Shoulder sprain: how to treat?

The joint structure of the shoulder is one of the largest, most mobile and important blocks of the musculoskeletal system. Its damage is not uncommon, and stretching of its elements - ligaments, tendons - should be the reason for an urgent visit to the traumatology department. Why?

This is one of the most painful types of sprains.
Inflammation of the ligaments leads to serious complications: tendonitis, bursitis may develop, and inflammation may “spread” to other tissues, increasing the risk of straining the arm muscles.
In the case of the shoulder joint, serious injuries are most often observed - ruptures and tears. Control of such consequences of stretching should be very careful.

The essence of sprains and muscles of the shoulder joint

The shoulder joint is very mobile and in some positions is not very stable. Connective tissue is especially susceptible to damage during sports activities when sudden movements are made.

Collagen fibers are not adapted to stretch, and their elongation is accompanied by shortening of the ligament, pain and inflammation. A partial tendon rupture begins with painful symptoms resulting from an injury to the rotator cuff. The inflammation then progresses to patellar tendonitis syndrome.

Mechanism of shoulder injury[edit | edit code]

Although the mechanics of a shoulder injury can be quite complex and individual, there are a few general patterns that can be identified:

external rotation of the arm or a strong jerking movement;
a blow to the front of the shoulder (can cause sprain due to dislocation);
a fall on the upper part of the shoulder (can lead to sprain as a result of dislocation of the acromioclavicular joint);
falling on an outstretched arm;
sudden traction of the arm (brachial plexus subluxation);

Causes of shoulder sprains

The cause of a sprain is always injury. This may be due to a fall, a careless turn of the shoulder, or a sharp blow. Major diseases are less common. Myasthenia gravis reduces muscle tension and strength, which increases the risk of injury. Limited mobility, paresis and paralysis can cause strain even when walking normally.

Pain syndrome caused by shoulder dislocation

The most common factors of stretching are:

Shoulder drop;
hit in the shoulder;
jerking hand movement;
falling on an outstretched hand.

At risk are athletes, young children and those involved in extreme sports. There is a high probability of injury due to pre-existing diseases of the joints and muscles, after operations and other injuries.

References[edit | edit code]

Tzannes A, Murrell GA. Clinical examination of the unstable shoulder. Sports Med 2002;32(7):447-457.
Gamulin A, Pizzolato G, Stern R, Hoffmeyer P. Anterior shoulder instability: histomorphometric study of the subscapularis and deltoid muscles. Clin Orthop 2002;May(398):121-126.
Nordin M, Frankel VH. Basic Biomechanics of the Musculoskeletal System, 2nd. ed. Philadelphia: Lea and Febiger, 1989:235.
Souza T.A. Differential Diagnosis for the Chiropractor. Gaithersburg, MD: Aspen Pubs, 1997:145.
Kibler WB, et al. Functional Rehabilitation of Sports and Musculoskeletal Injuries. Gaithersburg, MD: Aspen Pubs, 1998:157.
Roy S, Irvin R. Sports Medicine: Prevention, Evaluation, Management, and Rehabilitation. Englewood Cliffs, NJ: Prentice-Hall, 1983:195.
Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders, 2nd. ed. Philadelphia: JB Lippincott, 1990:177.
Hammer WI. Functional Soft Tissue Examination and Treatment by Manual Methods. Gaithersburg, MD: Aspen Pubs, 1991:31.

Symptomatic manifestations

Stretch marks have a characteristic clinical picture:

Pain occurs immediately after injury and intensifies within a few minutes;
there is swelling of the tissues, swelling of the skin;
after a few hours, pain and swelling, additional redness, a feeling of warmth, which already indicates the development of inflammation;
depending on the type of injury, hematomas, areas of minor hemorrhages, and capillary ruptures may appear
dysfunction of the shoulder, swelling makes it impossible to move, the patient tries to keep the sore arm healthy so as not to aggravate the pain.

Diagnostics

The diagnosis is made by a traumatologist. To do this, he conducts an external examination, asks about the presence of an episode of injury, requests various movements, and orders an x-ray. When palpating the shoulder, it is painful; the doctor sees swelling, redness, and limited movement.

Imaging studies are necessary to distinguish between different types of injuries, and in the case of a sprain, it is important to rule out dislocation. Magnetic resonance imaging will provide the most accurate information about the injury. During recovery, an MRI may be performed to rule out complications.

X-ray as one of the diagnostic methods

To obtain detailed information about the injury, the doctor prescribes:

X-ray - to exclude fractures and sprains;
Arthroscopy - if joint damage is suspected;
MRI - to assess the extent of the lesion and select the optimal treatment regimen.

Advantages

Sometimes surgery on the shoulder joint is performed with an open surgical approach. But arthroscopy has several significant advantages. It can replace open surgery (arthrotomy) in the vast majority of clinical situations. In this case, the following operation:

carries fewer risks to human health;
less blood loss;
complications occur less often;
improves tolerability of the postoperative period;
shortens rehabilitation;
provides the best aesthetic effect.

During the operation, good visualization of intra-articular tissues is provided, which the doctor can examine under magnification. The deltoid muscle and tendons are not cut, which provides a good functional effect.

Sprain Treatment

Treatment will include pre-medical and therapeutic measures. It is extremely important to follow the sprain first aid protocol immediately after the injury to prevent complications and reduce symptoms.

First aid for sprains:

Immobilization by applying a support bandage.
Apply cold - apply anything to the area of greatest pain with a cold compress (ice, meat from the freezer, a bottle of water). This will help reduce swelling and pain. Heat should not be used as it will only worsen the symptoms in the acute stage.
Gels and ointments should be used with caution when spraining ligaments. You can rub in a product based on NSAIDs (Fastum gel, Diclofenac). Do not use warming ointments (Finalgon, Capsicam).
Painkillers are NSAID-based drugs; to quickly relieve pain, you can dilute a packet of nimesulide. Medicines relieve pain and improve overall well-being.

It is not recommended to take any medications before visiting your doctor as this may mask important symptoms. For severe pain, you can take one painkiller.

Do not apply ice to the limb for more than 20 minutes and then take a break. Wrap a cold compress in a cloth and do not immediately apply to the skin.

Arm bandage

A bandage is applied for several days to increase stiffness. At this time, it is important to exclude all hand movements. The shoulder should not be immobilized for long periods of time as this results in loss of tissue supply and movement. As the pain subsides, gradually work on your arm.

Medical care begins with a diagnosis. After the examination, the doctor may prescribe muscle relaxants and other measures depending on the patient's condition.

It is extremely rare, but it happens when twisting requires surgical intervention. The indication for the procedure will be a ligament rupture or a fracture of the head of the humerus.

The doctor may prescribe drugs from the following groups:

Non-steroidal anti-inflammatory ointments and tablets - Ketoprofen, Diclofenac, Indomethacin, Ibuprofen. They soothe pain and relieve inflammation.
Cooling ointments - contain menthol and camphor oil. They eliminate cramps, relieve pain and prevent muscle spasms.
Anticoagulants improve blood flow and prevent blood clots. They are recommended to be applied to the sore spot throughout the entire treatment period.

To speed up healing, the patient is prescribed gymnastics, physiotherapeutic procedures, diet, and adherence to a physical activity regimen.

Ointments for shoulder sprains are one of the most effective ways to relieve symptoms and speed up healing. For such an injury, the use of painkillers with anti-inflammatory effects is effective.

Heparin ointment is used to resolve hematomas and relieve pain. Prevents the formation of new bruises. Recommended for use if there are bruises in the shoulder area. Use with massage movements 3 times a day for a week.

Diclofenac ointment is effective in relieving pain and reducing inflammation. Use up to 4 times a day for no longer than 2 weeks. To enhance the therapeutic effect, it is better to combine it with tablets or injections based on diclofenac. Contraindicated under 6 years of age and during fetal pregnancy.

Diclofenac ointment for sprains

The list of good ointments for sprains includes:

Finalgon;
Dolobene Gel;
Viprosal;
Alflutop;
Capsodermia;
Nicoflex.

Ointments should be used as prescribed by a doctor, as they have contraindications and restrictions for use during certain periods after injury.

For sprained ligaments in children, the doctor may prescribe Dolobene, Traumeel, and Capilar ointments.

Troxevasin, Voltaren, Indomethacin, Ketoprofen are used to relieve edema.

Warming ointments are used only from the 3rd day after injury. They improve local blood flow, accelerate ligament regeneration and help reduce inflammation. These include medicinal herbs, as well as products based on snake or bee venom. Representatives: Apisatron, Vipratox, Elaur, Capsoderm, Capsicam.

Folk remedies

How to treat shoulder sprains with folk remedies (compress recipes):

raw potatoes with sugar and onions;
aloe juice with honey;
loam;
gauze soaked in boiled milk;
a mixture of calendula, mint and sycamore;
sugar with onions and body butter.

Folk remedies can be used already during the recovery period, after the exacerbation of symptoms has subsided. Compressions will help relieve pain and reduce inflammation.

Gymnastics for shoulder sprains

Rehabilitation exercises are recommended a few days after the injury. Start with simple circular movements and arm abduction. After a week, you can do weight training exercises.

After sprains and cuts, do not exercise if every movement is accompanied by pain. It is also necessary to stop exercising when symptoms worsen during the process.

A set of exercises for shoulder injuries:

Standing, swinging movements are performed with the hands;
standing, hands clasped, raised to the chin, bent at the elbows;
standing with a stick in his hands, he makes chaotic movements with his hands;
against the wall with outstretched arms, sliding along the wall from bottom to top, without breaking away;
standing, raising and lowering your arms, putting your sore hand in a handkerchief.

Make a fist with your fingers and relax them throughout the day. This helps bruises resolve faster.