Children's Hospital Colorado

Shoulder Pain

What is shoulder pain?

The shoulder joint is a complex joint that combines many bones, tendons and muscles in order to allow a large range of motion of the arm. The large range of motion of the shoulder makes it more susceptible to injury, which can cause shoulder pain. Your child may feel pain only with certain movements – such as throwing a baseball – or it may be constant pain. Many shoulder conditions are aggravated by specific actions or sports. Hockey shoulder injuries as well as ski and snowboarding shoulder injuries are common.

What causes shoulder pain?

Shoulder pain usually involves the soft tissues of the shoulder, which include the muscles, ligaments and tendons, rather than bones. Another common cause of shoulder pain is traumatic injury, which can lead to shoulder instability, commonly called a dislocated shoulder when the shoulder moves out of its normal position.

Rare causes of shoulder pain are tumors, infection or nerve-related problems.

Soft tissue shoulder injuries include:

  • Tendonitis: A tendon connects muscle to bone or other tissue and has a cord or band-like quality. Tendonitis is often a result of the wearing process of the tendons that takes place over a long period of time, but it can also be caused from overuse or high-intensity sports. The rotator cuff is the unit of muscles and tendons that provides shoulder motion and stability; it is the most common area for tendonitis.
  • Bursitis: Excessive use of the shoulder can lead to inflammation and swelling of a bursa. Bursas are fluid-filled sacs located near friction areas in the joint that lessen the friction caused by movement of the shoulder. The condition known as bursitis can limit the range of motion of the shoulder because of pain.

What are the signs and symptoms of shoulder pain?

Symptoms include pain in the shoulder with certain movements, such as scratching the back or lifting the arms above the head. Shoulder pain can also occur during or after physical activities like sports.

How is shoulder pain diagnosed?

It is critical for doctors at Children's Hospital Colorado to determine the source of your child's shoulder pain so they can recommend the right method of treatment.

We’ll start with discussing your child's thorough medical history. Then, a Sports Medicine expert will perform a detailed physical exam to look for any abnormalities, swelling, deformities and tender areas in your child's shoulder. We'll also observe the range of motion in your child’s shoulder.

X-rays will most likely be used to help identify any shoulder abnormalities. Magnetic resonance imaging (MRI) may also be used to further evaluate the soft tissues surrounding your child's shoulder joint.

Occasionally, arthroscopic surgery (a procedure that allows an orthopedic surgeon to see and operate inside a joint) may be needed to further evaluate the joint if the problem is not apparent with the physical examination, X-rays and other tests.

How is shoulder pain treated?

Treatment of shoulder pain usually involves altering normal activities, along with rest and physical therapy to help improve shoulder range of motion, strength and flexibility.

Medication can also be used to reduce inflammation (swelling) and pain. The majority of kids and youth athletes with shoulder pain will respond to these treatments, but some shoulder problems, such as recurring dislocations, may end up requiring surgery.

Avoiding shoulder overexertion or extensive activities/sports can help to prevent shoulder pain. Learn more about our Sports Medicine Center that treats shoulder pain.

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