Acute Shoulder Injuries

Acute shoulder injuries

Sudden onset or acute shoulder injuries happen suddenly, often through a fall onto an outstretched arm or through direct impact. They include rotator cuff tears, dislocations and shoulder joint sprains.


Always seek medical advice if the pain is severe or you are in any doubt.

Rotator cuff tear

Rotator Cuff Tear

A rotator cuff strain is a tear to any of the four ‘rotator cuff’ muscles in the shoulder and is common in throwing and racket sports. Symptoms include:

  • Sudden shoulder pain with a feeling that something has torn.
  • Pain may also radiate down into your arm.
  • Rotator cuff strains can range from mild to very severe.

Read more on Rotator cuff strain.

Dislocated shoulder (anterior)

Dislocated Shoulder

A dislocated shoulder is a very traumatic and painful injury. Dislocations occur when the head of the humerus (upper arm bone) pops out of the shoulder joint. Shoulders usually dislocate anteriorly (forwards), as your arm moves upwards and outwards. Symptoms include:

  • Severe pain
  • Rapid swelling around the joint
  • Deformity or shoulder appears ‘dropped’

If you suspect your shoulder has dislocated then seek medical attention immediately. Do not try to pop it back into place as this may cause permanent injury to nerves or blood vessels.

Read more on a Dislocated shoulder.

Dislocated shoulder (posterior)

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A posterior shoulder dislocation is less common and occurs when the head of the humerus moves backwards out of the socket. This is a relatively rare injury as most shoulder dislocations are anterior.

Contact sports, car accidents or falls cause posterior shoulder dislocations. Symptoms are similar to anterior dislocations with severe pain, swelling and complete loss of function.

AC joint separation

AC Joint Separation

An AC joint separation, or AC joint sprain, is a tear to the ligament that joins the acromion and clavicular bones at the top of the shoulder. Falling onto an outstretched arm is a common cause. Symptoms include:

  • Severe pain and swelling
  • Pain radiates throughout the shoulder initially
  • Later pain is localized to the top of the shoulder

Read more on AC joint sprain

Long head of biceps rupture

Long Head Biceps Rupture

This is a tear or strain of the long tendon of the biceps muscle which originates from the shoulder. It is more common in older athletes. Symptoms consist of:

  • Sudden sharp pain at the front of the upper arm/shoulder
  • Visible swelling at the front of the shoulder joint
  • Pain contracting the biceps muscle against resistance
  • Pain on resisted shoulder flexion (straight arm raise)

Read more on Long head of biceps rupture.

Clavicle fracture

Clavicle Fracture - acute shoulder injuries

A clavicle fracture or broken collarbone often occurs as a result of a fall. If you suspect a broken collarbone seek medical attention immediately. Symptoms include:

  • Severe pain in the collarbone
  • Sometimes swelling
  • Bony deformity

Read more on broken collar bone.

Shoulder sprain

A shoulder sprain is damage to the shoulder ligaments or capsule supporting the glenohumeral or shoulder joint. Symptoms vary depending on how bad your injury is. Symptoms include:

  • Shoulder pain, usually at the front
  • Swelling
  • Tenderness when pressing in
  • Painful movement

Read more on Shoulder sprains.

Deltoid muscle strain/contusion

Deltoid Muscle Strain - acute shoulder injuries

Contusions are caused by a direct impact on the muscles, usually from a hard, blunt object such as a hardball or an opponent’s elbow! The deltoid muscle on the outside of the shoulder is most likely to suffer a contusion as it is superficial and exposed. Symptoms include:

  • Pain in the muscle after impact
  • Swelling with bruising developed soon after
  • Difficulty lifting the arm
  • A ‘dead’ arm with the muscle tender to touch

Read more on deltoid strains & contusions.

Pectoralis major tendon strain

Thankfully, this is a rare acute shoulder injury. The pectoralis major muscle is a large powerful muscle at the front of the chest. It is used to rotate the arm inwards. Its weak point is where the tendon attaches to the arm bone, and a strain or rupture can happen here when it is put under stress when weight training for example. Symptoms of this shoulder injury include pain and swelling at the front of the shoulder.

Fracture of the Neck of the Humerus

A fractured neck of the humerus is often caused by falling onto an outstretched hand or a direct impact on the shoulder. It is seen more often in young adults, adolescents, and the elderly. A sling will need to be worn to allow the fracture to heal, before commencing rehabilitation exercises. Read more on the treatment of this shoulder injury.

Read more on Humerus neck fracture.

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Proximal Humerus Growth Plate Fracture

A growth plate fracture, or epiphysis plate fracture, occurs at the end of a bone in children before the bone fully turns from cartilage to hard bone. A proximal humerus fracture occurs in the upper arm, near the shoulder, and is normally caused by a hard impact like a fall. Symptoms consist of:

  • Severe pain
  • Swelling in the upper arm
  • Painful movement

Read more on Proximal humerus growth plate fracture.

Scapula Fracture

A scapula fracture is a break in the shoulder blade bone at the back of the shoulder. This is a relatively uncommon injury, making up only 1% of all fractures, and can be caused by direct blows and car accidents. Symptoms include severe shoulder pain at the back of the joint and difficulty moving the arms. Read more about the causes, symptoms, and treatment of this fracture.

Read more on Scapula fracture.

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