Shoulder Injury: Symptoms, Self-Assessment, and When to Seek Help

How do you know if your shoulder is injured?

Identifying a shoulder injury involves recognizing specific pain patterns, changes in range of motion, weakness, and other tell-tale signs that deviate from normal function, often requiring a systematic self-assessment before professional medical evaluation.

Understanding the Shoulder's Vulnerability

The shoulder joint, comprised primarily of the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone), is the most mobile joint in the human body. This incredible range of motion, however, comes at the cost of stability, making it highly susceptible to injury. A complex interplay of muscles (especially the rotator cuff), tendons, ligaments, and the joint capsule work together to provide both movement and stability. When any of these structures are compromised, function is impaired, and pain often ensues. Recognizing the signs of injury early is crucial for effective management and recovery.

Common Signs and Symptoms of a Shoulder Injury

An injured shoulder will typically present with a combination of symptoms. Pay close attention to the following:

• Pain:
  • Location: Can be localized to the front, side, or back of the shoulder, radiate down the arm, or even into the neck.
  • Type: Sharp, dull, aching, throbbing, burning, or shooting.
  • Severity: Mild discomfort to excruciating, debilitating pain.
  • Timing: Pain that is constant, intermittent, worse with certain movements, at night, or after activity.
• Reduced Range of Motion (ROM):
  • Active ROM: Difficulty or inability to move your arm through its full range of motion (e.g., reaching overhead, behind your back, or across your body) without assistance.
  • Passive ROM: Pain or restriction when someone else moves your arm for you, indicating a structural limitation rather than just weakness.
• Weakness:
  • Difficulty lifting objects, pushing, pulling, or performing everyday tasks that require arm strength.
  • A sensation of the arm "giving out" or feeling unstable.
• Clicking, Popping, Grinding (Crepitus):
  • Audible or palpable sounds during shoulder movement. While some sounds can be benign, persistent or painful clicking/popping often indicates issues with the joint surfaces, labrum, or tendons.
• Instability or Apprehension:
  • A feeling that your shoulder might "pop out" of joint, especially with certain arm positions (e.g., arm abducted and externally rotated). This is a hallmark of shoulder dislocation or subluxation.
• Swelling and Bruising:
  • Visible inflammation or discoloration around the shoulder joint, indicating acute trauma or internal bleeding.
• Deformity:
  • A noticeable change in the contour of the shoulder, such as a bump, depression, or an arm that hangs at an unusual angle, often indicative of a fracture or severe dislocation.
• Numbness or Tingling:
  • Sensory changes in the arm or hand can indicate nerve involvement, potentially due to impingement, direct nerve injury, or referred pain from the neck.

Specific Tests and Movements to Assess Your Shoulder

While not a substitute for professional diagnosis, you can perform some simple self-assessments to gauge the extent of potential injury. Proceed with caution and stop immediately if you experience sharp pain.

• Active Range of Motion (AROM) Assessment:
  • Flexion: Raise your arm straight forward and overhead. Note any pain or limitation.
  • Abduction: Raise your arm out to the side and overhead. Pay attention to the "painful arc" (pain between 60-120 degrees of abduction), which can suggest rotator cuff impingement.
  • External Rotation: With your elbow bent at 90 degrees and tucked into your side, rotate your forearm outward.
  • Internal Rotation: With your elbow bent at 90 degrees and tucked into your side, rotate your forearm inward, or try to reach behind your back as high as possible.
• Resisted Movement Tests:
  • Have a friend or family member gently resist your movements while you attempt to move your arm. Pain or weakness during resisted movements can pinpoint specific muscle or tendon involvement.
  • Resisted External Rotation: Tests infraspinatus and teres minor.
  • Resisted Internal Rotation: Tests subscapularis.
  • Resisted Abduction: Tests deltoid and supraspinatus.
• Palpation: Gently press around the bony landmarks and soft tissues of your shoulder. Tenderness in specific areas can indicate localized inflammation (e.g., AC joint, biceps tendon, rotator cuff insertions).

Common Shoulder Injuries and Their Hallmarks

While a definitive diagnosis requires medical imaging and clinical examination, understanding common injuries can help you contextualize your symptoms:

• Rotator Cuff Tendinopathy/Tear: Pain with overhead movements, weakness, especially with rotation or abduction. Often worse at night.
• Shoulder Impingement Syndrome: Pain with overhead reaching, particularly in the "painful arc" of abduction. Pain often felt on the side or front of the shoulder.
• Labral Tear (e.g., SLAP, Bankart): Deep, aching pain, clicking/popping, instability, or a "dead arm" sensation, especially with throwing motions or overhead activities.
• Shoulder Dislocation/Subluxation: Immediate, severe pain, visible deformity, and inability to move the arm. Subluxation is a partial dislocation, less severe but still causing instability.
• AC Joint Sprain (Separated Shoulder): Pain and tenderness directly over the top of the shoulder (acromioclavicular joint), often with a visible bump after a direct fall onto the shoulder.
• Bursitis: Pain with movement and often at rest, tenderness over the deltoid, and limited range of motion, due to inflammation of the bursa (fluid-filled sac).
• Frozen Shoulder (Adhesive Capsulitis): Gradual onset of severe stiffness and pain that progressively worsens, significantly limiting both active and passive range of motion.

When to Seek Professional Medical Attention

While minor aches may resolve with rest and conservative measures, certain signs warrant immediate medical evaluation by a physician, physical therapist, or sports medicine specialist:

• Severe, excruciating pain that doesn't improve with rest.
• Inability to move your arm or lift it at all.
• Visible deformity of the shoulder joint.
• Numbness, tingling, or weakness extending down the arm or into the hand.
• Pain that occurred after a traumatic event (e.g., fall, direct blow, car accident).
• Pain that wakes you up at night consistently.
• Symptoms that persist or worsen after a few days of rest and conservative self-care.
• Concerns about instability or repeated dislocations.

Prevention and Rehabilitation Principles

Early identification of an injury allows for timely intervention, which is critical for preventing chronic issues. Beyond diagnosis, effective management often involves:

• Rest and activity modification to allow tissues to heal.
• Pain and inflammation management (e.g., RICE protocol in acute phases).
• Physical therapy to restore range of motion, strength, and proper biomechanics.
• Gradual return to activity, following a structured rehabilitation program.
• Addressing underlying muscular imbalances or movement patterns that contributed to the injury.

Disclaimer

This article provides general information and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new exercise program.