I’m often asked how an athlete or active person can know if his or her shoulder injury is serious. Should a woman who does CrossFit or fitness classes ice her shoulder and rest it for a day or two and see if her pain improves? Should a weightlifter go to an emergency room or see an orthopaedic surgeon right away after feeling a sharp pain during an exercise?
This list is far from comprehensive, but here are several signs you have a shoulder injury that might require surgery or an extended absence from physical activity.
You have an obvious deformity.
If you landed directly on your shoulder or someone hit you directly on your shoulder, it is possible you suffered a fracture or joint injury. An obvious deformity where part of the collarbone is sticking up likely represents a clavicle fracture. A large prominence at the top of the shoulder could signify an acromioclavicular (AC) joint injury. And the crooked appearance of the upper arm could represent a proximal humerus fracture.
Your shoulder popped out of place.
If you suffered a shoulder dislocation, especially a traumatic dislocation that required a doctor in an emergency room to put it back in place, there is a good chance that you tore the labrum and/or stabiliz-ing ligaments and stretched out the capsule. This fact is especially true if you are younger than 25 years old or so. Recurrent dislocations and instability can commonly result from these injuries. Sports medicine surgeons often repair these injuries surgically.
You have difficulty lifting the arm.
Pain can make it difficult to lift your arm. If you can tolerate the pain and still don’t have the strength to actively lift your arm (without using your other arm to do it), then you could have a rotator cuff tear or other structural injury.
You notice a clicking or popping sensation deep in the shoulder.
This symptom is tricky, because popping means different things to different people. It is by no means a definitive sign of a labral tear, but I’ve seen many young adults who complained of an uncomfortable popping in the front of the shoulder and deep within the shoulder who ended up having a tear. They often feel it doing a bench press, military press or push-up. Again, this complaint is not diagnostic, but it could represent a labral tear.
You have pain reaching across your body.
This sign can result from chronic issues in weightlifters, bodybuilders, collision sport athletes and manual laborers. It could represent overuse conditions like distal clavicle osteolysis or arthritis of the AC joint. After a traumatic injury, it could represent an AC joint injury.
Again, this list is not comprehensive, so it should not replace the advice of your doctor. If anything, I hope you would consider seeing your doctor or an orthopaedic surgeon soon after an injury if you have any of these complaints.
Dr. Geier is an orthopaedic surgeon at Sports Medicine Specialists of Charleston and the medical director of East Cooper Sports Medicine.