Even minor car accidents can leave people with various types of injuries that range from mild to severe. Some of the most common include shoulder injuries, thanks in large part to the strain on the shoulder from the seatbelt. If you experience shoulder pain after an accident, it is important to seek medical help right away, as the shoulder is a complex joint and the injury may worsen if not treated.
What are some common shoulder injuries after a car accident?
Some people waver about whether to seek medical treatment for shoulder pain after an accident, especially if the pain was not initially severe. It can often be challenging to grasp the seriousness of an injury based on pain alone. Understanding the risk that car accidents pose can help you feel more confident about seeking medical guidance.
Rotator cuff tear
The most common severe shoulder injury in vehicle collisions are rotator cuff tears, which involves the detachment of the tendon connecting the upper arm bone to the shoulder. Sudden trauma (such as an auto accident) is a frequent cause of these types of injury, though they can also occur gradually over time.
There are different types of rotator cuff tears:
- Partial tear. The tendon is not completely detached from the bone. Rather, the tear goes through only part of the thickness of the tendon, causing it to thin. Thus, it is more susceptible to further injury if left untreated.
- Full-thickness tear. A piece of the tendon is detached from the bone. When a small part is detached, it’s referred to as a full-thickness incomplete tear. By contrast, when a tendon completely detaches from the bone, you’ve experienced a full-thickness complete tear – a hole or gap in the tendon.
Symptoms of a rotator cuff tear
- Pain while resting or trying to sleep, especially when lying on the affected shoulder.
- Pain when lifting and lowering the arm, or when lifting heavy objects.
- Weakness or pain when twisting or rotating the arm.
- A crackling sensation (crepitus), when moving your shoulder in certain ways.
Bone Fractures and Dislocations
A dislocated shoulder happens when the humerus is pushed out of the shoulder blade’s socket. After the shoulder is put back in place by a physician, further orthopedic treatment is necessary to stop the shoulder from becoming dislocated or unstable again.
Bankart tears usually occur in younger people and can happen when the shoulder is coming out of the joint and the labrum is torn. This can cause instability and lead to further dislocations. Frozen shoulder can emerge when people don’t move the joint due to pain caused by another problem. To treat frozen shoulder, the original problem needs to be identified and treated.
Whiplash is a neck injury sustained during a blunt force trauma, and it can impact the shoulder and back as well. It occurs when the neck is forced to move back and forth rapidly.
While whiplash is a common type of injury, it is given serious consideration by medical professionals because the upper body (neck and shoulders) is especially prone to harm. When it does not lead to more serious injuries such as bone fractures and concussions, it often results in soft tissue damage of many types, as we discuss more below.
Soft tissue damage and bruising
A contusion is a type of injury that is caused by a strong impact, like a kick, fall, or hit, which leads to tenderness, swelling, and a change in skin color due to bleeding in the affected area. Note that bruising can also be an indication of more severe injuries as well. If you’ve lost your full range of movement or are experience numbness, tingling, or severe pain, you should seek consultation.
Symptoms of soft tissue swelling
- pain in the shoulder and upper arm – in some cases, this can appear as a sharp pain or ache and may radiate down the arm
- pain when lifting, driving or reaching overhead
- pain when lying on the shoulder – which may worsen at night while sleeping
- mild muscle weakness in the shoulder, making it difficult to raise the arm easily
Shoulder sprains and strains
When the ligaments in the shoulder are stretched or torn beyond their usual range of motion, it is known as a sprain. In a strain, a similar injury occurs with a tendon. Sprains involve the bands of tissue connecting two bones, whereas strains occur where muscle connects to bone. Both are typically caused by a hard, sudden pull of the upper arm away from its normal position.
Sprains are graded by levels, with the first grade being the least severe (presenting with only mild pain and swelling) while the third grade is considered a major sprain (intense pain and significant loss of function and swelling).
Sprains and strains can cause more intense and longer-lasting pain than dislocations, though the physical damage caused is typically less severe.
What treatments are recommended for shoulder injuries from car accidents?
You should see an orthopedic doctor immediately after a car accident to make sure you don’t have any hidden injuries that will worsen with time. In fact, because the injuries suffered in a car crash are often time-sensitive and difficult to detect, many primary care physicians will immediately refer their patients to an orthopedic specialist after a car accident.
Consultation and Imaging
There are multiple ways for your doctor to test for injuries to the shoulder. In the case of a possible labral tear, for example, the doctor will first do a physical exam, though these injuries can be hard to detect due to the cartilage being deep in the shoulder. They will evaluate range of motion, pain, and stability. Because physical exams can’t always confirm the diagnosis, a physician may order an MRI or CT-arthrogram to verify the presence of a tear or any other damage.
Although these tests are accurate, they may not be able to provide the full picture of a SLAP-type labral shoulder tear. In those cases, the doctor may suggest a minor surgical procedure known as arthroscopy. Advances in technology and innovative surgical practices have made it possible to perform a range of shoulder operations using this minimally invasive technique, which involves tiny incisions and the use of a camera to diagnose and treat internal injuries.
If you have had a shoulder injury or operation it is important to follow the R.I.C.E. technique, which involves taking time to rest, icing the area to reduce inflammation, wearing a bandage or brace for compression, and elevating the affected area while resting.
In addition to the R.I.C.E. method, be sure to attend follow-up appointments with your doctors and physical therapists. Your PT will give you strengthening exercises to practice as you recover. Be sure to consistently practice the exercises your PT prescribes. Finally, start slowly as you return to daily and athletic activities.
While RICE can mitigate some minor symptoms, if you have ongoing discomfort, limited mobility, or severe pain, it’s important to see your orthopedist right away.
Physical therapy is a form of care that relieves pain and gets back the ability to move (including activities such as standing, walking, running or other specialized athletic movements) after an injury or operation. Physical therapists can assist you in regaining movement and function through prescribed exercises and hands-on care.
Back, neck and shoulder discomfort and pain can be caused by a variety of injuries that can be helped with physical therapy. We suggest physical therapy for patients to reinforce their strength and get back full use of their shoulders.
Injections of corticosteroids help reduce swelling and improve symptoms associated with bursitis, tendonitis, and torn tendons. These injections are directed specifically at the areas of the shoulder causing discomfort.
Bursal injections are aimed at the bursa found over the tendons, relieving tendonitis. Joint injections in the shoulder joint work to treat frozen shoulder and arthritis, while AC joint injections treat acromioclavicular degeneration that causes pain at the top of the shoulder.
When experiencing pain in the front of the shoulder, your doctor may recommend Injections into the long head of the biceps to treat biceps tendonitis. Lastly, suprascapular nerve block is sometimes used for cases of arthritis and rotator cuff tears that can’t be easily operated on.
In most cases, shoulder injuries are handled with less intrusive measures, such as anti-inflammatory drugs, altered activity patterns, physical therapy, and cortisone shots. But when conservative measures fail to work, or when the trauma is severe, surgical techniques might be employed. Whenever possible, doctors usually recommend an arthroscopic procedure. Even a tear in the rotator cuff that separates the tendon from the shoulder bone can be fixed arthroscopically without large incisions.
In shoulder replacement surgery, a metal ball with a stem is positioned on the shoulder and the humerus is reconnected to it. This allows for greater movement and better functioning following the operation, which is usually done as an outpatient procedure and does not require a lengthy hospitalization.
Bankhart Lesion Repair is a surgical technique that addresses instability issues in the shoulder joint. It is done through minimally invasive arthroscopy–typically as an outpatient procedure. Following the procedure, physical therapy is recommended for up to twelve weeks to ensure a successful recovery.
Get help for your shoulder pain at Alexander Orthopaedics
Experiencing a car crash can be a difficult process for both your body and mind. Alexander Orthopaedics is here to support you on your journey to recovery and help return you to the activities you enjoy. If you are suffering from shoulder pain as a result of an automobile collision, schedule an appointment with Alexander Orthopaedics.