Shoulder Injuries and Shoulder pain

Cork Emergency Departments

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It is very easy to injure a shoulder through sudden movements during sport, gardening or DIY. Sometimes shoulders can become more vulnerable to injury with repetitive sports and movements.

Symptoms of shoulder injury, sprain or overuse

• Pain and stiffness of the shoulder with a reduced range of movement
• Pain and discomfort with activities such as dressing or lifting
• Moving the shoulder may caused increase pain
• The pain may radiate into the neck and the arms

Immediate management during the first 48 hours after injury

• Painkilling medicines are usually very helpful and you should take them regularly during this time to prevent the pain from becoming unbearable. You should have been advised on appropriate pain relief at the time of being seen. If the pain is not resolved or seems to be getting worse you should arrange to see your own doctor for further advice and management
• Relief of pain and joint swelling may be aided by regular ice packs. A packet of frozen peas wrapped in a towel can be applied to the area- do not use for any longer than ten minutes at a time. This can be repeated every 2-3 hours but should be avoided if it causes pain or discomfort
• You should rest your arm during this time and you may have been given a sling to support your arm and shoulder. If you find the sling uncomfortable, or when sitting, remove the sling and support the affected arm on a pillow
• You may find gentle massage of the shoulder muscles helpful - but massage should be stopped if it causes pain
• Dressing may be difficult. You should put the arm of the painful shoulder into clothes first and take it out of clothes after the unaffected shoulder

Management after 48 hours following injury

• You should continue with the painkilling medicine if you have been advised to do so
• You should start alternating periods of rest with gentle exercise
• You may wish to continue with the regular ice packs if they are helping to reduce the pain and swelling to your shoulder
• You can gradually start introducing normal activities into your daily schedule - but stop when they cause marked pain

Exercises

You should undertake the following exercises several times to prevent joint stiffness, aiming to gradually increase the range of movements in your shoulder. You should only exercise to the point of pain and if the exercise becomes increasingly painful stop and rest or try a different movement.

1. Stand beside a table and lean on it for support with your uninjured/ unaffected arm -allowing your injured arm to gently swing away from your body
2. Keeping the above position, you should start to gently swing your affected arm backwards and forwards,moving it as far back or forwards as pain allows. Repeat this exercise over 2 minutes if possible
3. Keeping the same position, you should gently move your arm across over your chest and out to the side as far as possible as pain allows. Repeat this exercise over 2 minutes if possible
4. From either a sitting or standing position - depending on which you find most comfortable - move the effected arm in small circular movements, gradually increasing to larger circles as pain allows. Repeat exercise for 2 minutes if tolerated
5. Either in a sitting or standing position,clasp your hands together, supporting the affected arm with the strong one and raise both arms up as high as possible. Try and repeat this movement 3-4 times
6. As time progresses you should start to be able to move the arm with greater ease and gradually introduce light activities as the pain allows

Seek further medical advice if:

• If you experience any neck pain or chest pain or feel generally unwell
• If you experience any tingling or numbness to your neck or down the affected or unaffected arm
• The treatment plan does not seem to be helping and the pain and reduced mobility is not improving or is getting worse
• You are unable to return to normal functioning - your GP will consider whether referral to a physiotherapist would be helpful for you or suggest other measures

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