Shoulder Sprain (Mild Acute Glenohumeral Ligament Injury)

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Definition

A shoulder sprain is stretching or partial tearing of the ligaments and capsule that support the shoulder, specifically, the glenohumeral joint. Ligaments are strong bands of tissue that connect bones to each other. The glenohumeral joint is the meeting of the upper arm bone, humerus, and the cup of the shoulder blade.

The major ligaments of the glenohumeral joint are the superior, middle and inferior glenohumeral ligaments, and they serve to stabilize the highly mobile joint. The capsule of the glenohumeral joint is thinner tissue that encloses and supports the shoulder joints.

An acute mild injury to the glenohumeral ligaments can be considered a shoulder sprain. More severe injury can result in dislocation.

Capsule of Glenohumeral Joint

Shoulder Joint Capsule

2008 Nucleus Medical Art, Inc.

Causes

Shoulder sprains involving the glenohumeral joint may be caused by:

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

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury.Risk factors for shoulder sprain include:

  • Playing sports
  • Poor coordination
  • Poor balance
  • Inadequate flexibility and strength in muscles and ligaments
  • Loose joints or connective tissue disorders

Symptoms

Symptoms of shoulder sprain may include:

Pain, tenderness, and swelling around the shoulderRedness, warmth, or bruising around the shoulderLimited ability to move the shoulder and increased pain with movement DiagnosisThe doctor will ask about your symptoms and how you injured your shoulder. The doctor will examine your shoulder to assess the stability of the joint and the severity of the injury. Tests may include: X-rays to make sure that no bones are broken or displaced MRI scan to see the extent of damage to the soft tissue of the shoulder (rarely needed) Arthrograman be with CT or MRI TreatmentTreatment includes:RestAvoid using your injured arm.IceApply ice or a cold pack to the shoulder for 15-20 minutes, four times a day for at least 2-3 days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin. MedicationFirst consult your doctor if you have any questions about using medications. OTC drugs that are commonly used to help reduce inflammation and pain include: Nonsteroidal anti-inflammatories such as ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn)Acetaminophen (Tylenol)AspirinBrace or slingYou may need to wear a sling to immobilize your arm and shoulder. If you play sports, you may need to wear a shoulder brace when you return to play.Rehabilitation exercisesBegin exercises to restore flexibility, range of motion, and strength in your shoulder as recommended by your healthcare professional. Sometimes electrical stimulation is used to aid recovery.Surgeryis not always needed to repair a mild shoulder sprain without instability or dysfunction. In certain athletes, earlier surgery may be considered to avoid recurrent injury. Prevention To reduce your risk of spraining a shoulder:
Do exercises to strengthen arm, back, and chest muscles.Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, ligaments, and tendons, including those around your shoulder. RESOURCES: American Academy of Orthopaedic Surgeonshttp://www.aaos.org American Orthopaedic Society for Sports Medicinehttp://www.sportsmed.org CANADIAN RESOURCES: Canadian Orthopaedic Associationhttp://www.coa-aco.org/ Canadian Orthopaedic Foundationhttp://www.canorth.org/ References: American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org . Benjamin HJ, Hang BT. Common Acute Upper Extremity Injuries In Sports. Clinical Pediatric Emergency Medicine . 2007;8(1):15-30. DeLee and Drez's Orthopaedic Sports Medicine . 2nd ed. Philadelphia; Elsevier; 2003. Ch. 21. Micheo WF, Ramos E. Frontera: Essentials of Physical Medicine and Rehabilitation . 1st ed. Philadelphia; Hanley and Belfus; 2002. Ch. 15. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . Sports Injuries: Basic Principles of Prevention and Care . Blackwell Scientific Publications; 1993.
Last reviewed January 2008 by John C. Keel, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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