Capsule tear in the shoulder
Definition - What is a capsular tear in the shoulder?
Like all movable joints, the shoulder is also surrounded by a joint capsule. This consists of connective tissue with an inner and an outer layer.
The capsule surrounds and protects the joint on the one hand and promotes the mobility of the arm in the shoulder through the production of synovial fluid on the other. A sports or traffic accident, for example, can lead to a capsule rupture, which limits the stability and mobility of the shoulder.
Depending on the extent of the injury, healing can be achieved through rest and targeted exercises. However, surgery is required in more severe cases. A capsule tear in the shoulder often heals well, but the risk of further injuries is increased. In some cases, long-term damage remains that lead to a reduction in the function of the shoulder joint.
Do you suffer from a capsule rupture and would you like to find out about every important piece of information? So it is recommended that you first study general information about the capsule tear and the structure and function of a joint capsule. Details can be found at:
- Joint capsule - that's behind it
- What is a capsule tear?
Accompanying symptoms of a capsule tear in the shoulder
The most significant accompanying symptom that arises when the capsule ruptures in the shoulder is severe, usually sharp pain in the shoulder area. In addition, normal mobility of the affected arm is usually no longer possible. Usually a relieving posture is adopted, as every movement in the shoulder increases the pain.
Within a few minutes to hours, another accompanying symptom of a capsular tear in the shoulder is usually swelling of the region. The injury to the capsule results in an inflammatory reaction, which is expressed, among other things, by an increased influx of tissue water and thus leads to swelling. In addition, synovial fluid can leak out and be deposited in the tissue.
If a blood vessel on the shoulder was injured as part of the capsule rupture, bleeding can also occur. As an accompanying symptom, this manifests itself in the formation of a bruise or a bruise.
If the arm is dislocated in the injury that led to the capsular tear in the shoulder, the accompanying symptom is a misalignment. In most cases, the upper arm is moved forward relative to the trunk.
Furthermore, various other complaints can occur if additional nerve tracts have been injured. The result can either be numbness or abnormal sensations such as tingling in the arm or hand.
The symptoms mentioned can also indicate a torn ligament in the shoulder.
To be able to differentiate the diseases from each other, read also:
- Torn ligament of the shoulder
- Torn tendon of the shoulder
Pain if the capsule tears in the shoulder
With a capsule tear in the shoulder, pain is usually the main complaint.
Usually, an acute trigger such as an injury during sports or a fall on the arm leads to the capsule rupture. Immediately after the triggering event, severe pain, which is usually described as sharp or light, occurs. After a few minutes, the nature of the pain often changes. The pain then turns into a throbbing, dull form.
In addition, the pain of a capsule tear in the shoulder is usually dependent on movement. The symptoms are best endured if the arm is protected in a neutral position. If there is an active or passive movement in the shoulder joint, a new pain stimulus can be triggered. Pain triggered in this way is also usually of a stabbing character.
Shoulder pain can be caused by a number of events. You can find out what causes the pain are in the following text: Pain in the shoulder blade - these are the causes
Swelling when the capsule ruptures in the shoulder
If the capsule ruptures in the shoulder, swelling in the joint area usually occurs within a few minutes to hours.
Such an injury leads to water retention in two ways, which is responsible for the swelling.
On the one hand, the rupture of the capsule leads to leakage of synovial fluid into the surrounding tissue. On the other hand, the body reacts to the damage with an inflammatory reaction. There is an increased blood flow and a widening of the small blood vessels. This also leads to increased deposition of fluid in the tissue.
If the capsule tear in the shoulder heals, the water is also reabsorbed and the swelling goes down.
At this point, it is essential to look at the main page regarding the swelling. Learn more about the topic at: Swelling - what's behind it?
Appointment with a shoulder specialist
I would be happy to advise you!
Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of Dr. Gumpert.
The shoulder joint is one of the most complicated joints in the human body.
The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.
Bursitis caused by a capsule tear in the shoulder
A capsule tear and bursitis are two of the most common diseases or injuries in the shoulder area, which have a common cause, but can also occur independently of one another.
The bursa are bags of connective tissue filled with fluid that act as a kind of shock absorber between heavily stressed muscles and the eyes in the large joints. Bursitis can develop due to various causes, such as overstressing, which can lead to severe pain and restricted movement of the arm in the shoulder joint.
In some cases, bursitis develops due to a ruptured capsule in the shoulder. While the capsule rupture usually suddenly leads to discomfort as a result of a direct trigger, bursitis often develops rather slowly and without a specifically recognizable trigger.
You might also be interested in the most important things about bursitis in the shoulder area: Bursitis of the shoulder
Treatment of a tear in the capsule in the shoulder
If the capsule ruptures in the shoulder, so-called conservative therapy is usually carried out, which includes various measures.
Surgical therapy may only be necessary in the case of very serious injuries involving ligaments, bones or muscles.
In all other forms of capsular tears in the shoulder, the joint should first be relieved and protected for a few weeks. If necessary, a special bandage is applied or the shoulder is taped.
After an injury, it is also helpful to cool the shoulder region temporarily so that there is no excessive swelling.
In addition, the temporary use of an anti-inflammatory pain medication in the form of tablets may be appropriate.
Furthermore, a gradual resumption of exercise should take place. Professionally guided and individually tailored physiotherapy is best.
In the long term, once the injury has healed, targeted training of the shoulder muscles can prevent a recurrence of an injury, such as a capsule rupture, as much as possible.
Nevertheless, after a single injury there is often an increased susceptibility to renewed damage to the capsule. Surgical treatment may be necessary to stabilize the joint, especially if the shoulder joint is dislocated frequently.
Since the capsule tear in the shoulder area is often associated with a shoulder dislocation, it is important to also take a look at the following article: What is the best therapy for a shoulder dislocation?
How do you tap a capsule tear in the shoulder?
In the case of injuries in the shoulder area such as a bruise or an overload reaction, it can be helpful to tape the joint.
If the capsule tears, however, immobilization in a bandage or bandage is usually indicated. In general, taping should only be done by a trained person if the shoulder is injured. It is possible to apply the tapes to yourself. However, this requires knowledge of the anatomical course of the muscle fibers.
In addition, certain postures have to be taken when gluing and the strips have to be affixed partly with tension and partly loosely.
Due to this large number of factors to be considered, you can do a lot wrong when taping, so that the desired effect is not achieved. In addition, in most cases it is not the appropriate form of treatment for a capsular tear in the shoulder.
In the event of such an injury, you should seek medical treatment and discuss with the doctor which possible therapy options are possible.
When is taping an advantage and is it a suitable therapy? Find out from the following articles:
- Is taping suitable for a torn ligament?
- Taping a torn hamstring
Bandage for a capsule tear in the shoulder
The bandage most frequently used for a capsule tear in the shoulder is the so-called Gilchrist bandage (named after the doctor Thomas Gilchrist). The bandage consists of a loop that immobilizes and stabilizes the arm in an angled position. The entire upper body is not included and the mobility of the hand and fingers is retained.
The bandage bears the weight of the injured arm. A tour of the sling runs in the neck and thus enables the arm to be suspended from the torso. With this compromise between relief and mobility, the Gilchrist bandage is in many cases the best type of bandage for healing a torn capsule in the shoulder.
As an alternative for injuries with particular instability, the Dessault bandage offers a stronger immobilization.
Edema or thrombosis can also be treated with bandages. Find general information about treatment with a compression bandage at: What are the advantages of a compression bandage?
When do you need surgery with a capsule tear in the shoulder?
In most cases, a capsular tear in the shoulder does not require surgery. Even if the arm is dislocated, it can usually be adjusted again without surgery.
In the case of certain accompanying injuries, however, an operative intervention is required, as the damage can only be repaired in this way and otherwise there is a risk of long-term loss of function of the shoulder. An operation is necessary, for example, if ligaments are torn in addition to the capsule or a dislocated bone fracture has occurred. Damage to nerve tracts or blood vessels can usually only be treated with surgery.
In addition, younger people with a capsule tear in the shoulder are more likely to have surgery.
The injury can cause the joint to become unstable, which surgery can correct.
A distinction must be made between the open surgical form and the minimally invasive procedure using the “keyhole technique” in the form of a joint mirror.
At this point, it is important to deal with the joint endoscopy and treatment by means of surgery in the shoulder area:
- How does an arthroscopy work?
- Surgery to split the shoulder joint
Healing time for a capsule tear in the shoulder
The healing time for a capsular tear in the shoulder can vary widely and in most cases is in the range of a few weeks.
In addition to the severity of the offending injury, the treatment as well as the age and pre-existing restrictions on the patient's shoulder joint have a significant influence on the duration of healing.
In addition, it must be taken into account that after a long period of immobilization to heal the capsular tear, it can take weeks or months before the shoulder can move freely again and be fully loaded.
Furthermore, the healing process is different for each person. Even with the same injury pattern, the time it takes for two people to heal can differ significantly.
Causes of a ruptured capsule in the shoulder
There are many possible causes that can lead to an injury in the shoulder such as a capsular tear.
In many cases, athletes are affected. Overstretching or sudden, violent forces at an unfavorable angle can shift the joint parts against one another and thus damage the surrounding capsule.
A capsule tear in the shoulder is often accompanied by a dislocation of the arm. Usually the capsule tears in one or more places.
A complete tear is rather rare and only occurs with severe injuries.
In addition to various sports, traffic accidents are also possible causes for a capsule rupture in the shoulder. But even with a variety of other injuries, such as a fall in everyday life, one can tear the shoulder joint capsule.
A capsule tear in the shoulder is not infrequently the result of a dislocation of the shoulder. Therefore, it is very important that you also read the following article: Dislocated shoulder - you need to know that now!
What can be the long-term consequences of a capsular tear in the shoulder?
If a capsule tear in the shoulder does not heal completely, symptoms such as pain can persist over the long term. A restricted mobility of the arm can also be a possible long-term consequence.
Furthermore, injuries such as a capsule tear increase the risk of omarthrosis (wear disease of the shoulder joint). Treacherously, the immobilization of the shoulder necessary for the capsular tear to heal can result in the joint stiffening. Therefore, in the event of an injury, a good balance must always be found between rest and stress in order to avoid long-term consequences as much as possible.
Otherwise, pain and restricted mobility can have serious consequences for the ability to work as well as everyday activities.
In addition, as a long-term consequence of a capsular tear in the shoulder, there can also be an increased susceptibility to renewed injury in the joint.
Immobilization of the shoulder joint during treatment can also cause undesirable side effects, such as stiffening of the joint. You might also be interested in the following article: Shoulder osteoarthritis - what you should be aware of
Consequential damage from a capsule tear in the shoulder
A rotator cuff is a complex of different muscles that pull from the shoulder blade to the upper arm and surround the shoulder joint like a cuff on all sides. The rotator cuff is necessary for stability on the one hand and for the various movements in the shoulder on the other.
An injury that leads to a capsule tear can also damage the rotator cuff. Usually, individual muscle fibers tear, which leads to pain and limited mobility of the affected arm.
In rare, particularly severe cases, a muscle can even be torn off completely. As a result, certain movements in the arm can no longer be carried out or only with severe restrictions or pain.
Often, the rotator cuff damage heals with temporary immobilization and physical therapy. In the event of a muscle tear, however, continuity can only be restored through surgery.
In some cases, especially in older people, surgery is still not needed, as the loss of function can be compensated for by other muscles and the long-term symptoms and restrictions can be tolerable.
Sometimes, however, a capsular tear with damage to the rotator cuff causes great discomfort despite the exhaustion of all therapeutic measures.
The consequences and symptoms of damage to the rotator cuff are also serious. You can find these and much more at:
- What to expect from a rotator cuff tear
- Rotator Cuff Rupture - What's Behind It?
Diagnosis of a ruptured capsule in the shoulder
In order to make the diagnosis of a torn capsule in the shoulder, a thorough physical examination of the joint by the doctor as well as a targeted discussion with the patient regarding the cause of the injury and the complaints is required.
Questions about the history of the person concerned are also relevant. Previous shoulder injuries such as a dislocation of the arm or the presence of medical conditions and the use of medication can be of great importance.
Through the examination, the doctor can determine the stability and the active and passive range of motion of the shoulder.
If the findings suggest that the capsule or the ligamentous apparatus of the joint may have been injured, the doctor will initiate further investigations.
A simple x-ray is usually only used to detect or exclude bony injuries.
An ultrasound scan may be more likely to provide clues as to whether or not the capsule may be injured.
The best way to visualize a capsular tear is by MRI (magnetic resonance imaging).
MRI of the shoulder for a capsule tear
Magnetic resonance imaging is the best way to detect a possible capsular tear in the shoulder.
However, the examination is costly and time-consuming and should therefore only be carried out if there is justified suspicion and if the result of the examination is associated with a consequence for the patient.
A targeted medical consultation with the patient and a thorough physical examination of the shoulder should therefore be a prerequisite for the decision to perform an MRI.
If this leads to the suspicion of a capsular tear in the shoulder and this is confirmed by the MRI, it may be possible to decide whether a surgical intervention is necessary from a medical point of view or not.
In contrast to CT (computed tomography), MRI is not associated with radiation exposure. However, the examination must not be carried out if there is metal in the body, such as a pacemaker or bone screws after an accident.
What you should consider when considering an MRI and more on the subject can be found at: MRI of the shoulder joint
Duration of inability to work in the event of a capsule tear in the shoulder
How long the inability to work after a capsule rupture in the shoulder cannot be stated in general terms.
The length of time the doctor is on sick leave depends on the one hand on the type and extent of the injury and on the other hand on the activity performed. For example, anyone who works in an office can expect a shorter period of inability to work than someone who has to work hard.
In the case of a capsule tear in the shoulder that does not require surgery, the expected duration of the inability to work is between two to six weeks.
However, if a surgical procedure is required, it is even less possible to make a statement about the length of the sick leave. This depends largely on the success of the operation and the healing process.
In the event of serious injuries, depending on the activity, you may be unable to work for several months.
In the worst case, the work that has been done so far cannot be resumed at all due to incomplete healing.