - Apply an ice pack (crushed ice in a plastic bag covered with a moist towel) to reduce bleeding, swelling, and pain.
   • Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first 2 days.
   • REST the injured shoulder for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.
3. Pain Medication:
   • For pain relief, take acetaminophen or ibuprofen.
   • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
   • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
   • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
   • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
   • CAUTION: Do not take acetaminophen if you have liver disease.
   • Read the package instructions thoroughly on all medications that you take.
4. Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.
5. Call Your Doctor If:
   • Pain becomes severe
   • Pain does not improve after 3 days
   • Pain or swelling lasts more than 2 weeks
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.