Part 2: Ice it or ER? Shoulders by Tufts MC

Part 2: Ice it or ER? Shoulders by Tufts MC

We’re back again for a Q&A with Dr. Matt Salzler, MD from Tufts Medical Center’s Sports Medicine program.  Not only is Dr. Salzler a seasoned orthopedic doctorssurgeon with an expertise in sports medicine, he has extensive experience working with athletes as the team physician for Tufts University, Emerson College, Quincy High School, North Quincy High School and the Quincy Militia Football team.

This week, we’re focusing on shoulder injuries.  We’ll help you figure out – should you just ice it, or is further treatment needed?

Because it has the largest range of motion, the shoulder is the least stable joint in the body.  This can lead to a number of different injuries, but unlike knee injuries, shoulder injuries are less commonly caused by overuse – those are mainly seen in overhead throwing and hitting sports.  Shoulder injuries that the casual athlete might experience often will be from a traumatic event – i.e. sudden or violent movements or falls.

One common shoulder injury is dislocation or subluxation.  Dislocation is when the upper arm pops out of the shoulder socket and stays that way. Subluxation is when the upper arm pops out or almost out of the socket and then back in again on its own.

Typically, dislocation and subluxation occur as a result of a traumatic movement or impact, when your arm and hand is positioned up over your head, in a field goal position.

If you dislocate your shoulder, you should head straight to the Emergency Room for treatment.  For a suspected subluxation, you should call a sports medicine doctor for a fairly urgent follow-up.

12118tnOther shoulder injuries include a SLAP tear or a labral tear, in which the tissue around the shoulder socket tears.  An AC joint separation, which occurs from falls onto the outstretched arm or onto the shoulder itself. This type of injury results in an unusual bump on the top of the shoulder.

Surprisingly, an injury you hear a lot about – a torn rotator cuff or other rotator cuff issues – are fairly uncommon in the under-40 population!

Symptoms

With shoulder injuries, you’re unlikely to experience swelling or bruising, since the joint is so deep.  However, you might experience pain and deformity (most clearly in the cases of a dislocation).  If you have difficulty moving your shoulder, or cannot move it at all, that is another indication of a shoulder injury.

General Prevention

Since most causes of shoulder pain and injury are from traumatic experiences – sudden, violent twisting, contact or falling – it is difficult to recommend prevention methods.  However, periscapular strengthening exercises to keep the shoulder and the muscle groups around the shoulder strong can help.


Your Questions, Answered!

Q: What are some at-home exercises I can do to prevent shoulder injuries?

A: If you strengthen the muscles around your shoulder and keep your chest and back muscles strong, you are less likely to injure yourself.

Try periscapular strengthening exercises such as dumbbell shrugs, band rows and internal and external weighted rotations.  You can do these or similar exercises at home with weights and resistance bands, or at the gym with machines.  It is better to start these exercises with lighter weights, especially for slender people. Regardless, make sure you’re doing them correctly to prevent other injuries.

Q: If I have shoulder pain but it is nothing too serious and I have been icing it, how long until I can go back to playing sports?

A: If the pain is the result of a specific event such as a fall, you probably want to have your shoulder checked out by a sports medicine doctor.  However, if there was just a general onset of pain not as a result of a traumatic event, you can go back to playing sports as soon as it feels comfortable.  If the pain returns when you start tuftsplaying sports again, plan to see a doctor.

Q: If I have tendinitis in my shoulder, will icing it cure it? Or should I go see someone at Tufts Medical Center?

A: Tendinitis in the shoulder in young people can sometimes be caused by an underlying problem. If icing doesn’t make the tendinitis go away, you should see a doctor to make sure there is nothing else going on.

Q: Yesterday I injured my shoulder playing golf and I was in a lot of pain. Today I have complete mobility but some areas still have pain. Should I see a doctor or just ice it?

A: If you developed the pain after playing golf, ice the shoulder and give it a few days to improve before seeing a doctor.  However, if a specific movement caused the pain and you think your shoulder dislocated or subluxated, you should see a doctor.

Q: Besides icing, how can I treat shoulder soreness/pain at home?

A: RICE (Rest, Ice, Compression & Elevation) and the exercises mentioned above are good for treatment, not just prevention of injury.  You can take ibuprofen to help with pain and soreness, but you should do so under the direction of a doctor.

Q: Yesterday I was playing dodgeball and right after I threw a ball, my shoulder started to hurt. There was a sharp pain in my shoulder and it was very sore. How long should I wait to see a doctor at Tufts Medical Center?

A: If you have any sort of deformity (dislocation) you should see a doctor right away.  Without dislocation, if you can’t move your arm the next day and are concerned, call the sports medicine program.  If you have full mobility the next day and the injury is slowly improving, give it a week or two before seeing a doctor, in case it resolves itself on its own.


Do you have any questions or other parts of the body you’d like to ask questions to Tufts MC about? Tweet@socialboston or @tuftsmedicalctr and let us know!

The content provided in this post is intended solely for the information of the reader. This information is not medical advice and should not replace a consultation with a medical professional. Please call 617-545-5352 to make an appointment with a physician if you’d like more information.

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