The shoulder is a complex ball-and-socketlike joint consisting of three main bones -the humerus (the upper part of the upper arm bone), the clavicle (the collarbone), and the scapula (or shoulder blade, the largest bone in the chest-shoulder region). The humerus forms the ball in the ball-and-socket-like joint and is attached by ligaments -connective tissue- to the scapula. Bursas -fluid-filled sacs or saclike cavities-surround and cushion the bones and allow for movement. Muscles, including the trapezius, deltoid, pectorals, and latissimus dorsi, travel over, under, and around the shoulder joint and add stability. Tendons (also connective tissue) connect these muscles to bone.
What the Shoulder Does: The shoulder allows movement of the hand and arm in space. What the Injury Is: A shoulder separation occurs when ligaments that hold the collarbone to the shoulder blade are torn. The collarbone also may be pushed out of alignment.
Cause: The injury occurs from a traumatic event, as in a blow to or a fall on the shoulder area. It can also result from falling on your outstretched hand or arm. It is very common in contact sports, especially football. Other sports in which the injury may occur: downhill skiing, lacrosse, hockey, volleyball, rugby, and soccer.
Symptoms: Severe pain at the moment the injury occurs. Limited movement in the shoulder area. Swelling, bruising, and internal bleeding. The shoulder may look malformed.
Immediate Treatment: Use an ice pack, if possible, as soon as the injury occurs. Cold treatments help stop internal bleeding and the accumulation of fluids in and around the injured area, thus decreasing swelling.
Seek medical treatment at a physician’s office or hospital emergency room at once. The injury should not be treated without professional medical attention. The shoulder will be put in a sling or wrapped to immobilize the area and aid recovery.
Medication: First, follow the advice of your physician. You may be given a pain-relieving drug, such as codeine with aspirin or acetaminophen. You may also be given a nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and swelling.
WARNING: Do not give aspirin to children under the age of 16. If pregnant or nursing, consult with your physician first before taking any medication.
Continued Care: Avoid participation in sports until the injury has healed. Depending on its severity, the injury may take 2 to 10 weeks to heal. With your physician’s okay, work with a trainer or physical therapist to strengthen muscles in the shoulder region.
Medication: First, follow your physician’s advice. Take aspirin, ibuprofen, or acetaminophen to help reduce pain and inflammation.
NOTE: Acetaminophen may not contain as much of the anti inflammatory agents as aspirin or ibuprofen. Ask your physician or pharmacist for guidance.
Long-Term Effects of Injury: There may be no lasting effects from the injury. In some individuals, however, stiffness or limitation of motion in the shoulder area may occur. In severe cases, surgery may be necessary to remove damaged tissue and to repair ligaments.
Prevention of Recurring Injury: Avoid situations in which another injury could occur. Wear layers of clothing or padding to help cushion any fall that may be likely. Use weights and exercises advised by a trainer or physical therapist to strengthen muscles in the shoulder region. Muscle-strengthening exercises also hel strengthen ligaments and tendons. Use an ice pack to reduce swelling, then a heating pad to aid recovery. (Heat treatments help to enlarge the small blood vessels in and around the injured area, thus increasing blood circulation.)
See Your Physician: If pain and swelling reappear and limit motion in the shoulder.