Shoulder Contusion Causes, Symptoms & Treatment Options
A shoulder contusion results from a direct blow or fall impacting the soft tissues of the shoulder. It causes localized bleeding within muscles, leading to pain, swelling, and stiffness. Although most shoulder contusions heal without complications, a careful medical evaluation is important to rule out bone or tendon injury and to ensure proper recovery through guided rehabilitation.
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A shoulder contusion, or bruising of the shoulder muscle, is a mild sports injury that can occur due to a direct blow or a fall. The muscle may be stretched, though it does not tear, and you may have visible bruising just below the skin and deeper bruising.
While a shoulder contusion is uncomfortable and may temporarily make it difficult to move your arm normally, it is an injury that typically resolves quickly.
What causes Shoulder Contusion?
A shoulder contusion results from blunt-force trauma to the shoulder region, leading to microvascular disruption and bleeding within the muscular and subcutaneous tissues.
- How the Injury Occurs: Results from a direct blow or fall that compresses the shoulder’s soft tissues, causing bleeding and swelling within muscles and subcutaneous tissue.
- Common Everyday Causes: Can occur during daily falls, accidents while lifting heavy objects, or collisions with furniture or other hard surfaces.
Shoulder contusions frequently occur in contact and high-impact sports involving collisions or repetitive physical impact.
- Football: Direct tackles and high-impact collisions frequently cause shoulder trauma.
- Rugby: Continuous physical contact and scrums place athletes at risk for soft-tissue injury.
- Lacrosse: Stick checks and forceful player contact can result in blunt trauma to the shoulder.
- Soccer: Shoulder-to-shoulder challenges or falls may produce localized muscular contusions.
- Baseball: Diving catches and on-field collisions can lead to bruising and soft-tissue swelling.
- Basketball: Forceful contact during rebounds or hard landings often contributes to shoulder bruising.
Symptoms
A shoulder contusion typically presents with the following clinical features:
- Localized pain: Discomfort around the shoulder joint that intensifies with movement, lifting, or direct pressure.
- Ecchymosis: Visible skin discoloration, ranging from redness to deep bluish hues, may extend to adjacent areas depending on injury severity.
- Swelling and tenderness: Mild to moderate edema accompanied by warmth over the affected site.
Most patients maintain active shoulder movement, though motion may elicit pain or a dull ache. Mild stiffness and reduced range of motion can also occur during the initial recovery phase.
When to see a doctor
Although most shoulder contusions resolve without medical intervention, you should seek evaluation if:
- Pain or swelling increases following the injury.
- Bruising spreads extensively around the shoulder.
- Shoulder movement becomes restricted, making lifting or using the arm or hand difficult.
- A hand or wrist injury occurs while bracing during a fall.
During your appointment, the physician will:
- Review the circumstances of your injury and current symptoms.
- Examine the shoulder, arm, and hand to identify any deeper or associated injuries.
- Imaging studies, such as an X-ray or MRI, should be ordered to assess bone integrity and soft tissue condition.
Prompt assessment helps rule out fractures, rotator cuff injuries, or other complications, ensuring proper recovery and safe return to normal activity.
Non-operative treatment
Shoulder contusions are typically managed with conservative, non-surgical care. Treatment generally includes:
- Rest: Avoiding sports, strenuous activities, and heavy lifting is crucial until pain and swelling decrease.
- Immobilization: Your doctor may recommend a sling to support the shoulder and limit movement during the initial healing phase.
- Ice Therapy: Applying ice for 20 minutes every one to two hours during the first 24–48 hours can help reduce pain and swelling. Heat should be avoided during this period, as it may increase bleeding and inflammation.
- Medication: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can manage discomfort and inflammation.
- Rehabilitation: A physical therapist or athletic trainer can guide gentle stretching and strengthening exercises as healing progresses and will determine when it is safe to return to sports or other activities.
A physical therapist or athletic trainer typically manages more severe shoulder contusions. They provide guidance on rehabilitation and determine when it is safe to resume sports or other physical activities.
Recovery
After a shoulder contusion, you may be able to restart normal activities after just a few days, though more severe contusions may require several weeks of resting your shoulder.
Starting stretching exercises within a few days of your injury and progressing to strengthening and weight-bearing shoulder exercises, under the guidance of your doctor or physical therapist. Players can return to play once you’ve regained your full range of motion and strength in the shoulder.
Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.
Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.
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/MonthFrequently Asked Questions
How do I know if it’s a contusion or a fracture?
A contusion usually shows bruising and swelling without deformity. If you experience severe pain, inability to move the arm, or hear a crack at the time of injury, seek medical imaging to rule out fractures.
Can I continue daily activities if my elbow hurts from repetitive strain?
It’s usually okay to keep doing light activities, but avoid anything that triggers sharp pain or worsens symptoms. Pushing through pain can make the injury worse, so listen to your body and give it rest when needed.
Can a contusion lead to permanent damage?
Rarely. Most shoulder contusions heal fully, especially with proper treatment. However, failure to rest or manage a severe impact injury could cause shoulder stiffness and possibly a frozen shoulder.
How do I reduce swelling from a shoulder contusion quickly?
For the first 48 hours, apply ice for 20-minute intervals every couple of hours. Avoid heat early on, and begin gentle range-of-motion exercises as tolerated.