Shoulder injuries are very common in collision sports (eg rugby union) and in sports that use a large range of motion of the shoulder (eg swimming or gymnastics). The large freedom of movement and the shallow fit between joint surfaces make the shoulder prone to injury. Damage to the ligaments and muscles may lead to pain and instability.
How do shoulder injuries occur?
Shoulder injuries occur after falling on an outstretched hand or on the point of the shoulder, following a direct blow to the shoulder or from overuse. These forces may cause an over-stretching, tearing or a complete rupture of one or more of the ligaments or muscles.
Treatment
Apply the R.I.C.E.D. procedure.
Rehabilitation
Always seek advice from a medical professional, for a rehabilitation programme specific to you and your injury. To minimise the risk of re-injury, ensure you are completely rehabilitated before returning to sport.
Range of motion
Pendulum exercises can improve shoulder movement. For example, let your arm gently swing forwards and backwards while bending forward.
Cardiovascular fitness
Keeping fit will ensure a more comfortable return to both training and competition. Power walking, running and stationary cycling are excellent methods of maintaining fitness.
Strength
Strength can be improved by performing isometric contractions (holding a fixed position for 10 to 20 seconds) against resistance. As strength and range of motion improve, light weights or flexibands can be used for added resistance through a greater range of motion.
Balance
Proprioception training will help re-educate the shoulder muscles, improve joint stability, and protect against future injury. Push-ups and chest-passing a ball against a wall will improve strength and coordination.
Psychological status
Gradually attempting more difficult agility tasks and setting realistic goals and timeframes may help rebuild sporting confidence.
Sport-specific rehabilitation
When general function has been restored, rehabilitation should focus on preparing the shoulder for sport-specific activity, for example throwing, hitting and passing actions.
Reduce the risk of re-injury
Always seek the advice of a medical professional before returning to sport. Inadequate rehabilitation will increase the risk of re-injury. You can reduce re-injury by:
- continuing stretching, balance and strengthening exercises
- warming up before any explosive movements or impacts
- practising correct tackling and falling techniques at all times
- learning to roll safely instead of breaking a fall with an outstretched arm.
Bracing and taping
Bracing and taping provides some protection against joint injuries. The support provided by taping is generally reduced after 20 minutes of play, so where possible use braces rather than tape. Ensure that the brace:
- fits correctly
- complies with the rules of the game
- is suitable for you and the sport.
If shoulder pain persists, consult a medical professional for advice on other possible contributing factors.
Resources
For more information, see Shoulder injuries (PDF 183K).
Last updated: 20 April 2009