Mild soft tissue injuries of the shoulder should settle and resolve within a short period of time. Expect movement of your arm to be uncomfortable immediately after your injury.
You will have been assessed in A&E and given advice relating to your specific injury with regards to the protection of your shoulder, with rest and possible pain relief.
Take advantage of adequate pain relief. If the medication you have been prescribed is not easing your pain, go to your GP or pharmacist for a medication review.
Timescales of healing vary between individuals and their specific injury; however, it may take up to 6 – 8 weeks for pain and symptoms to completely settle. Returning to higher activity levels and sport may take longer. These time frames may be dependent on following early advice and rehabilitation.
Common symptoms include:
- Pain – Use regular pain relief, if needed. Your GP / Pharmacist can advise you on this
- Poor movement
- Swelling – Generally worse in the first 2 – 3 weeks but can last longer than this
- Bruising – Can last 2 – 3 weeks and may spread into the elbow, wrist and hand
Less common symptoms include:
- Neck pain
- Pins and needles in the arm
- Numbness of the arm
It often takes at least 6 – 8 weeks for symptoms to fully settle after a significant shoulder injury. Returning to higher activity levels and sport may take longer. These time frames may be dependent on following early advice and rehabilitation.
First 48 hours
Protection and rest
- It is important to protect your shoulder in the early stages from further stresses. This will allow the healing process to take place effectively
- Depending on the severity of your injury, you will be provided with a sling to support your arm to make you more comfortable. The professional assessing you will decide whether this is necessary
- It is important that you take the sling off for short periods on a regular basis, at least three or four times a day
- While your arm is out of the sling, or if you are not wearing a sling, it is important to keep your arm and neck moving
Ice
- This can help to limit the swelling and pain in your shoulder
- Place crushed ice or a bag of frozen peas wrapped in a damp towel on the injured area, ideally every 3 hours after the injury; for up to 20 minutes each time
- Check the skin regularly as ice can burn
Elevation
- Soft tissue injuries can swell quickly due to gravity
- Raising the arm will help to limit swelling and should be done immediately after an injury
Hand: open and close your fingers to form a full fist
Wrist: move you hand backwards and forwards; turn it palm
up and palm down
Elbow: fully bend and straighten your elbow
Neck: slowly move your head up and down, side to side and
turn to the left and right
- Moving, too much, too soon can disrupt the healing process; however, early gentle movements can actually promote the healing process, and prevent stiffness or weakness developing from disuse
- For the shoulder, gentle pendular exercises will prevent it from stiffness and help promote healing
- Perform each exercise below, approximately 1 minute, three to four times a day
Exercises
Pendular swinging
Gently swing your arm backwards and forwards, side to side and in circles, clockwise and anti-clockwise. Repeat little and often.
With pain relief medication, rest and the gentle exercises, the pain should begin to ease within a few days.
Assisted movement on your back
Lie on your back. Use your good arm to gently help your affected arm, up and towards your head. Repeat 5 – 6 times every 2 hours.
Unless you have been given strict instruction by the medical staff to wear your sling for a certain period of time, the sling should only be worn to protect the arm when it is painful.
Once it becomes more comfortable, you should try and remove the sling and gently begin to use your arm.
It is important to maintain the movement of your shoulder using your other arm if you are unable to maintain this on its own. As your pain settles, you may find that you are able to lift your arm progressively higher on its own.
Driving / Work / Sport
- Returning to driving and work will depend on your individual injury, and what your occupation is
- We recommend before returning to driving that you can perform an emergency stop without hesitation and discomfort, and inform your insurance company
- As you return to work, you may find that your arm becomes more fatigued as the day goes on. You may wish to rest it temporarily in the sling in the evening to reduce discomfort. This change may be more significant if you do a manual job
- Return to sport is usually dependent on symptoms and the individual’s injury. You should be able to use the limb normally with no pain but a return to racket sports may take a little longer. Return to sport should be with graded return; for example, returning to light activity / training before taking part in a match. If you have any concerns regarding your recovery, please see your GP.
Evidence based information compiled by: Suzannah Jones, Senior Physiotherapist – Leeds Teaching Hospitals
Information approved by: Andy Webster, ED Consultant – LGI