Sprained Shoulder – Causes, Sign, Symptoms & Treatment
Shoulder sprain refers to the tears in the ligaments that hold the shoulder joint in place.
Bones like the scapula (also know as shoulder blade), the acronym and the breastbone (also known as sternum) are all connected by ligaments around the shoulder.
Tearing of the ligaments on this bones usually results in pain and inflammation of the shoulder area and difficulty in moving the shoulder or arm.
The flexibility and increased mobility of the shoulder joint makes it prone to injuries and accidents that result in muscular sprains.
Common causes of shoulder sprain includes
- Direct fall on the shoulder,
- A blow to the shoulder blade,
- Car accidents and sport injuries like injury from a hockey stick, the rugby game or a kick to the shoulder in football.
When a person falls on the shoulder the impulse pushes the tip of the shoulder down and in the process ligaments get affected. Direct impulse on the shoulder in all these events may injure your Acromioclavicular joint during collision.
The contact force when one falls on their arm is transmitted through the arm up to the shoulder causing separation of the shoulder bones. The ligaments become overstretched and damaged in the process.
Shoulder joint injuries mostly occur after bicycle wrecks and car accidents too. The accidents and sporting activities may not only cause tearing of ligaments but also fracture of the clavicle and acromion, the cartilage within the joints may be injured too.
This may result in complications like distal clavicle osteolysis and accelerated osteoarthritis.
Categories of shoulder sprains
It is the tearing of the ligaments that supports the acromioclavicular joint near the collarbone.
The acromioclavicular and the coracoclavicular ligaments bind the shoulder blade and the collarbone together. It takes a high impact collision or fall to break tear them.
Acromioclavicular sprains are either partial or complete, in severe acromioclavicular sprains the collarbone is totally out of place and movement of the arm is almost impossible.
Grade 1 of acromioclavicular sprain is when the ligaments are overstretched or partly torn .The symptoms are mild pain but the shoulder still remains intact.
Grade 2 includes a rupture of the AC ligaments and the collarbone is slightly displaced.
Grade 3 includes the ligaments in the AC and the nearby coracoclavicular ligaments. It results in upwards displacement of the collar bone. The shoulder will appear lowered with the weight of the arm.
Sternoclavicular joint sprain
This joint is where the collarbone meets the breastbone.
The sternoclavicular joint is more tightly connected and these types of sprains are rare by nature. In athletes it occurs when they sustain a direct kick to the breastbone but majority of sternoclavicular sprains occur in accidents.
In grade 1 of the sternoclavicular joint sprain the ligament tears are mild and small.
In grade 2 the ligaments between the collarbone and the breastbone are torn but those between the collarbone and the ribs remain intact. The joint is slightly deformed but still connected.
In grade 3 all the ligament are severely torn and the joint is deformed and totally separated. The collarbone is displaced from its normal position.
Signs and symptoms of shoulder sprains
Symptoms vary depending on how bad the injury is.
Common signs include pain at the top of the shoulder when moving your arms and when your shoulder is in contact with anything, even when sleeping. The pain may gradually progress after many attempts to move the arm
Deformity over the top of the shoulder that subsequently results in general arm weakness.
A popping sound while moving the shoulder could also indicate a shoulder sprain.
At least every case of shoulder sprains have produced Inflammation and tenderness just at the outside tip of your collarbone.
This may also be accompanied by bruising on the surface of the skin where the impact of the injury or accident occurred.
In some cases of shoulder sprain there is the total inability to move your shoulder or arm and or inability to lift any small amount of weight in your arms.
Treatment varies with the type of sprain.
Most people recover in a few weeks without major medical interventions. However recovery is usually slower for patients who have shoulder arthritis, damaged cartilage in the shoulder or a severe shoulder separation.
Surgical treatment is recommended for patients who have suffered multiple sprains over time. In Acromioclavicular joint sprain, the injury is treated with anti-inflammatory drugs, painkillers like ibuprofen.
The patient can also place ice over the shoulder area to prevent inflammation. In severe acromioclavicular sprains the patient’s arm is placed in a sling four a few weeks to allow time to heal.
In young children severe acromioclavicular sprain will sometimes require surgery for treatment. During this time the patient is required to rest and avoid engaging the affected arm in involving tasks.
For sternoclavicular sprains ice, anti-inflammatory drugs and the sling for two to three weeks. In grade three of sternoclavicular joint sprains the patient is sedated and then the displaced collarbone is carefully slipped back into place.
The patient then made to wear the sling for four to six weeks along with a clavicle strap Injuries that do not heal with conservative treatment methods require surgery.
Professional athletes or heavy laborers are most prone to severe shoulder separation and physicians recommend surgery to repair the injury.
The surgery involves the surgeon making incisions on the shoulder and using graft tissue from a different part of the body to replace the torn tissues in the shoulder. The surgeon will then secure the repaired ligaments with stitches.
Prevention of shoulder sprains
Regular shoulder strengthening exercises and wearing protective padding during high impact spots or job activities is highly recommended measures to prevent shoulder injuries.
Minimize your chances of fresh injuries when you return to play or work after recovering from a sprain, by not overworking or severe twisting of the arm and shoulder.
It is appropriate that you wear supportive strapping to improve stability of your ligaments when you are involved in high collision sports like rugby and certain types of weight lifting at work.
The strappings de-load the vulnerable structures and facilitate balanced muscle movement. In exercises it is advisable that you normalize your muscle lengths.
Do not over work the upper part of the arm than other parts of the body. Perform scapular stabilization exercises and regular tissue massage for those involved in hard work
Featured Image Via – Kaolin fire(Flickr)