Shoulder Pain after Car Accident

Shoulder injuries can result from different types of traumatic events, the most common ones being car wrecks.

Shoulder injuries can range from soft tissue injuries to serious ones such as fractures and dislocation.

Soft Tissue Injuries

Car accidents can lead to a variety of soft tissue injuries, including whiplash and shoulder impingement. Shoulder impingement happens when the rotator cuff tendon is pinched by the bone on top of the shoulder. Rotator cuff damage also occurs when trauma causes the bursa to become inflamed. The bursa is the lubricating sac that helps tendons to move freely. Another type of injury that car accident victims experience is a torn rotator cuff. These shoulder injuries can cause severe pain and limited range of motion and may require surgical intervention.

Common symptoms of a tear in the shoulder socket

Most symptoms of a tear in the shoulder socket are similar to that of many other major shoulder injuries. These include:

• A feeling of instability in the shoulder
• Locking or popping sensation or sound
• Pain when performing overhead activities
• Decreased strength
• Inability to sleep on the shoulder and nighttime pain
• A decrease in range of motion

Diagnosing a torn labrum/shoulder socket

This injury is generally diagnosed by physical exams and clinical observations. A doctor will also take the medical history of the accident victim, and ask how exactly the injury occurred. The doctor will perform several tests to determine stability, mobility and the kind of motions that cause pain.

Irregularities in bones are diagnosed using X-rays, however, they are not useful in the diagnosis of glenoid labral tears, because the glenoid labrum is not made of bone, and is instead composed of soft tissue. An MRI or CT scan is typically the best test for diagnosis of a glenoid labrum tear.

How is a torn labrum treated?

A torn labrum is a painful injury and restricts movement. The treatment usually depends on the type and severity of the tear. If the car accident victim is not experiencing serious pain, discomfort and other discomforts the doctor may just prescribe rest and anti-inflammatory medications. The doctor may also recommend physical therapy to strengthen the muscles around the labrum. This can greatly reduce the stress and tension on the labrum, and give it time to heal. However, if the injury is extremely serious, the patient may have to undergo surgery. Arthroscopic surgery is used when all other treatment options fail.

Types of shoulder dislocations

There are three main types of shoulder dislocations that can occur when there is a blow to the shoulder.

Anterior or forward dislocation

Anterior dislocation of the shoulder bone is one of the most common types of shoulder dislocations. The anterior dislocation accounts for about 95% of all dislocations, and are mostly caused by a direct blow to an outstretched arm. An anterior shoulder dislocation can be sub-coracoid, under the clavicle, retroperitoneal or intrathoracic.

Posterior or backward dislocation

Posterior dislocations are often caused when a person suffers an electric shock or a seizure. They are also caused if there is a strength imbalance in the rotator cuff muscles. Posterior or backward dislocations, at times, can be missed by doctors in an elderly person or a person in a coma.

Inferior or downward dislocations

Inferior or downward dislocations are rare and make up only 1% of all shoulder dislocations. Inferior or downward dislocations occur if the humeral head gets pushed up against the acromion, caused due to the excessive abduction of the arm. Inferior or downward dislocations cause a number of complications as such dislocation damages many vascular and neurological structures, tendons and ligaments.

Shoulder dislocation symptoms

The most obvious symptom of a shoulder dislocation is acute pain that originates in the shoulder and spreads to surrounding areas like the back, arm, chest, and neck. The arm cannot be moved from its position.

A visible distortion of the shoulder is seen and numbness in the affected arm is another symptom of shoulder dislocation. While all shoulder dislocations have no palpable bone in the shoulder area, some dislocations can make the shoulder look boxy.

Complications in a shoulder dislocation

Apart from the actual shoulder dislocation injury, one can experience certain complications as well, depending on the extent of the impact one faces in the car accident.

1. A fracture in the humeral head is a commonly found complication and is associated with about 25% of shoulder dislocations.
2. It has also been seen that about 75% of anterior dislocations have a Hill-Sachs deformity in the shoulder.
3. At times, patients with shoulder dislocations can injure a nerve as a result of the shoulder fracture. A nerve injury often results in numbness in the nerve region. Never injuries often heal within a few weeks, however, at times, they can affect the strength of the deltoid muscle if it does not heal well.
4. Older patients with a shoulder dislocation often have a complication with an injury to the rotator cuff muscles, which can be easily missed until the sling is off.
5. A rare complication resulting from a shoulder dislocation is rupturing or tearing of the axillary artery, the main artery that supplies blood to the arm.
6. A brachial plexus injury can also be an outcome of a shoulder dislocation.