Shoulder subluxation

Summer brings warm weather and outdoor activities — but you don’t want summer to bring a trip to the doctor’s office. Whether you’re working in the yard, swimming, or gardening, be mindful of common orthopaedic injuries.

While enjoying favorite summer pastimes, many of us forget that reaching, lifting, and pulling motions can cause strains, sprains, and tears in our shoulders, hands, and wrists. Orthopaedic injuries occur when the bones, ligaments, and tendons are damaged in an acute (sudden) or chronic (long-term) manner. When an individual is unable to perform everyday tasks or physical activities without pain or limitation, an injury has likely already occurred.

General safety tips to help avoid orthopaedic injuries:

  • Use proper form and warm up when participating in an activity.
  • Practice good posture.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Do not push through pain or injury.
  • See your doctor annually and when injured.
  • Wear supportive, comfortable shoes appropriate for the activity.
  • Wear gloves when necessary.
  • Watch for cuts and stay up to date on tetanus shots to prevent infection.

Orthopaedic surgeons Nathan Wool, MD, and Jyoti Sharma, MD, both of UPMC West Shore Orthopaedics, outline some common injuries, including the risks and treatment options for acute and chronic conditions.

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Overhead Shoulder Injury

Overhead shoulder injuries typically involve the rotator cuff. This area of the body can be affected by movements that tear the muscles or tendons surrounding the shoulder joint. Tendonitis — inflammation or irritation of the tendon — at the shoulder, elbow, or wrist can happen over time, causing pain and the need for treatment.

“Consider sports like swimming, tennis, volleyball, golf, and baseball that require a repetitive, overhead motion, or something like loading boxes into trucks that causes the arm to arc above the head,” says Dr. Wool. “The rotator cuff is responsible for keeping the ball and socket joint balanced. When these muscles are injured or overused, it can cause pain and difficulty with motion since the balance has been thrown off.”

As a result, individuals are at a greater risk for shoulder injuries like labral and rotator cuff tears. Rest and isolating the shoulder area, along with anti-inflammatory medicines, can ease the pain and help people get back to their daily activities within a few weeks. Heat compresses help soothe stiffness and relax the muscles, while cold application is better for numbing pain and reducing swelling.

“If pain persists for more than three to five days, however, we recommend further evaluation,” Dr. Wool says.

A physical exam is the first step to determine the strength of your muscles around the arms and shoulders, as well as the overall range of motion. Imaging tests, such as an x-ray, MRI, or ultrasound, may be ordered.

“We can differentiate between overhead injuries and other shoulder injuries when we talk to the patient, asking how the injury occurred, what activities cause pain, and what has been done before. The physical exam gives us critical information in distinguishing between different injuries,” says Dr. Wool.

Bone spurs, fractures, and even arthritis could be the source of or contribute to the discomfort.

Symptoms of a rotator cuff injury may include:

  • A dull ache or stiffness in the shoulder.
  • Pain when lifting the hand or arm overhead — making it difficult to perform simple daily activities.
  • Pain accompanied by weakness in the arm.
  • Pain that disturbs sleep when lying on the affected side.
  • Pain that wakes you at night.
  • Feeling of instability in the shoulder.

Hand Injury

We use our hands in nearly everything we do — catching balls, holding children, hammering nails, pulling weeds, and picking up dumbbells. During the summer, many people become more vulnerable to injuries such as a jammed or dislocated fingers, fractures, or strains and sprains in the hands and wrists.

The hand has 27 bones, many of which are thin and only have a scant layer of muscle and fat to protect them. The same is true for the tendons, nerve fibers, and blood vessels in the hand. As for your wrist, its delicate two-part joint allows it to bend, extend, and move sideways.

“Stubbing or jamming a finger happens fast. When you jam a finger, it likely is fully extended and either smashes into something or gets hit. Once that happens, it is difficult to bend, because the joint is swollen and tender,” says Dr. Sharma. The treatment is basic: rest, ice, and tape the damaged finger to the one next it. Dr. Sharma says patients can return to normal activity almost immediately.

A dislocated finger, however, occurs when force applied to the limb displaces the joint (usually the middle joint). Patients experience severe and sudden pain at the joint, and they usually can tell it’s dislocated because it looks out of place. For this level of injury, a doctor needs to manipulate the joint back into place. With minor dislocations, you may be able to return to normal activities quickly. A more severe dislocation may require surgery and a longer recovery.

With the wrists, pain may result from inflammation, tendinopathy, or small tears in a tendon.

Most wrist sprains will heal on their own over time. To treat a sprain, wrap your wrist, rest it for at least 48 hours, and apply an ice pack every few hours for 20 minutes at a time. It’s also important to keep the wrist straight — not bent — during the healing process.

“As with any activity where you might stretch and get warmed up, it’s wise to warm up your wrists and fingers before beginning. This can be done with wrist circles, fanning your fingers, and stretching the wrists forward and back,” Dr. Sharma says. It’s also a good idea to take frequent breaks from activities that require repetitive wrist and finger motions.

For more information about all UPMC Orthopaedic Care services and experts or to schedule an appointment at one of our locations, visit

Walk-In Orthopaedic Care

Our UPMC Orthopaedic Care experts treat injuries that affect bones, cartilage, muscles, tendons, joints, and ligaments. Our doctors are fellowship-trained and use state-of-the-art imaging, pain management, and rehabilitation therapies, as well as surgical treatments for a full range of orthopaedic injuries and conditions.

Although appointments are preferred, walk-in care is available at many of our West Shore locations. For a complete list of locations and hours, visit Our orthopaedic experts at the Mechanicsburg and Enola locations are prepared to treat the following conditions:

  • Sports-related injuries.
  • Possible broken bones.
  • Bone, joint, and muscle injuries.
  • Acute back and/or neck pain.

Arlington Orthopedics-UPMC1830 Good Hope Road Enola, PA 17025 717-652-9555

PinnacleHealth Bone and Joint CenterMedical Office Building 2, Suite 100 2005 Technology ParkwayMechanicsburg, PA 17050 717-791-2620

UPMC West Shore Orthopaedics 1830 Good Hope Road Enola, PA 17025 717-988-8135

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.

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