Shoulder sprain

Synonym for sprain:

• Strain

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What is a shoulder sprain?

A shoulder sprain involves the stretching or tearing of one or more ligaments in the shoulder. When a ligament is stretched or torn, bleeding can occur within the joint, leading to swelling and bruising.

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What is a ligament?

A ligament is a tissue that holds bones together. We have hundreds of ligaments in the body between each of our bones to stabilize them.

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What causes a shoulder sprain?

A sprain is always the result of an accident, a blow, or a twist. There needs to be a clear traumatic event. Common causes of shoulder sprains include:

• A fall on the shoulder
• A sudden and rapid twisting of the arm (for example, the arm gets stuck while the body continues to move forward)

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Therefore, if the pain appeared slowly and gradually, without any clear accident, it is not a sprain.

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What are the symptoms of a shoulder sprain?

The main symptoms are:

• Shoulder pain that started after a fall or accident
• Shoulder weakness and pain when lifting loads
• Pain, stiffness, and difficulty raising your arms overhead
• There may or may not be swelling. Swelling is rarely seen in the shoulder, even after significant trauma.

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How is a shoulder sprain diagnosed?

Diagnosis is possible through a review of your symptoms and a clinical examination. Depending on the severity of the incident, an X-ray may be necessary to rule out a fracture.

Did you know that physiotherapists can prescribe X-rays if the injury occurred less than 72 hours ago? If you do not have quick access to a doctor, you can obtain this prescription from a physiotherapist.

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When should I see a physiotherapist for a shoulder sprain?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

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If you've had an accident that caused your pain, you should promptly consult a physiotherapist who can guide you on the best course of action.

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You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What are the physiotherapy treatments for a shoulder sprain?

As with all traumatic injuries, we must allow the body to perform its natural healing process.

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« Inflammation is a normal and necessary process for proper healing. There is therefore no miracle way to speed up healing. »

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However, it is very important to make sure to eliminate any factors that could slow down healing. 

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Here are some examples of things that could slow down healing:

• Improper dosage of exercises and daily activities
• Poor biomechanics of your movements
• Stiffness in the joints, muscles, and nerves
• Worries or fears related to the injury or pain

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« For this reason, your physiotherapist can help you optimize the healing of the injury. They will be able to guide you in the best possible direction to ensure that the injury heals effectively. »

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Think of healing from a traumatic injury like taking care of a plant. Pulling on the plant won't make it grow faster. However, you can make sure it gets enough water, sunlight, and fertilizer. We want to put the plant in a good environment to heal. It's the same for a traumatic injury.

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Your physiotherapist will perform an assessment to determine your limitations and the severity of the injury by evaluating the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your shoulder to reduce pain and improve your range of motion.
• Give you specific exercises to increase shoulder mobility, reduce pain, and improve control of your movements and muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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In some cases, it may be necessary to immobilize the shoulder for a certain period using a brace. If this is the case, the physiotherapist will work with the doctor or orthopedist to manage the immobilization period.

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What can I do at home for a shoulder sprain?

As with any traumatic injury, you should follow the PEACE and LOVE principles. Read the blog post on PEACE and LOVE, and then read the advice here that applies to shoulder sprains.

PEACE and LOVE tips specific to shoulder sprains:

(make sure you have read the blog post that explains the PEACE and LOVE steps in detail)

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For P = Protection:

You can use a triangular bandage to support your arm for 24-48 hours to reduce pain.

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For C = Compression:

It is not necessary to compress the shoulder.

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For L = Load:

Start moving the injured shoulder again and using that arm for your daily tasks without significantly increasing the pain. Do the dishes, pick up lighter objects with the injured side, etc.

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For V = Vascularisation:

Light to moderate cardio exercise, done without pain, speeds up healing. Therefore, for a rotator cuff tear, you can:

• Walking
• Use a stationary bike with your arm well supported
• Do aquajogging
• Use an elliptical machine without using your arms

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Here are some other tips to help you:

• If you have pain at night or morning stiffness, make sure your neck is well supported while sleeping with a pillow that fills the hollow of your neck.
• Avoid sleeping with your arm behind your head or under the pillow. Keep your arm along your body or supported with a pillow.
• Avoid sleeping on the painful shoulder.
• If you can't find a comfortable position for the night, use one or two pillows to support your arm.

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Sources

• Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.

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