How shoulders get hurt in crashes, falls and at work

The shoulder moves through a wider arc than any other joint, and it trades stability for that freedom. In a collision the diagonal seatbelt pins one shoulder while the arm and trunk keep travelling; that belt load can bruise the joint, strain the rotator cuff or, with enough force, break the collarbone. A driver who braces both hands on the steering wheel just before impact sends the force up straight arms into the front of the shoulder. In a side-impact collision the shoulder is driven into the door frame.

Away from the road the pattern changes. A slip and fall on an icy Long Island parking lot often ends with an arm thrown out or a direct landing on the point of the shoulder. At work, overhead lifting, pulling a pallet jack or catching a falling load can tear a tendon or the labrum in a single moment, or aggravate a shoulder that was already working hard. Injuries the orthopedic physician looks for include:

• Rotator cuff strain or tear — see rotator cuff tear
• Damage to the cartilage rim of the socket — see labral tear
• Dislocation or partial dislocation — see shoulder instability
• A broken collarbone — see clavicle fracture
• AC joint separation and deep bruising over the joint

What the orthopedic shoulder exam checks

Everyday shoulder symptoms are covered on our shoulder pain page; this page is about what an orthopedic physician does with them. The visit starts with how you were hurt, which arm took the load, and what you cannot do now — reach a shelf, fasten a seatbelt, sleep on that side, lift a child.

• Look and feel: swelling, bruising in the line of the belt, a step at the collarbone or AC joint, muscle wasting.
• Motion: how far you can raise the arm yourself compared with how far it moves when the physician lifts it. A gap between the two points toward a tendon problem rather than simple stiffness.
• Strength: each rotator cuff tendon tested on its own.
• Stability: whether the ball of the joint feels as though it wants to slip, and apprehension in certain positions.
• Neck and nerves: pain felt in the shoulder sometimes comes from the neck, so reflexes, sensation and neck movement are checked as well.

Formal range of motion testing records the measurements, so each later visit is compared against a real baseline rather than a memory.

Imaging: X-ray first, MRI when the exam calls for it

Digital X-ray, on site at select offices, answers the bone questions: fracture, dislocation, the alignment of the joint and the position of the collarbone. Tendons and the labrum do not show on an X-ray. When the exam suggests a cuff tear, a labral injury or ongoing instability, the physician orders an MRI through our diagnostic imaging coordination. Whether you need one depends on the findings, not on the fact of the crash; the reasoning is laid out in do I need an MRI after a car accident.

When numbness, tingling or weakness runs down the arm, EMG nerve testing helps separate a shoulder injury from a nerve problem in the neck or the arm itself. That distinction matters, because the treatment is different.

What a non-surgical shoulder plan coordinates

After the diagnosis you receive a written treatment plan. Shoulder care leans heavily on rehabilitation, and the plan brings the pieces together under one roof:

• A sling or brace for protection or comfort when the injury calls for one, with the physician reviewing its use at each visit
• Physical therapy that restores motion first, then strength and control of the shoulder blade
• Injection treatments where the diagnosis supports them
• Pain management review when pain is limiting therapy or sleep
• Written work restrictions — which arm, how high reaching is appropriate, what lifting or pushing is appropriate — reviewed and updated as the shoulder changes

How long shoulder care runs varies with the injury, and your clinician will set expectations after examining you. The plan ends when you have met your goals, not on a fixed schedule; if you no longer need treatment, your physician says so.

When a shoulder needs a surgical opinion

Findings that can lead to a surgical conversation include a full-thickness rotator cuff tear, a displaced collarbone fracture, and a shoulder that keeps dislocating. When the examination or MRI points that way, you are referred for a surgical opinion. Injury Recovery MD does not perform surgery. You choose the surgeon. We prepare the work-up documentation that surgeon will want to see, and if you have an operation, your operating surgeon sets the rehabilitation protocol and milestones while the rehab itself can take place at IRMD. Our page on rotator cuff repair explains what that operation involves.

No-Fault and workers’ compensation billing

If your shoulder was hurt in a motor vehicle accident in New York, No-Fault insurance covers medically necessary care whoever caused the crash, and IRMD bills it directly — see our No-Fault doctor page. The No-Fault application must reach the insurer within 30 days of the accident; our guide to the No-Fault 30-day deadline explains what to file.

Shoulder injuries from lifting, reaching or falling at work are billed to the workers’ comp carrier; see workers’ compensation orthopedic doctor. Under either system it is $0 out of pocket for covered patients, and you choose your own treating provider. Under workers’ comp, that choice is among providers authorized by the New York Workers’ Compensation Board, and Injury Recovery MD is one.

Where to be seen for a shoulder injury

Orthopedic physicians see patients at all 7 IRMD offices — Medford, Islandia, East Islip, Mineola, Bohemia, Smithtown and Stony Brook — with addresses on our locations page. Same-day and next-day visits are often available at (631) 560-8357. For every injury a crash can cause, see car accident orthopedic care. Other joints are covered under orthopedic care, including the hand, wrist and elbow and the neck and back, where some shoulder pain actually begins.

Where to see an orthopedic physician

• Medford3243 NY-112, Bldg 1, Suite 4, Medford, NY 11763Suffolk County
• Islandia1717 Veterans Memorial Hwy, Suite 100, Islandia, NY 11749Suffolk County
• East Islip11 Carleton Ave, East Islip, NY 11730Suffolk County
• Mineola300 Old Country Rd, Suite 321, Mineola, NY 11501Nassau County
• Bohemia1690 Washington Ave, Bohemia, NY 11716Suffolk County
• Smithtown732 Smithtown Bypass, Suite 200, Smithtown, NY 11787Suffolk County
• Stony Brook2500 Nesconset Hwy, Building 10A, Stony Brook, NY 11790Suffolk County

Orthopedic physicians see patients at every Injury Recovery MD office. Intake books the office and time that suit you. Call (631) 560-8357 — answered 24/7.

Frequently asked questions

Can a seatbelt injure my shoulder in a car accident?

Yes. The shoulder belt holds one shoulder in place while the body keeps moving, and that load can bruise the joint, strain the rotator cuff or fracture the collarbone. Bruising along the line of the belt is common and does not reveal whether a deeper structure is hurt; an orthopedic exam and, where needed, an X-ray answer that. An arm that is numb, cold, pale or visibly deformed needs the emergency department now.

Do I need an MRI for a shoulder injury after an accident?

Not always. An X-ray shows bone, while an MRI shows tendons, the labrum and cartilage. An orthopedic physician orders a shoulder MRI when the examination suggests a rotator cuff tear, a labral tear or instability, or when the shoulder is not responding to treatment as expected. The decision rests on the exam findings, not simply on the fact that there was a crash.

Does Injury Recovery MD operate on shoulders?

No. IRMD’s shoulder care is non-surgical: examination, X-ray, MRI when indicated, diagnosis, a written plan, bracing where appropriate, physical therapy, injections and pain management. When a shoulder needs a surgical opinion you are referred and you choose your own surgeon. IRMD prepares the work-up documentation and can provide rehabilitation afterwards, following the protocol your operating surgeon sets.

My shoulder did not hurt at the scene. Can the pain still be from the accident?

It can. Shoulder pain that appears after the day of a crash is common, because swelling and muscle guarding build once the adrenaline wears off, and a delayed start does not rule out a tendon or labral tear. An orthopedic exam checks motion, strength and stability to find the source. If left shoulder or arm pain comes with chest pressure, sweating or shortness of breath, call 911, because that can be a heart attack.

Is shoulder treatment after a car accident or work injury covered on Long Island?

New York No-Fault covers medically necessary treatment after a motor vehicle accident, and workers’ compensation covers shoulder injuries that happen on the job. IRMD bills both directly, so it is $0 out of pocket for covered patients. The No-Fault application must be filed within 30 days of the accident, and you choose your own treating provider. Under workers’ comp, that choice is among providers authorized by the New York Workers’ Compensation Board, and Injury Recovery MD is one.

Where can I see an orthopedic doctor for my shoulder on Long Island?

IRMD orthopedic physicians see shoulder patients at all 7 offices: Medford, Islandia, East Islip, Mineola, Bohemia, Smithtown and Stony Brook. Same-day and next-day visits are often available when you call (631) 560-8357.