Definition, Types and Classes of a Sprained Shoulder

A sprained shoulder is not an injury to be taken lightly. Unlike a strain, in which one or more muscles has been stretched or torn, a sprain involves one or more ligaments. A torn ligament normally takes much longer to heal than does a muscle injury, and at times may require surgical repair, especially in cases where the tear has been complete.

Ligaments consist of bands of tough, fibrous tissue that connect bone to bone and serve to hold the bones of a joint in place. Ligaments are extremely strong, but they are not particularly flexible. If stressed too much or too suddenly, they tend to tear rather than stretch, resulting in what is commonly known as a sprain.

Categories of Sprains

Depending upon the physician you talk to, there can be up to six different categories, classes, or grades of sprain, with those three descriptors being used more or less interchangeably. In most cases, however, sprains are said to fall within one of three different categories, class 1 being the least severe and class 3 the most severe.

  • If you experience a class 1 sprain, a ligament has been partially torn, but not enough to affect the stability of a joint, which remains tightly connected. Usually only a single ligament has been injured, and the tears in that ligament are not particularly severe. They may, in fact, be only microscopic in size.
  • In a class 2 sprain, more than one ligament may have been injured, with at least one of them having been badly torn. The joint remains connected, but a certain amount of instability may be present, and the joint may even become slightly deformed.
  • A class 3 sprain is a situation in which more than one ligament is completely torn, or the injury is such that the joint becomes extremely unstable or separates completely due to a lack of support. Until the injury has healed at least partially, the joint in question is, for all practical purposes, unusable.

The Two Most Common Shoulder Sprains

There are a number of ligaments in the shoulder, but most sprains involve either the ligaments present in the acromioclavicular joint or the sternoclavicular joint. The former joint is located on the outside of the collarbone at the shoulder, and its ligaments bind the clavicle or shoulder blade and the collarbone tightly together. The latter, the sternoclavicular joint, is located where the inner end of the collarbone meets the breastbone. While the sternoclavicular joint is located at some distance from the shoulder, it is still considered a shoulder sprain if it is damaged, as the ability of the shoulder to function properly can be directly impacted.

Of these two joints, the acromioclavicular joint is the one that is by far the most commonly injured or sprained. An injury to this joint tends to occur most often during high speed activities or sports such as skiing, rugby or football when the joint is subjected to a sudden, hard impact. The sternoclavicular joint is less exposed and, therefore, well protected. A sprained ligament in this joint is normally the result of a hard impact affecting the frontal part of the chest.

If you suffer a sprain in either of these joints, you will definitely know it, although if it is a class 1 sprain, the pain is not likely to be particularly severe. Some swelling in the area surrounding the affected joint is to be expected. Depending upon the severity of the injury, you may also experience pain or tenderness and the immediate area may exhibit redness, bruising, or feel warm to the touch. Your ability to move your shoulder or move it without experiencing discomfort or pain will depend upon which class of sprain you have been subjected to.

Treating a Sprain

In most cases, the best treatment for a sprained shoulder is rest. This assumes the injury was not severe enough to require surgery. If this should happen to be the case, rest will still be required, but for a much longer time. For mild to moderate sprains, you want to not only see that your shoulder joint is well rested, but that undue stress is not placed upon it. This usually means the cessation of certain activities for a time.

In the initial stages of treatment, ice can be applied, though not directly to the skin. This is done to reduce swelling and inflammation. If the sprain is moderate to severe, you will likely need to keep your arm in a sling or wear a shoulder brace to give your shoulder both the rest it needs and protection from further damage.

One of the challenges you will often face is trying to find the right balance between resting your shoulder and rehabilitating it through exercise. If your injury has been moderate to severe, you should consult with your physician or a physical therapist to determine a plan of action for rehabilitating your shoulder as painlessly as possible without injuring it further. In the case of a mild sprain, you can often figure those things out for yourself.

Strong Muscles as a Preventive Measure

This type of injury is something that is not completely preventable. Football players wear shoulder pads for good reason, but sprains still occur on occasion. Aside from wearing protective equipment, the best way to avoid a sprain or a similar injury to any other joint is to exercise your muscles. While the function of a ligament is to hold two bones together, many muscles do the exact same thing, even though ligaments are much stronger. Strong muscles can, however, handle a good deal of stress, and often do so to the point where a ligament does not experience tearing, or at worst only experiences minor tearing.

If you stay in shape, there is no guarantee you will never experience this type of injury, but if you do, the chances are much greater it will be a class 1 rather than a class 3 sprain.

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