SHOULDER CONTUSION |
|
General Information
DEFINITION--Bruising of the skin and underlying tissue of the shoulder due to a direct blow. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate muscles, tendons or other soft tissue.
BODY PARTS INVOLVED
Shoulder, particularly the part over the acromium, the outer front end of the shoulder.
Blood vessels, muscles, tendons, nerves, covering to bone (periosteum) and connective tissue.
Injury to the axillary nerve, the most serious possible injury resulting from shoulder contusion and sometimes requiring surgery for repair.
{292}
SIGNS & SYMPTOMS
Local swelling--either superficial or deep.
Pain at the site of injury.
Numbness and decreased function of the arm and hand if the axillary nerve was seriously damaged.
Feeling of firmness when pressure is exerted on the shoulder.
Tenderness.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Restricted activity of the shoulder directly proportional to the extent of injury.
CAUSESDirect blow to the shoulder, usually from a blunt object.
RISK INCREASES WITH
Contact sports, especially football, soccer, hockey, baseball or basketball.
Medical history of any bleeding disorder such as hemophilia.
Poor nutrition, including vitamin deficiency.
Inadequate protection of exposed areas during contact sports.
Use of anticoagulants or aspirin.
HOW TO PREVENTWear appropriate protective gear and equipment, such as shoulder pads, during competition or other athletic activity if there is risk of a shoulder contusion.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the contusion is quite small.
Self-care for minor contusions and during rehabilitation following serious contusions.
Physical therapy for serious contusions.
Possible surgery if the axillary nerve is damaged severely.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor, with particular attention to the possibility of axillary-nerve damage for all except minor injuries.
X-rays of the shoulder to assess total injury to soft tissue and to rule out the possibility of underlying fracture. The total extent of injury may not be apparent for 48 to 72 hours.
POSSIBLE COMPLICATIONS
Excessive bleeding leading to disability. Infiltrative-type bleeding can sometimes lead to calcification and impaired function of the injured muscle.
Prolonged healing time if usual activities are resumed too soon.
Infection if skin over the contusion is broken.
Unstable or arthritic shoulder joint following repeated injury.
PROBABLE OUTCOMEHealing time varies from 2 to 6 weeks, depending on the site and extent of injury.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
CONTINUING CARE
Wrap an elasticized bandage over a felt pad on the injured area. Keep the area compressed for about 72 hours.
Use an ice pack 3 or 4 times a day. Wrap ice chips or cubes in a plastic bag, and wrap the bag in a moist towel. Place it over the injured area for 20 minutes at a time.
After 72 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, heat liniments or ointments, or whirlpool treatments.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
For minor discomfort, you may use:
Acetaminophen or ibuprofen. Topical liniments and ointments.
Your doctor may prescribe stronger medicine for pain.
ACTIVITYBegin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Your doctor may prescribe vitamin and mineral supplements to promote healing.
REHABILITATION
Begin daily rehabilitation exercises when a sling is no longer needed.
Use ice massage for 10 minutes before and after workouts. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have a contusion that doesn't improve in 1 or 2 days.
Skin is broken and signs of infection (drainage, increasing pain, fever, headache, muscle aches, dizziness or a general ill feeling) occur.
Numbness or tingling in the arm begins. These may be signs of axillary-nerve damage.
|
|
|
|
Dserun mollit anim id est laborum. Lorem ipsum and sunt in culpa qui officias deserunt mollit. Excepteur plus sint occaecat the best cupidatat nonr proident, sunt in culpa qui officia deserunt mollit anim id est laborum. September 24, 2004
