Shoulder Injury

By David A. Thompson, M.D. 
March 22, 2017

911 warning

Shoulder Injury

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Does this describe your symptoms?

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Bruise on Shoulder (4 Days Old)

Bruise on Forearm

First Aid - Bleeding Arm

First Aid - R.I.C.E.

X-Ray - Shoulder Dislocation

First Aid - Sling - How to Put On

First Aid - Splint for Wrist Injury

X-Ray - Normal Shoulder


  • Injuries to a bone, muscle, joint or ligament in the shoulder

Types of Shoulder Injuries

  • Fractures (broken bones)

  • Dislocations (bone out of joint)

  • Sprains - stretches and tears of ligaments

  • Strains - stretches and tears of muscles (e.g., pulled muscle)

  • Muscle overuse injuries from sports or exercise (e.g., strain, bursitis, tendonitis)

  • Muscle bruise from a direct blow (e.g., contusion)

  • Causes extrinsic to shoulder (referred pain) - Examples include neck pain, cardiac disease, abdominal disorders, spleen injury

If not, see these topics

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase bleeding).

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for Suspected Fracture or Dislocation of the Shoulder:

  • Use a sling to support the arm. Make the sling with a triangular piece of cloth.

  • Or, at the very least, the patient can support the injured arm with the other hand or a pillow.


When to Call Your Doctor

call 911

Call 911 Now (you may need an ambulance) If

  • Major bleeding (actively dripping or spurting) that can't be stopped

  • Amputation or bone sticking through the skin

call now

Call Your Doctor Now (night or day) If

  • You think you have a serious injury

  • Injury looks like a broken bone or dislocated joint (crooked or deformed)

  • Can't move injured shoulder at all

  • Collar bone is painful or tender to touch

  • Severe pain

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen

  • Can't move injured shoulder normally (e.g., full range of motion, able to touch top of head)

  • There is a large swelling or bruise (wider than 2 inches) at the site of the injury

  • You are over age 54, have osteoporosis, or use steroid medications routinely

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Injury interferes with work or school

  • Pain has not improved after 3 days

  • Injury is still painful or swollen after 2 weeks

home care

Self Care at Home If

  • Minor shoulder injury and you don't think you need to be seen



  1. Treatment of a Bruise (e.g., direct blow to shoulder):

    • Apply a cold pack or an ice pack (wrapped in a moist towel) to the area with ice for 20 minutes each hour for 4 consecutive hours (i.e., 20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).

    • Rest the injured part as much as possible for 48 hours.

    • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.

  2. Treatment of Sprains and Strains:

    • FIRST AID - Apply an ice pack (crushed ice in a plastic bag covered with a moist towel) to reduce bleeding, swelling, and pain.

    • Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first 2 days.

    • REST the injured shoulder for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.

  3. Pain Medicines:

    • For pain relief, take acetaminophen, ibuprofen, or naproxen.

    Acetaminophen (e.g., Tylenol):

    • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.

    • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.

    • The most you should take each day is 3,000 mg.

    Ibuprofen (e.g., Motrin, Advil):

    • Take 400 mg by mouth every 6 hours.

    • Another choice is to take 600 mg by mouth every 8 hours.

    • Use the lowest amount that makes your pain feel better.

    Naproxen (e.g., Aleve):

    • Take 250-500 mg by mouth every 12 hours.

    • Use the lowest amount that makes your pain feel better.

    Extra Notes:

    • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An acetaminophen overdose can hurt the liver.

    • Caution: Do not take acetaminophen if you have liver disease.

    • Caution: Do not take ibuprofen or naproxen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of medicine. Do not take ibuprofen or naproxen for more than 7 days without consulting your doctor.

    • Before taking any medicine, read all the instructions on the package

  4. Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.

  5. Call Your Doctor If:

    • Pain becomes severe

    • Pain does not improve after 3 days

    • Pain or swelling lasts more than 2 weeks

    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.


March 22, 2017