Shoulder ligaments are fibrous bands that hold the bones of the region together and stabilize the shoulder joints. Sports injuries, trauma and repetitive stress can cause tears in one or more of the shoulder ligaments. These tears range from mild to severe. Physical examination and imaging tests aid healthcare providers in assessing the extent tearing, which guides the treatment plan. Depending on the severity of the injury, a torn shoulder ligament may be treated with rest and anti-inflammatory medicine, physical therapy, injections or surgery.
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Rest and Anti-inflammatory Medicines
A torn ligament is called a sprain. Shoulder sprains range from microscopic tearing of ligament fibers to complete tears. Mild shoulder sprains often heal with simple treatment. Resting the shoulder, applying ice and taking anti-inflammatory medicine may be enough to bring relief. Ice and anti-inflammatory medicines, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), help reduce pain and swelling. Resting the shoulder gives the ligament time to heal and prevents the injury from becoming worse. Depending on the location of the shoulder ligament tear, your doctor may recommend a sling, compression bandage or shoulder taping to limit movement of the affected joint while the injury heals.
Physical therapy (PT) is typically a cornerstone of treatment for shoulder injuries, including ligament tears. Initial PT often involves activity modification to allow healing of the damaged tissue. As pain decreases, PT generally focuses on overcoming shoulder stiffness and strengthening the area. A therapist may perform shoulder joint mobilizations, which involve moving the arm into various positions to improve range of motion. Stretches and other shoulder exercises help improve mobility and strength. The duration and timing of PT varies, depending on the severity of the shoulder strain and other treatments.
A torn shoulder ligament typically causes inflammation and pain in the shoulder region, which can severely limit use of the affected shoulder and arm. Inflammation, pain and swelling increase in parallel with the severity of the shoulder sprain. If rest, oral anti-inflammatory medication and physical therapy fail to produce significant improvement, injection therapy may be recommended.
Corticosteroid injections reduce inflammation and pain, which can help you tolerate and more fully participate in physical therapy. Some healthcare providers employ prolotherapy for shoulder sprains, particularly if the ligament injury results in ongoing laxity and instability of the joint. Although the mechanism of action remains unclear, the intent of prolotherapy is to induce a controlled level of localized inflammation to promote healing. While some healthcare providers report success with this form of injection therapy, research proving effectiveness for shoulder sprains is lacking.
Unfortunately, some shoulder ligament tears will not heal properly without surgery. This is particularly true for severe shoulder sprains and complete ligament tears. Surgery to repair a torn shoulder ligament aims to restore stability so the shoulder joints can function normally. Surgery may be recommended as initial treatment for people with a complete shoulder ligament tear. For those with a severe shoulder sprain but without a complete tear, a trial of nonsurgical therapy may be recommended first to see if the injury will heal without surgery. People who undergo surgery to repair a shoulder ligament tear participate in physical therapy afterward to regain full function of the joint.
Warnings and Precautions
Shoulder injuries and long-term problems occur commonly in people of all ages. Many types of shoulder injuries share common signs and symptoms, so it's important to see your doctor for an accurate diagnosis and appropriate treatment. This is particularly important if a shoulder ligament tear is suspected because this type of injury is often accompanied by damage to other shoulder structures. Seek urgent medical care if you sustain a traumatic shoulder injury, especially if your shoulder appears deformed or bruised, or you are unable to move your arm normally.
Reviewed and revised by: Tina M. St. John, M.D.