Shoulder Contusion

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.

Causes

Direct blow to the shoulder, usually from a blunt object.

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.

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

Use Instructions for R.I.C.E., the first letters of rest, ice, compression and elevation.

Continuing Care

• Wrap an elasticized bandage over a felt pad on the injured area. Keep the area compressed for the 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.

Home Diet

Eat 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.

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 tissue and to rule out the possibility of  underlying fracture. The total extent of injury may not be apparent for 48 to 72 hours.

Prevention Tips

Wear appropriate protective gear and equipment, such as shoulder pads, during competition or other athletic activity if there is risk of a shoulder contusion.