Shoulder injuries: acute management


Shoulder injuries are common in primary care and can be difficult to correctly diagnose and manage. The shoulder is a mobile joint and vulnerable to injury from sport, falls, and overhead work. Common shoulder injuries include: rotator cuff tendinopathy or tear, rotator cuff impingement, capsular stiffness, glenohumeral instability or dislocation, muscular tears, or acromioclavicular joint (ACJ) sprains. 

Acute injury can be associated with considerable pain and disability, making early assessment difficult. While compensating for pain or dysfunction after a shoulder injury, further mechanical disruption can occur. This can compound the dysfunction and the time until full recovery.

Early intervention, restoration of normal function and appropriate analgesia are therefore important. A careful history and examination should allow the clinician to make an accurate diagnosis, even in the acute setting.

The initial management should then focus on managing the patient’s pain, arranging appropriate investigations and initiating more definitive treatment or, in some cases, obtaining a specialist opinion.

Objectives of this course:

  • Develop an understanding of the varied presentation and possible diagnoses in acute shoulder injury.
  • Be able to take a careful history and conduct an examination of an acute shoulder injury.
  • Understanding the appropriate imaging investigations for shoulder injuries and the indications for these.
  • Develop an understanding of the options for the initial management of acute shoulder injuries. 
  • Understand the indications for early specialist referral of shoulder pathology.


Once you have completed this short course and quiz, please click 'submit' where you will be taken to the results page. From here you can print your certificate for 1 Continuing Professional Development (CPD) hour.


This content was created by Dr Helen Joyce Fulcher MBChB, DipPaed, PGCertHSc (Sports Med), in June 2016.

The material is presented by the Goodfellow Unit (GFU), an accredited continuing medical education/ continuing professional development (CME/CPD) provider for the Royal New Zealand College of General Practitioners and functions under a tripartite agreement between the Goodfellow Foundation, the College and the University of Auckland. The Unit is located within the Department of General Practice and Primary Health Care, and within the School of Population Health.


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