Shoulder Contusion is an injury to the shoulder that usually heals without consequences. It is usually caused by a fall or impact trauma. A contusion can cause bruising and swelling due to the force applied to the affected tissue. A contusion of the shoulder is painful; often, the affected shoulder cannot be loaded as usual. The pain can also restrict movement, and the patient may involuntarily assume a relieving position. A contusion of the shoulder usually heals without consequences.
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Causes of shoulder contusion
The cause of a contusion of the shoulder is a violent impact on the shoulder, which damages the tissue. In everyday life, such an accident often occurs during sports. Especially in contact sports, falls on the shoulder, collisions, or fouls can cause a bruise of the shoulder. Bicycle falls or accidents at work, especially during manual activities, are also frequent accident mechanisms. The application of force to the shoulder causes the tissue to be bruised. This can lead to swelling or bruising, which is caused by small vessels rupturing. This irritation of the tissue causes pain. Pain serves as a protective function for the body and, in this case, prevents the shoulder from continuing to be subjected to heavy strain since the tissue needs to be protected to heal properly. The patient should listen to his pain and not perform any activities that cause him severe pain. Light activities that are not painful are, however, harmless and can even contribute to faster healing by improving blood circulation in the tissue.
Accompanying symptoms of shoulder contusion
Depending on how the shoulder was bruised, other parts of the body may have been injured due to the accident. Especially when the pain in the shoulder is at its greatest after the accident, the patient may not notice other injuries because he or she is distracted by the complaints in the shoulder or is still startled by accident. In such a case, it is important to observe the body closely in the initial period after an accident and to contact a doctor again if necessary if new pain occurs elsewhere.
Due to a relieving posture, which is often taken when the shoulder is bruised due to pain, tension can occur in the neck and back muscles. Patients often move less after a contusion of the shoulder, and there may also be other injuries so that they cannot move as usual. However, this maintains tension and sometimes makes it worse. Tension in the neck can also cause other symptoms such as headaches, dizziness, and tinnitus. Heat treatments and physiotherapy can help relieve tension.
Pain during the of shoulder contusion
Many complaints in the shoulder occur, especially at night. This is because, in an upright position, the weight of the arm creates more space between the head of the humerus and the shoulder height (acromion). If we lie down at night, this space becomes narrower, and the structures lying there become constricted. If the shoulder is bruised, structures lying there such as bursae and muscle-tendon sheaths can be swollen by accident, and the narrow space in a lying position is no longer sufficient. Their bruising can cause pain. However, there may also have been signs of wear and tear in the shoulder before, such as a calcified shoulder or irritation of the rotator cuff or the long biceps tendon, which now cause more pain due to the contusion and the associated inflammatory reaction. These diseases can also cause pain, especially at night.
Diagnosis of shoulder contusion
A contusion of the shoulder is a diagnosis of exclusion. If a shoulder is painful after an accident, injuries to the bone, tendons, and muscles, and other structures in the shoulder area should be ruled out by a doctor. If movement is restricted and painful, an x-ray is usually taken to assess the bony structures and joint conditions in the shoulder. In the case of a shoulder injury, specific examinations of strength and motor function are important to give the doctor indications of a rotator cuff injury. The rotator cuff consists of four muscles that surround the shoulder joint and are responsible for movements in the shoulder. If a lesion is suspected, further imaging with an MRI of the shoulder is usually necessary.
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Therapy of shoulder contusion
Shortly after the accident event that caused the bruising of the shoulder, cooling can be an analgesic therapy. Cooling can also reduce swelling. It is important not to cool for too long and with objects that are too cold; there is a risk that the tissue, especially the skin, will suffer frostbite. A good thing is a changing rhythm from 10 minutes cooling to 20 minutes, not cooling. Light painkillers such as ibuprofen can also relieve the pain. Immobilizing bandages such as an arm sling are not usually necessary in the case of a contusion of the shoulder; on the contrary, they can cause neck tension. Also, the shoulder is then often protected too much and is not moved at all.
However, a slight movement that does not cause the patient any pain, without great strain, is beneficial for healing, as the tissue is better supplied with blood, and secondarily the joint does not stiffen. The prescription of physiotherapy can also be useful here. The aim is not to lose the previously achieved extent of movement through the sparing and to support the structures during regeneration. As a rule, bruises of the shoulder heal without great therapeutic effort and consequences.
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What can be done about the pain?
In the acute stage, immediately after the accident, it is advisable to cool the affected shoulder to relieve the pain. Taking pain medication is also helpful, but should not be taken for more than a few days without medical supervision. Analgesic ointments can also be applied. It is important in the case of a contusion of the shoulder to take care of the affected shoulder and arm and not to subject them to any movements or strains that are painful. The pain has a warning function for the body and should not be ignored.
If the shoulder is bruised, measures such as Kinesio taping can be used to help. It is believed that Kinesiotaping has a positive influence on the regeneration of muscles and joints. Analgesic effects by inhibiting inflammatory reactions are also being discussed. Due to the supporting function of the tape, the joint is also relieved, which can lead to a relief of pain. Kinesiotaping is offered by many physiotherapists and doctors. Therapy with Kinesiotape is not paid for by the statutory health insurance companies.
Physiotherapy can help to release tension.
A contusion of the shoulder is a minor injury to the shoulder in which the joint structures do not suffer any consequential structural damage. As a rule, the shoulder can be used again shortly after the accident. For this reason, physiotherapy is not necessary. In the case of more protracted courses or accompanying symptoms such as tension, tense muscles can be loosened in physiotherapy, and complaints can be permanently alleviated by stretching and muscle strengthening.
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A contusion of the shoulder usually heals after three to four weeks, so that the complaints are then gone, and the shoulder is fully resilient again. Since bruising of the shoulder is a diagnosis of exclusion and is often diagnosed based on the symptoms without the need for complex diagnostics, it is advisable to consult a doctor again if the healing process takes longer. It must then be evaluated whether the complaints may be caused by an initially overlooked injury to the shoulder. Overloading shortly after a contusion of the shoulder, before the symptoms have disappeared, can prolong the healing process. Overloading the bruised shoulder causes irritation of the tissue, which leads to an inflammatory reaction. The tissue must then recover not only from the original bruise of the shoulder but also from this irritation. This recovery may take a longer period, especially in the case of repeated overloading.
How long is a person on sick leave?
The duration of sick leave after a shoulder contusion depends on several factors. Firstly, the patient’s pain symptoms must be taken into account. An important factor is, of course, the type of work the patient does. In the case of manual activities that require a high load on the shoulder, the patient may not be able to perform this activity due to the bruise of the shoulder. After two to three weeks, however, most manual activities should be able to be performed again. Especially work at the desk cannot be performed very quickly or even immediately after the accident.
What is the amount of compensation for pain and suffering?
If a contusion of the shoulder has occurred in an accident caused by another person, compensation can be claimed. Also, the injured person may have been unable to work and have lost work, and he or she can also claim compensation from the person who caused the accident. The amount of compensation for pain and suffering depends on any concomitant injuries and the limitations and symptoms associated with the injury. Tables for compensation for pain and suffering can provide initial orientation.
When can I start doing sports again?
When sport can be resumed after a contusion of the shoulder depends on the pain and limitations of the patient. The rule is that the shoulder should only be loaded as much as is painlessly possible. Especially contact sports and sports that put a lot of strain on the shoulder, such as throwing sports, should be avoided if the shoulder is bruised. They should only be resumed when there is no more pain. This can take a few weeks, but usually, the healing time for a bruise of the shoulder is three to four weeks. If pain reoccurs during sport, the load should be stopped, and the shoulder should be protected even further.
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