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Martha Rose asked the Guru about an old shoulder injury she sustained, which has suddenly got worse

Aug 12th, 2014

Hi Six Physio,

About two and a half years ago I was in a car accident, wherein I jarred my shoulder quite badly. It wasn’t fractured or broken etc. so the medics just said to keep an eye on it. For a while it was fine – sometimes it would ache in cold weather or if I carried a heavy bag – but for the past couple of weeks it has been hurting consistently and is affecting my sleep and ability to work efficiently.

I am going to go to my GP but have found them slow to refer conditions in the past so am thinking of self-referring but am unsure if this is the kind of injury/problem that you guys deal with? It seems to be more sport related injuries on your website?

Any advice would be gratefully received!

Many thanks.

In order to give a full response the Guru replied:

Hi Martha Rose

Thanks for getting in touch…..just need a few more clarification points

In your accident did you bang your shoulder, or were you told that you jolted it ie someone gave you a probable cause for your pain?

Is the pain at the front, side, back of your shoulder?

Do any movements in particular make it feel worse?

Age, job…..

We look after everyone – not just sports injuries. It just seems that most people who have injuries also play sports. The injury rarely is due to their sport!

Lemme know

The Guru
Six Physio

Martha has replied with more details:

To confirm

I jolted my shoulder in the accident – the car rolled over and to try and counter I steered hard left and in the process of that movement and the physical shock on my shoulder of the car hitting the ground the injury occurred.

The pain is mostly on top of the shoulder – so the joint between collar bone and shoulder – and the back.

No particular movements make it worse although it sort of clicks and crunches if the arm is rotated. It has been aching and painful consistently for a while now and occasionally I get shooting pains down my left arm.

I’m 22 years old and work as a theatre producer so spend a lot of time emailing on my laptop and also carrying heavy loads across London – which definitely doesn’t help!

Thanks,

Martha Rose

The Guru Responded:

Wow – sounds like a nasty crash, but has given me the answers I need.

 

I think you’ve got an issue with your ACJ (acromioclavicular joint) – the bit where your collar bone meets your shoulder. It may have a lump and bump and a step feel to it (or it may not ;). It may be also get worse if you try to wrap your hand across your body, over your opposite shoulder, with you elbow held at shoulder height.

 

This joint is pretty important as it’s the only boney connection between your arm and your body – all the other ones are held by muscles and tendons. If this joint has been sprained or stretched (ie the ligaments have been tweaked) then every time you move your arm, the ACJ will “wobble” more than it should and start to produce pain. The clicks and crunches is the joint moving, not a lot, but more than it should. Lying on it also causes problems as it is either stressing the joint (that wants to be kept still) or it’s making the end of your collar bone rub against a tendon in your shoulder giving you an impingement.

 

Sometimes an X-ray can give your more information about the ligamentous stability of your ACJ, but there are also lots of clinical tests that marry with your physical presentation that can be more laser guides in what’s causing what. ACJ instability or shoulder impingement due to ACJ instability.

 

Either way any competent Physio should be able to get you back on the straight and narrow. It’ll involve some rehab around your shoulder to improve the muscle control and endurance to help keep the ACJ stable and allow tissue to heal.

 

Your age should indicate an excellent recovery…..but carry heavy bags around will be sore as it keep irritating the ACJ. Try sticking your bag on the other shoulder. Try not to stretch your arm into end range positions and some gentle pain free exercises with your arm (non specific) wouldn’t go amiss until you’ve seen somebody who can be more specific….

 

Hope this helps.

 

The Guru,
Six Physio

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