Shoulder Pain and Problems | Johns Hopkins Medicine Health Library
The injury actually involves the acromioclavicular (AC) joint. The AC joint is where the collarbone (clavicle) meets the highest point of the shoulder blade. WebMD's Shoulder Anatomy Page provides an image of the parts of the The clavicle (collarbone) meets the acromion in the acromioclavicular joint. Pain with overhead activities or pressure on the upper, outer arm are. Distal clavicle osteolysis is shoulder joint pain at the end of the collarbone of cartilage on the adjacent AC joint where the clavicle meets the shoulder blade.
- Types of Shoulder Sprains, Strains & Tears
- How to Self-Diagnose Your Shoulder Pain
Shoulder Sprain A separated shoulder, or acromioclavicular joint injury, is sometimes referred to as a shoulder sprain. The AC joint is the area where the acromion—the bony projection at the top of the shoulder blade—meets the clavicle, or collarbone. In this injury, the ligaments that support and stabilize the shoulder are stretched or torn, and the bones of the AC joint become dislocated or separated.
Common causes of a shoulder sprain include trauma directly to the shoulder—from a car accident, for example—as well as a fall onto an outstretched arm.
Shoulder sprains are separated into grades, depending on the extent of damage to the ligaments and the degree of separation between the clavicle and the acromion.
Mild pain and swelling may interfere with normal daily activities, such as putting on a coat. In a Grade 2 sprain, ligaments tear, causing pain and swelling.
Shoulder Pain and Problems
In a Grade 3 sprain, the AC joint becomes completely separated. Tears in the AC ligament and the nearby coracoclavicular ligaments, which connect the shoulder blade to the clavicle, cause the collarbone to dislocate. This leads to bruising, pain, and swelling that can prevent you from performing your usual activities. The dislocated collarbone usually appears as a bump on the shoulder. Grades 4, 5, and 6 sprains are more severe and less common.
In these injuries, ligaments tear, the AC joint separates, and muscles detach from the collarbone. Shoulder Strain A shoulder strain is a stretching or tearing of a muscle or tendon in the shoulder. It can happen when the shoulder remains in one position for long periods of time, such as when carrying a heavy backpack over one shoulder or having poor posture while typing.
Shoulder Tear A shoulder tear is an injury to the soft tissues that give the joint range of motion and stability. A tear can occur in the tendons, the muscles, or the labrum, a rim of fibrous tissue that lines the glenoid. A tear may be partial or it may sever a tendon, muscle, or the labrum completely. Over time, small tears in a tendon can lead to a bigger tear.
Shoulder tears can be caused by repeated use or by sudden injury. Years of repetitive arm motions performed during sports, chores, or jobs can lead to a tear. Athletes who play sports that require repetitive motions, such as baseball, tennis, and weightlifting, may experience a shoulder tear.
A tear can also occur if you break a fall with an outstretched arm. A dislocated shoulder occurs when the humerus becomes dislodged from the glenoid, which can pull muscles and tendons out of place and cause them to tear. Bony growths in the joint called bone spurs can rub against tendons, causing friction that may lead to a tear. Symptoms include pain, a decrease in range of motion, and instability, which can feel like your shoulder may shift out of place. You may not notice a very small tear, whereas a complete tear can cause persistent, aching pain accompanied by weakness or even paralysis in the affected arm.
If this is the case, have your partner gently press on the front of your shoulder to relocate the joint. The shoulder blade scapula connects to the collarbone clavicle at this joint.
While seated, have your partner place one hand at the front of your shoulder joint and one hand at the rear. The partner should slowly, but firmly press on both sides of your shoulder to compress the AC joint. In addition, pain while raising the arm upward and while sleeping are also indications of an AC joint separation. While you relax the arm, the partner lets your arm drop. If your arm drops involuntarily and you are unable to maintain that parallel position you may have a rotator cuff tear.
Some may compensate for a torn rotator cuff by elevating the scapula toward the ear. Be vigilant of this when performing the rotator cuff tear test. The supraspinatus is located on the upper part of the shoulder joint and is involved in abduction arm raising. While seated or standing, lift the sore arm forward and to the side about thirty to 45 degrees. Pronate your wrist so the palm of your hand faces down to the floor as if you were trying to empty a glass of water.
In this position your partner should gently push your arm down. If pain or weakness prevents you from maintaining your arm position, you may have a supraspinatus tear. Frozen Shoulder A frozen shoulder is also known as adhesive capsulitis. It occurs slowly over time and can limit functional use of your arm. A frozen shoulder manifests in pain and tightness. This makes it difficult to reach overhead, press a dumbbell, or scratch your back.
A frozen shoulder diagnosis is made by observing the specific shoulder moving through a range of motion. Stand in front of a mirror. A partner should observe you while moving the arm and shoulder.
The partner should be noting the range and quality of motion of the shoulder joint. Slowly raise both arms to the front and overhead.
Collarbone (clavicle) pain: 8 causes
If you suffer from frozen shoulder, your painful arm may only come up to a point just past parallel with the floor. Additionally, as your scapula elevates towards your ear, you will feel general pain in the shoulder. From this position, slowly lower the arm down, and then slowly lift the arm out to the side. Note the range of motion that occurs.
What could be causing my collarbone pain?
If the arm only goes up to a point parallel to the ground - and it's painful - then you likely suffer from frozen shoulder syndrome. A final test for frozen shoulder is to stand with both arms at the sides and the elbows flexed at ninety degrees. Externally rotate the arms outward.