By Dr. Nicholas Calabrese, Chiropractor | EMPACT Wellness, Burlington, ON
Shoulder Pain After a Hit or Fall is Not Always “Just a Bruise”
Falls and body checks in ice hockey often happen fast and in awkward positions. The shoulder often takes the brunt of the force as athletes will typically reach out or land on their side. It is common to feel sore after a hit or fall, but not all shoulder pain is harmless.
The shoulder is one of the most mobile joints in the body, which makes it particularly vulnerable to injury. Even if someone has functional range of motion after a hit, damage to muscles, ligaments, or joint structures can be present and worsen if not assessed and treated appropriately. This post will help in understanding common shoulder injuries after a fall or check, important symptoms to look out for, and when a thorough assessment may be beneficial.
Common Shoulder Injuries
Shoulder sprains and muscle strains
Sprains affect ligaments, while strains affect muscles/tendons. These are two of the most common injuries we see in practice after an impact. Pain, stiffness, and/or swelling may often increase over the first 24-48 hours due to inflammatory process in the area. Early controlled movement, compared to complete rest, may often lead to better outcomes for most soft tissue injuries.
AC joint injuries
The acromioclavicular (AC) joint is located at the top of the shoulder and is frequently injured during contact sports, especially in ice hockey. Pain is typically felt on top of the shoulder and worsens with cross-body movements. AC joint injuries may go underdiagnosed when symptoms are mild but persistent.
Rotator cuff or labrum injuries
Rotator cuff or labrum injuries can often be noticed a couple of days following an initial impact. Pain with overhead movement, weakness, night pain, and clicking are some of the most common signs. Referral for an MRI or ultrasound imaging may assist in identifying rotator cuff and labrum injuries even when X-rays appear normal.
When Does Your Shoulder Pain Need Further Attention?
You should consider seeking an early assessment if you notice:
- Pain that is not improving or is worsening after a few days following the initial impact
- Limited range of motion or stiffness that is not improving
- Weakness or feelings of instability
- Pain that wakes you up at night
- Numbness or tingling felt down the arm or into the hand
An early assessment can help in differentiating minor injuries from those that may benefit from targeted rehabilitation, treatment, or referrals for further imaging.
What to do in the first 48 to 72 hours
Guidelines support early, guided movement for the majority of shoulder injuries to facilitate recovery and reduce long-term complications.
- Relative rest, avoiding complete immobilization of the arm
- Gentle, specific, pain-free movements may help to prevent stiffness and reduce pain
- Ice may help reduce pain and inflammation in the early hours following the injury
- Avoid pushing through sharp, stabbing, or worsening pain
Specific, individualized, recommendations can be provided following a thorough assessment.
How Chiropractic Care Can Help Facilitate Recovery and Prevent Future Injury
Chiropractic care for shoulder injuries often focuses on restoring pain-free shoulder range of motion, improving shoulder and spine mobility, and strengthening the muscles that stabilize the shoulder joint. Treatment often includes hands-on manual therapy, soft tissue work to reduce muscle tension, acupuncture, and a targeted rehabilitation program to restore movement patterns and strengthen the shoulder. This approach is fundamentally important for athletes returning to contact sports after a hit or fall, as well as individuals returning to their normal activities of daily living, as it can facilitate improved load tolerance, aid in reducing reinjury re-occurrence, and help to support long-term shoulder function.
When to book an assessment
If your shoulder pain is lingering, limiting daily activities, delaying a return to sport, or causing hesitation with movement, an early assessment can help to clarify the cause of your shoulder pain and guide recovery. You can book an assessment through our online portal or by contacting us directly.
Written by Dr. Nicholas Calabrese, Chiropractor. Dr. Nick enjoys working with active individuals and athletic populations recovering from musculoskeletal injuries, with a focus on restoring pain-free movement, building strength, and supporting long-term resilience to future injuries.