Virtual Fracture Clinic: Shoulder Soft Tissue Injury

Nikki Harrison

  • Reference Number: HEY1637/2026
  • Departments: Physiotherapy
  • Last Updated: 31 May 2026
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Introduction

This leaflet has been produced to give you general information about your injury and to back up the information you were given at your virtual fracture clinic telephone appointment. After reading it you have any concerns or require further explanation, please contact a member of the team using the details at the end of the leaflet.

What is a soft tissue injury of the shoulder?

The term soft tissue refers to muscles, ligaments and tendons that surround and support our joints.  Injuries to the soft tissue around the shoulder can occur due to falling on an outstretched hand, overuse or direct impact.

What are the symptoms?

A soft tissue injury to the shoulder may result in the following:

  • Pain
  • Heat, redness or bruising
  • Stiffness and loss of function

What if I need pain relief?

To manage your pain, over the counter pain relief can be taken such as paracetamol or ibuprofen.

However, if you have allergies or conditions which prevent the use of pain relieving or anti-inflammatory medication or are taking medication(s) for other conditions – please seek advice from your doctor or a pharmacist before taking any pain relief.

What should I do in the first 72 hours after the injury?

Initial treatment aims to control the pain and swelling in the shoulder by following the PRICE principle.

P         PROTECTION

If necessary, you will be given a sling to help support your shoulder. This should be discarded as soon as the pain is under control, this is usually within 72 hours, unless advised otherwise.

R         REST

Complete rest is not advisable, but it is important that you prevent putting the shoulder under strain in the early stages of healing. Ensure you continue to move the elbow, wrist and fingers as normal as it is common to quickly become stiff in these areas.

I    ICE

Ice will help reduce the pain in your shoulder and so should be applied for 10 to 15 minutes. This will help to reduce the swelling.

There are many different ways in which ice can be applied however it is believed crushed ice, in the form of frozen peas for example, is the most effective. Whichever method you choose it is important that you wrap the ice in a damp towel, in order to prevent it from ‘burning’ the skin.

Please Note:

  • Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold
  • Do not apply ice to an open wound
  • Do not apply an ice pack to an area that has poor circulation
  • When you apply ice to your skin, check the skin every five minutes and stop using it if:
    • the area becomes white, blue or blotchy
    • the area becomes excessively painful, numb or tingles

C         COMPRESSION

It is not normal to need any form of compression with an acute shoulder injury.

E         ELEVATION

If you develop swelling in your wrist or hand elevate it above the level of the heart as much as possible. You can do this by placing your hand on your opposite shoulder or, if you are wearing a sling, adjust it so your hand is above the level of your elbow.

What not to do

Consuming alcohol, massaging the injured area and applying heat can all be detrimental in the early stages of healing and therefore should be avoided in the first 72 hours. It is important to note that smoking may also delay the healing process

For further advice on stopping smoking, please see the ‘Quit smoking’ information page on the NHS website or use the following QR code

When can I start driving again?

You should only return to driving when you are able to:

  • Comfortably move your shoulder and arm without significant pain
  • Grip and control the steering wheel safely
  • Perform an emergency stop and manoeuvre the vehicle safely

If you are still using a sling, you should not drive.

Always ensure you feel confident and safe to control the vehicle before returning to driving. If you are unsure whether you are safe to drive, speak to your healthcare professional or check with your insurance provider.

Sleeping advice

You may find sleeping uncomfortable during the early stages of your injury. The following positions may help:

  • Sleep on your back with a pillow supporting your injured arm
  • Sleep on your uninjured side with a pillow placed in front of you to support the injured arm
  • Avoid lying directly on the injured shoulder until the pain improves

If you were given a sling, it may be more comfortable to remove it when sleeping unless you were advised otherwise by your healthcare professional.

Rehabilitation and Recovery

If you follow this basic advice your injury should take around six weeks to heal.  However, everyone recovers from injuries at different rates, and it is dependent on the severity of the injury and the presence of any other medical problems.  It is possible that you may be back to normal in two weeks however it is also possible you may suffer symptoms for up to three months.

A rough guide to recovery is as follows:

  • First few days – Pain and swelling gradually begin to settle.
  • 1 to 2 weeks – Shoulder movement starts to improve, daily activities become easier
  • 4 to 6 weeks – Most people return to normal everyday activities
  • Up to 3 months – Some people may continue to experience mild discomfort or stiffness before making a full recovery.

After 72 hours you can remove your sling, if you were provided with one. It is very important you try to start using your shoulder normally again when doing everyday tasks like washing and dressing. The exercises below will help you to regain full function, flexibility and strength.

It is normal to feel some discomfort when performing the exercises. Gentle movement helps to prevent stiffness and supports healing. Mild discomfort is acceptable, but pain should settle shortly after completing the exercises

Rest the hand of your uninjured arm on a table. Step back and lean forward a little so your injured arm is hanging free.  In a pendular motion swing your arm:

Side to side

Forward and back

As if you are drawing a circle on the floor

Whilst in a lying position. Hold a stick with both hands at shoulder width apart with your arms straight.

Use the uninjured arm to assist the injured arm to lift the stick out in front of you as high as possible.

To begin with this may only be a short distance from your body.

Hold at this point for 10 seconds.

You can try this in sitting or standing if you are unable to get into a lying position.

Still in lying hold the stick and with the palms facing upwards, bend your elbows and tuck the injured arm into your side.

Use the uninjured arm to push the stick to the injured side as far as is possible while elbow is kept tucked into the side

Hold for 10 seconds.

You can do this exercise in sitting or standing.

Now in standing, grip one end of the stick with the injured arm.

Use the uninjured arm to push the stick up sideways away from your body.

Ensure as you lift your arm your thumb points towards the ceiling and not down at the floor.

Hold for 10 seconds.

Lastly, place the hand of your injured arm behind your back.

Take hold of it with your uninjured arm and try to gently pull the hand up your back as far as is comfortable.

Hold the stretch for 10 seconds.

All photos with kind permission of ©Physiotec™

You should practice each exercise 10 times, 3 to 4 times every day. You may experience more discomfort when you start the exercises.  However, this is normal and does not mean you should stop.  If your symptoms remain worse for more than two hours after the exercises, then you should decrease the number of each exercise that you do and build up again slowly.

Repetitive shoulder movements and lifting objects heavier than a teacup should be avoided to begin with. However, as your movement improves and pain reduces, little by little you can increase the amount of weight that you are able to lift but this should be done sensibly.  Progressing from lifting a teacup to a heavy shopping bag for example would not be advisable as is likely to result in overloading of the soft tissue and consequently re-injury.

When can I return to normal activities?

It is important to gradually increase activity as your pain improves. Avoid heavy lifting or repetitive shoulder movements until your strength and movement have returned.

If your job involves regular activities using your shoulder you must ensure that you practice similar tasks so that you build your strength and function up gradually.

If you participate in an active hobby then it is advised that you do not return to this until you have full strength, full range of movement and you can use your shoulder normally without experiencing pain or swelling.

If you play a sport, practice sports specific activities like throwing to prepare the shoulder and build this up gradually before returning to full training sessions and competition.

Do I require a follow up?

Do I need to be referred to Physiotherapy?

If the fracture clinic team feel you need to be seen by the Physiotherapy team, you will be directly referred to physiotherapy from fracture clinic and if this is the case, you will have been informed of this in your telephone call following your Virtual Fracture Clinic appointment. You will receive a letter or phone call to book this appointment within 2 weeks of the referral being made.

If you have not received one within this time, please contact the physiotherapy department on Tel: 01482 674880 between the hours 8.00am to 4.00pm Monday to Friday. If there is no answer, please leave a message and your call will be returned with the same working day.

Most of the time however, a referral to Physiotherapy is not needed, but if you have any concerns, are unable to follow the advice in this leaflet, or if you still have reduced movement, strength or function, East Riding GP patients can contact the East Riding MSK Physiotherapy service on Tel: 01377 208300. Alternatively, you can complete a self- referral form on https://www.chcpmsk.org.uk/self-referral-form-introduction. Hull GP patients should call Tel: 01482300003 to self- refer.

Do I need a Fracture Clinic follow up appointment?

You will have been informed at your telephone appointment if a follow up appointment in clinic is required. If this is not the case, you have been placed on a Patient Initiated Follow Up (PIFU) pathway. This means you will not have another appointment to be seen in fracture clinic.

If, however you have any problems or further queries relating to this injury within the next six weeks, you can contact us on Tel: 01482 674378 during clinic hours 9.00am to 4.30pm Monday to Friday. Please do not choose an option and when prompted leave a message if there is no answer and we will aim to get back to you within the same working day. If you have not needed to contact us in the six weeks after your injury, you will be discharged and should seek advice from your GP.

When to seek further help?

Seek urgent medical attention if you experience:

  • The arm becoming cold, pale, or blue
  • Numbness, tingling, or increasing weakness in the arm or hand
  • Signs of infection such as fever, increasing redness, warmth, or swelling around the shoulder or arm
  • Severe swelling that continues to increase
  • Severe pain that is rapidly worsening or not controlled with pain relief

Please contact the fracture clinic if:

  • Your pain is worsening rather than gradually improving
  • You are having increasing difficulty moving the shoulder or arm
  • Your symptoms are not improving as expected
  • You have any concerns about your recovery or your treatment plan

The fracture clinic team will assess your symptoms and advise you if further medical assessment or attendance at the Emergency Department is required.

Your feedback matters to us…

To ensure we deliver a safe and quality service and to help us understand the experience you have of the care you receive from our staff we would value your thoughts about the service you received.

You may be contacted as part of our quality assurance programme which is where we visit our teams and staff and talk to them about the care they provide to our patients or at any time during or after you have needed our services.

To collect this feedback, we would contact you using the registered telephone number we hold in your care record. This feedback will be strictly anonymous and whilst we will share the feedback as part of the process, we will not share any details which may identify you.

We will never ask you any personal questions about your health during these telephone calls.

If you do not wish to speak to us, please say this when we call, we do not want you to feel pressured

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.