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Repairing Torn Shoulder Ligaments

By: Kathryn Senior PhD - Updated: 28 Feb 2015 | comments*Discuss
Shoulder Ligaments Rotator Cuff Tendons

If you are unlucky enough to be involved in an accident or fall in which your shoulder ligaments are torn, this is extremely painful, and repairing the shoulder usually involves an intricate operation. The complex of muscles, ligaments and tendons that hold the shoulder joint in place are termed the rotator cuff. The four main muscles allow a full range of movement at the shoulder and this is one of the most flexible joints in the body. Imagine a tennis player who is serving – the shoulder joint allows the arm to be bent back behind the head and then forwards. It is also possible to move the arm in several complete arcs, all at different angles.

If the muscles and ligaments are wrenched, the whole area becomes inflamed very quickly and the shoulder stiffens up. Any movement of the arm or upper body makes the pain much worse and a torn shoulder usually requires a trip to the emergency department of a hospital. It is not the sort of injury that you can go home with and see your GP a couple of days later. Surgery might be necessary and results are better if this is not delayed as the injury can get worse if you carry on moving your shoulder.

Emergency First Aid for a Shoulder Injury

If the shoulder tear is severe, it is best to call an ambulance and if there are ice packs or frozen food packs – peas work well – these should be wrapped in a cloth and packed around the shoulder to decrease the swelling. For less severe but obviously bad shoulder injuries with no other parts of the body involved, perhaps sustained playing tennis rather than being in a car accident or rugby tackle, it may be possible to apply ice packs and drive the injured person to the accident and emergency unit.

Hospital Treatment for Torn Shoulder Ligaments and Muscles

By the time you are seen at a hospital, it will be impossible to assess the severity of the injury without using some sort of imaging. It is normal to have an X-ray but, because the shoulder muscles and tendons are soft tissue and don’t show up very well on X-rays, you may also need an ultrasound scan or even an MRI scan. The medical team can then see exactly where the damage is and how it can be repaired. In bad cases, this will involve surgery. The operation involved is quite complex and can take between one and four hours, depending on the injury. In some cases, surgery needs to be done by opening the shoulder but keyhole techniques are proving popular as recovery time is faster and greater mobility can be achieved after healing is complete.

If the torn muscles and ligaments have not damaged the entire shoulder, and can heal naturally without surgery, the arm is usually immobilised carefully in a sling and weeks of physiotherapy will be needed to help the shoulder heal so that it retains as much movement as possible.

As inflammation will continue to be a problem for some time, anti-inflammatory drugs are often used. For less serious injuries, using ibuprofen with paracetamol can help the pain and inflammation, reducing both over the few days following the trauma to the shoulder. In more serious cases, it may be necessary to have steroid injections directly into different parts of the shoulder.

Recovering from a Shoulder Injury

Even if you wear a sling, and suffer constant pain, it is still easy to move your arm or make another movement that involves your shoulder without realising it. Sleeping can prove difficult when the pain and inflammation is at its worst and you must not expect to get back to normal too quickly. Gentle exercise done regularly as recommended by your physiotherapist can help but it can take several weeks, perhaps more than three months from the time of your surgery for your shoulder to heal.

Shoulder Pain without Injury

It is possible to tear the shoulder ligaments and muscles simply by stretching, or by repetitive strain. In this case, the pain of a shoulder tear develops and gets worse, but there may be no particularly event or accident that marks the start of it. Shoulder pain must always be checked out – although it can indicate a shoulder muscle tear that is not too serious, some heart conditions can cause referred pain to the shoulder and this needs to be ruled out. If the muscles and ligaments in the shoulder appear normal, an electrocardiogram is a safe precaution. Rather than a surgical shoulder repair, you could require emergency and life saving heart surgery.

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@bea - I'm afraid we can't advise on specific treatments, he would have to see his consultant or GP for this.
AboutOperations - 3-Mar-15 @ 2:00 PM
my husband had a stroke in November 2013.also right carotid artery sugery.since then he has suffered with worsening shoulder & arm/hand pain a MRI scan revealed torn muscles (recent scan).what could the appropriate treatment be? THANK YOU.
bea - 28-Feb-15 @ 5:46 PM
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