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Paediatric Shoulder Pain
Paediatric Shoulder Pain
Shoulder injuries in children and adolescents are common, particularly among young athletes. These injuries can result from trauma, repetitive motion, or overuse. Because children’s bones and joints are still growing, paediatric shoulder injuries require prompt diagnosis and appropriate treatment to prevent long-term issues and ensure proper recovery.
Symptoms
The signs and symptoms of paediatric shoulder injuries can vary based on the specific injury and its severity:
Pain
Pain in the shoulder or upper arm, which may worsen with movement.
Swelling
Inflammation around the shoulder joint or upper arm.
Limited Range of Motion
Difficulty or inability to move the shoulder fully in one or more directions.
Weakness
A feeling of weakness or instability in the shoulder, particularly during overhead activities.
Deformity
In cases of fractures or dislocations, there may be visible changes in the shape of the shoulder.
Numbness or Tingling
Nerve involvement may cause a sensation of numbness, tingling, or reduced feeling in the arm or hand.
Causes
- Fractures: Fractures of the collarbone (clavicle) or the upper part of the arm bone (proximal humerus) are common in children and usually occur from falls or direct trauma.
- Dislocations: Shoulder dislocations occur when the upper arm bone (humerus) is forced out of the shoulder socket, often caused by a fall or contact during sports.
- Growth Plate Injuries: The growth plates (areas of developing cartilage) in the bones around the shoulder are susceptible to injury in children, especially during rapid growth phases.
- Overuse Injuries: Repetitive stress from activities like throwing or swimming can cause conditions such as Little League shoulder, which involves irritation of the growth plate in the upper arm bone.
- Rotator Cuff Injuries: The rotator cuff is a group of muscles and tendons that help stabilise the shoulder. In children, these injuries are usually related to overuse rather than trauma.
Risk Factors
Certain factors can increase the likelihood of paediatric shoulder injuries:
- Age: Rapid growth spurts during adolescence can make children more prone to growth plate injuries and fractures.
- Sports Participation: Children involved in contact sports (e.g., football, basketball) or activities requiring repetitive overhead motion (e.g., baseball, swimming) are at higher risk of shoulder injuries.
- Improper Technique: Poor technique in sports, such as improper throwing mechanics, can lead to overuse injuries.
- Previous Shoulder Injury: A history of shoulder injury may increase the risk of future injuries, particularly dislocations.
Diagnosis
- Physical Examination: The doctor will assess the child’s shoulder for tenderness, range of motion, strength, and stability. They will also check for signs of nerve or blood vessel damage.
- X-rays: Often the first imaging test used to detect fractures, dislocations, and growth plate injuries.
- MRI: Provides detailed images of soft tissues, such as muscles, tendons, and ligaments, useful for diagnosing rotator cuff injuries or overuse conditions.
- CT Scan: Occasionally used to better visualise complex fractures or assess bone alignment.
- Ultrasound: May be used to assess soft tissue injuries and inflammation around the shoulder joint.
Rehabilitation
Rehabilitation plays a vital role in the recovery process following both surgical and non-surgical treatment:
- Strengthening Exercises: Focus on restoring strength in the shoulder muscles to support the joint and prevent future injuries.
- Range of Motion Exercises: Gradual stretching and movement exercises help regain full mobility in the shoulder.
- Functional Training: Specific exercises to restore normal shoulder function, especially for children returning to sports or physical activities.
- Sport-Specific Training: Rehabilitation may include sport-specific training for young athletes to ensure a safe return to play.
Complications
While most paediatric shoulder injuries heal well with proper treatment, complications can occur if the injury is severe or not properly addressed:
- Growth Plate Damage: Injury to the growth plate can result in improper bone growth, leading to deformities or uneven limb length.
- Chronic Instability: Repeated shoulder dislocations or inadequate healing of ligaments may cause ongoing instability in the joint.
- Reduced Range of Motion: Failure to rehabilitate the shoulder properly after an injury can lead to stiffness and reduced flexibility.
- Arthritis: In rare cases, significant joint injuries can increase the risk of developing early arthritis in the shoulder.
- Nerve or Blood Vessel Damage: Severe trauma, such as a dislocation or fracture, can damage nearby nerves or blood vessels, resulting in numbness, weakness, or circulation issues in the arm.
When To See A Doctor
Seek medical attention if your child experiences:
- Severe shoulder pain or swelling that does not improve with rest.
- A visible deformity or misalignment in the shoulder.
- Difficulty moving the shoulder or arm.
- Numbness, tingling, or weakness in the arm or hand.
- Persistent shoulder pain or discomfort during or after physical activity.
Doctors In-Charge
Specialist Orthopaedic Surgeon
Specialist Orthopaedic Surgeon