Shoulder soft tissue injury  

Information for patients who will need to have a follow up appointment 

What is this information about?

This information is about shoulder soft tissue injury. 

It tells you:  

• how to look after yourself when you go home from hospital with a shoulder soft tissue injury 
• what exercises you can do to help heal and strengthen your arm  
• what follow-up treatment you might have  
• who to contact if you need further help and support  

What is a shoulder soft tissue injury?

If you have a ‘shoulder soft tissue injury’ this means that you have had damaged some of the parts of your body that that support your shoulder. These include ligaments (the tough tissue that connects your bones together), muscles, or the capsule that surrounds the joint. The capsule is a dense connective tissue that appears like ‘’sac-like sleeve’’ and surrounds the joint.  

How long is it likely to take for my injury to heal?

It usually takes about 2 to 6 weeks to settle. However, you might feel be some light aching on heavy or repetitive overhead activities for up to 3 months. Use the sling for the first week and follow the advice in this information to allow the soft tissues to settle.  

Will smoking or vaping slow down my healing?

Yes. Smoking slows healing so if you smoke or vape try to stop or cut down. This is most important in the first 2 weeks after your injury. If you would like help to stop smoking talk to your GP or visit  Quit smoking for further information.  

What should I do if I am in pain after my shoulder soft tissue injury?

There may be some swelling over your shoulder, and you will have some pain. If you are in pain, take your usual pain killers or pain killers given to you in A&E. Follow the dose instructions on the packet. If you are struggling with pain do speak to your GP or pharmacist.  

Put ice or a cold pack over the painful area for short term ice pain relief.  

Will I be fitted with an arm sling?

You may or may not be fitted an arm sling. If you were fitted with an arm sling it was done to support your shoulder and to help the soft tissue structures around the shoulder to begin to heal. 

When should I be wearing my arm sling?

Wear your sling if, and when, it makes your arm more comfortable. Take it off to wash, dress, and do the “week one” exercises listed below.   

What should I do if I am struggling with my sling?

Do contact the Virtual Fracture Clinic. We can give you advice or arrange for your sling to be changed if needed. 

When should I start exercising?

It is important to start gentle exercises straight away to prevent stiffness when you are doing the exercises which are shown later in this information.  

Will I have further (follow up) appointments?

No. We do not usually follow up people with this type of injury. Please contact the Virtual Fracture clinic for further advice if: 

• are unable to follow this rehabilitation plan or notice pain other than at your shoulder 
• you struggling to regain full range of movement in your injured shoulder 4 weeks after injury. 

What should I do during week 1 after my injury?

• If you were given an arm sling, use it for comfort only. Take it off to wash, dress and do the ‘week 1’ exercise listed below.  
• Rest your arm for the first 24 to 72 hours (1 to 3 days). However, it is important to keep moving around. 
• Move your fingers and wrist and elbow whilst wearing a sling, so they do not get stiff.  Do this gently, without causing too much pain.  
• Apply cold packs (ice pack or frozen peas wrapped in a damp towel) to the sore area for up to 15 minutes, every few hours. This can provide short-term pain relief. Be aware, the ice must never be in direct contact with the skin.  
• Aim to practice all the exercises which are shown below 5 times a day. These exercises should not cause too much pain.  Do fewer if they are making your pain worse.  

Hand, wrist and elbow exercises

Finger and wrist bending and straightening: open and close your hand as shown 10 times. Then move your wrist up and down 10 times. 

After a few days, hold a soft ball or a ball of socks. Squeeze the ball as hard as possible without pain. Hold for 5 seconds and repeat 10 times. 

Elbow Bending to Straighten: bend and straighten your elbow as far as you can without pain. You should not feel more than a mild to moderate stretch. You can use your other arm to help if you need to. Repeat 10 times if there is no increase in pain.  

Forearm Rotations: keep your elbow at your side and bent to 90 degrees. Slowly turn your palm up (supination) and down (pronation). You should not feel more than a mild to moderate stretch. You can use your other arm to help if you need to.  Repeat 10 times if there is no increase in pain.  

Posture Exercise:

Bring your shoulders back and gently squeeze your shoulder blades together. Hold for 30 seconds. Repeat 5 times.  

Shoulder pendulum exercises

Stand next to a firm surface. Support yourself with your un-injured arm and lean forwards. Let your injured arm relax and hang down to the ground.  

Gently swing your arm, making a small movement. Try to do this forward and backward, side to side and in small circles.   

Aim to do this for 1 to 2 minutes in total. This exercise can cause some discomfort when you first start to do it. This will usually ease off after you have repeated the exercise a few times. 

Swing your arm gently so is does not cause you too much discomfort. Remember keep your arm relaxed. 

What should I do from week 2 to week 4 after my injury?

• You should stop using your arm sling.  
• Start using your arm for light activities. Start with gentle movements and be guided by pain or discomfort you experience. Movements above shoulder height are still likely to cause discomfort. 
• Start the exercises as described below 2 weeks after your injury. Aim to do them 5 times a day. Repeat each exercise 10 times. These exercises should not cause too much pain.  Do fewer if they are making your pain worse. 
• You should not do any heavy lifting for 4 weeks. 
• You can move on to the next stage of exercises as soon as you feel ready. 

Exercises:

Supported arm raising (arm elevation) 
Use your other hand to lift your injured arm up in front of you, as shown in these pictures.  

Supported arm rotation 

With your elbow touching the side of your body, bend your injured arm as shown below. Hold onto a stick, umbrella, or something similar. Then move your injured forearm outwards aways from your body. As you do this, keep your elbow bent and tucked into your side.  

Use your good arm to gently push the hand of your injured arm outwards. Remember to keep your elbow tucked in. If you do not have a stick, hold your injured arm at the wrist and guide it outwards with your good hand. 

Arm elevation 

Lift your arm forwards in front of you. Try to raise the arm as high as you can. This exercise can cause some discomfort. You do not need to raise your arm so high or for so long that it causes to much pain. If this is too difficult, try the same movement with a bent elbow.   
 

Raising your arm out to the side 

With your palm facing forwards, move your arm out to the side in a big arc. Try to raise your arm as high as you can. If this is too difficult, try the same movement with a bent elbow. You do not need to raise your arm so high or for so long that it causes too much pain. 

Arm rotation 

Start with your elbow bent by your side. Move your forearm out to the side, keeping your elbow bent and near your waist. 

What should I do from week 4 after my injury?

• Your pain should have settled 
• You should be able to return to normal activities if you have not already done so.  

What other things can the Virtual Fracture Clinic help me with?

Please contact the Virtual Fracture Clinic if you:  

• are concerned about your symptoms  
• are unable to follow this rehabilitation plan or notice pain other than at your shoulder 
• are struggling with your arm sling 
• are struggling to return to exercise or your usual activities  
• would like further information or support after you have read this information.   

When can I start driving?

You can return to driving when:  

• you are no longer using your arm sling    
• you can turn the steering wheel as much as you need to without it hurting  
• you can safely deal with all emergency situations without being in pain or hesitating. For example, you must be able to stop the car quickly and in full control and safely avoid obstacles  
• you are covered by your insurance company.  

 How can I get a certificate to say that I am fit to work?

You can get a fitness for work statement from the Virtual Fracture Clinic.  

How do I contact the Virtual Fracture Clinic?