
SHOULDER SURGERY

	SHOULDER ARTHROSCOPY ARTHROSCOPIC ACROMIOPLASTY ROTATOR CUFF REPAIR TOTAL SHOULDER REPLACEMENT TYPES OF SHOULDER SURGERY
SHOULDER CONDITIONS

	COMPARTMENT SYNDROME SHOULDER ARTHRITIS BURSITIS OF THE SHOULDER SHOULDER TENDONITIS ERB'S PALSY FROZEN SHOULDER SHOULDER FRACTURES ROTATOR CUFF TENDONITIS SHOULDER IMPINGEMENT SHOULDER SPRAINS & STRAINS SHOULDER DISLOCATION
PATIENT RESOURCES

	FREQUENTLY ASKED QUESTIONS BEFORE SHOULDER SURGERY AFTER SHOULDER SURGERY ANATOMY OF THE SHOULDER SHOULDER SURGERY GLOSSARY

Shoulder Sprains and Strains

What is a shoulder sprain?

A person with a shoulder sprain has stretched or torn a ligament in the shoulder. Ligaments are strong bands of tissue that hold the bones together in a joint during movement. A force that bends or twists the shoulder beyond the normal range of motion causes a shoulder sprain. The most common cause of shoulder sprain is a sports injury. Shoulder sprains are the most common type of shoulder injury.

What Causes Shoulder Sprains?

Falling on an outstretched arm
Forced twisting of the arm
A blow to the shoulder

Symptoms of a shoulder sprain or strain:

Shoulder pain:
- Shoulder pain is worse with movement
Shoulder tenderness
Shoulder swelling
Arm weakness (unilateral):
- Shoulder weakness
Arm pain
- Shoulder pain may radiate into the arm

Diagnosing Shoulder Strains and Sprains:

The doctor will inspect both your shoulders, comparing your injured shoulder with your uninjured one. The doctor will note any swelling, shape differences, abrasions or bruising and will check for extra motion in the acromioclavicular and sternoclavicular joints. He or she will test your ability to move your shoulder, and will ask about arm pain. Your doctor will gently press and feel your acromioclavicular joint, sternoclavicular joint and collarbone.

Because many important blood vessels and nerves travel through your shoulder area, the doctor will also check the pulses at your wrist and elbow and will check the muscle strength and skin feeling in your arm, hand and fingers.

If your physical examination suggests that you have a severe shoulder sprain or fractured bone in the shoulder area, your doctor will order X-rays. In more severe acromioclavicular joint injuries, your doctor may also order magnetic resonance imaging (MRI) scans or computed tomography (CT) scans.

Shoulder Sprain Surgery

In most cases, conservative treatment is recommended to resolve painful symptoms unless a rupture of the affected ligament, muscle, or tendon is present and results in significant shoulder instability or weakness.

Grade I and II shoulder sprains and strains are initially treated with rest, cold therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce painful symptoms. A sling may be used for the first few days following injury to allow symptoms of acute pain to subside; however, prolonged use of a sling may lead to shoulder stiffness and slowed recovery time. Early range of motion exercises should be performed as tolerated to promote healing and reduce the risk of a frozen shoulder (adhesive capsulitis). Whereas grade I injuries will typically heal with conservative treatment, grade II injuries may also require physical therapy to improve range of motion and promote muscle strengthening.

Grade III shoulder sprains and strains may be initially treated with a sling and cold therapy, but many cases may require surgery to repair the ruptured ligament, muscle, or tendon. Acromioclavicular dislocations and grade III strains in older individuals are typically treated conservatively unless the individual engages in heavy overhead work or is very active. However, muscles and tendons that have sustained full thickness tears often require surgery to trim torn muscle or tendon fibers (débridement), to reattach the ruptured muscle or tendon, or to repair torn or detached cartilage (labral tear and SLAP lesion).

Surgical repair of the shoulder muscles, tendons, or cartilage may be performed arthroscopically through tiny incisions using a fiberoptic scope and small instruments, or with open surgery to reconstruct larger, more complicated, or avulsed tears with grade III injury. A mini-incision between 4 cm to 6 cm long also may be used to access and repair torn soft tissues in certain individuals, promoting reduced healing time. Upper arm and shoulder surgery may be performed with either a regional or general anesthesia. Following surgery, rehabilitation is important to help the individual regain functional strength and mobility.