Shoulder sprains are relatively common injuries to the shoulder that are typically the results of a fall or direct trauma to the shoulder or extended arm. This can be quite painful and can be relatively quick or quite prolonged, depending upon the nature of the injury.
While the terms shoulder sprain and strain are often misused interchangeably, shoulder strains involve injury to the muscle or tendon around the shoulder. In contrast, shoulder sprains involve the ligaments that surround the joint. Shoulder sprains typically involve one of two joints, the glenohumeral joint or the acromioclavicular joint. Depending upon which joint is injured, treatment can be significantly different.
Injury to the acromioclavicular joint often occurs when the patient falls directly onto the outside portion of the shoulder with the arm at his or her side. Injuries are classified on a 1-3 scale based on the severity of disruption of the ligaments that attach the collarbone or clavicle to the scapula or shoulder blade.
To learn about rotator cuff injuries, go to rotator cuff injuries
Dr. Kamal Bohsali is a board-certified, fellowship-trained orthopedic surgeon specializing in managing shoulder and elbow pathologic conditions.
He states, "A sprain of the shoulder usually means that a ligament has been injured. Sprains generally involve two shoulder joint locations: the AC (acromioclavicular) joint or the (glenohumeral) shoulder joint. Some types of AC ligament sprains require surgical intervention due to instability between the collarbone (clavicle) and the acromion. However, most can be initially managed with a sling and physical therapy. When the shoulder joint dislocates, it is common to sprain or injury the labrum and the lining of the shoulder (capsule). Particularly in younger individuals, these ligaments may need to be surgically repaired to prevent further dislocations. For people who require surgery, it may take 4 to 6 months to be able to return to unrestricted activity."
Grade 1 and 2 injuries are typically managed conservatively with a period of immobilization for 1 to-3 weeks followed by progressive active and passive range of motion exercises.
Following this, strengthening and stabilization exercises can be initiated, and the patient can be slowly returned to his or her prior level of function. Grade 3 injuries will often result in significant cosmetic deformity though full function can be restored without surgical intervention.
Highly active patients or patients concerned with the cosmetic appearance of the shoulder may opt for surgical intervention. The recovery from surgery depends significantly on the surgical technique, but the full functional return can often occur around 3-4 months.
Injury to the glenohumeral joint can also occur when the patient falls typically, the arm is extended and not at the patient’s side. Direct impact to in outreached arm can also cause a sprain to the shoulder’s glenohumeral joint. Sometimes a complete dislocation can occur when the joint is sprained significantly.
Most often, the glenohumeral joint dislocates anteriorly and inferiorly or towards the front of the body. Dislocations that do not go back to put this on their own may need to be reduced by a medical professional. As the joint dislocates, injury to the ligamentous structures that surround the glenohumeral joint occurs. Injury may also occur to the cartilaginous ring that surrounds the shoulder joint, known as the labrum.
Severe sprains of the shoulder or recurrent dislocations that injured the glenohumeral labrum may need surgical intervention for the patient to regain normal function of the shoulder. Mild shoulder sprains first-time dislocations can often be managed conservatively with a period of immobilization followed by progression to active range of motion and strengthening exercises around the 2-3 week mark.
Return to normal function often occurs within 4-6 weeks with conservative treatment. Severe injuries that require surgical intervention can take 4-6 months to heal completely following a progressive formalized physical therapy protocol. To schedule an appointment with one of the 12 JOI Rehab Centers, please call 904-858-7045.
The quick answer is to rest your shoulder.
To learn the 5 worst shoulder exercises read this ARTICLE.
Watch this VIDEO to perform the sleeper stretch for shoulder stiffness.
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