Sprained Shoulder: What It Means and How Long It Takes

A sprained shoulder usually means a ligament holding one of the shoulder joints together has been stretched or partly torn, most often after a fall onto the shoulder or an outstretched arm. “Sprain” is a loose label. It is often an AC joint sprain at the top of the shoulder, and sometimes an injury to the joint capsule, the labrum or the rotator cuff. Mild sprains often settle in 1 to 3 weeks; more severe ones can take 6 to 12 weeks or longer.

Because the word covers several different injuries, a sprain that is not clearly settling within 2 to 3 weeks is worth having assessed, so the injured structure can be named.

Key takeaways

A loose label: a “sprained shoulder” can mean an AC joint sprain, a capsule or labrum injury, or a rotator cuff strain.
Most common: an AC joint sprain at the top of the shoulder, after landing on its point.
Grades: grade 1 is a stretch, grade 2 a partial tear, grade 3 a complete tear.
Typical timeline: grade 1 often 1 to 3 weeks; grade 2 often 3 to 6 weeks; grade 3 often 6 to 12 weeks or longer.
When to get assessed: a sprain not clearly settling in 2 to 3 weeks, or any weakness lifting the arm.

What “sprained” usually means

AC joint sprain: pain on the bony point at the top of the shoulder, where the collarbone meets the shoulder blade. Reaching across the body hurts, and there may be a bump. Separated shoulder (AC joint sprain) covers this in detail.
Capsule or labrum injury: deep pain inside the ball-and-socket joint after the arm was forced back or out, sometimes with catching or a slipping feeling. If the ball slipped partway out and back in, that is a shoulder subluxation. A persisting catch can mean a labral tear.
Rotator cuff strain: strictly a strain, not a sprain, because it is muscle or tendon. An ache over the outer upper arm, worse lifting the arm out to the side.
SC joint sprain: less common. Pain at the front, where the collarbone meets the breastbone. See SC joint pain.

Grades of sprain

Grade 1: the ligament is stretched. Tender and sore, with near-normal movement and strength.
Grade 2: the ligament is partly torn. More pain, some swelling or bruising, and movement hurts.
Grade 3: the ligament is fully torn. There may be a visible step at the top of the shoulder, or the joint may feel unsteady.

AC joint injuries have their own six-grade scale, so your doctor may use different numbers. The higher grades are the ones where surgery is sometimes discussed.

Where are you right now?

It has just happened: check the safety sections, then the week-by-week section.
Two to three weeks in and not settling: go to “If it isn’t going to plan”.
Told it is something more specific: use the page for that structure, linked in the section above.
Getting back to work or sport: see the “When can I…” table.

Week by week

Days 1 to 3: pain and swelling peak. A sling for comfort, a cold pack for 10 to 15 minutes at a time, and keeping the elbow, wrist and hand moving are usual.
Days 3 to 14: gentle movement within comfort, such as sliding the hand forward along a table. Most grade 1 sprains are easing clearly by the end of week 2.
Weeks 2 to 6: strengthening for the rotator cuff and shoulder blade muscles, arm low at first. Grade 2 sprains usually improve steadily through this stage.
Weeks 6 to 12: heavier lifting, overhead work and sport return in steps. Grade 3 sprains often need this long, sometimes longer.

“Sprain” describes what happened to you. The next step depends on which part of the shoulder took the force.

Where else this could be coming from

A broken collarbone: pain and often a lump along the collarbone itself, rather than at its end. Broken collarbone recovery covers it.
A broken upper arm: after a fall, especially over about 60, heavy bruising down the arm and pain moving it at all can mean a break near the top of the arm bone.
A rotator cuff tear: weakness lifting the arm that stays as pain settles, especially after about 40, suggests a torn rotator cuff rather than a sprain.
The neck: after a car crash or a fall onto the head, aching across the top of the shoulder can come from the neck. Whiplash tends to stiffen neck movement and cause headaches.

Is this normal?

“The bruise has moved down my arm.” Common. Bruising often tracks down toward the elbow over the first week or two.
“There’s a bump on top of my shoulder.” Common after an AC joint sprain. The bump often stays, and many people find it does not limit how the shoulder works.
“It’s stiff in the morning.” Common early on, and it usually loosens with gentle movement through the day.

If it isn’t going to plan

It is week three. Pulling the seatbelt across still catches at the shoulder, and you have stopped reaching into the back seat. The thought in your head is that it is only a sprain, so a bit more rest will settle it.

That works when the injury really is a mild ligament sprain, which usually improves clearly within 2 to 3 weeks. When it does not, the label may be hiding something with a different timeline: a rotator cuff tear, a labral injury, a slipping joint or a small fracture. Some of these, such as a cuff tear after an injury, are easier to treat when they are found early.

If you are 2 to 3 weeks in and not clearly better, get assessed by a physical therapist or doctor. Ask:

Structure: which part of my shoulder is injured, and which grade?
Imaging: do I need an X-ray, ultrasound or MRI?
Strength: is my rotator cuff strength normal for my age?
Timeline: what should I be able to do in 4 weeks?

When can I…

Activity	Typical range
Sleep on that side	Often 2 to 6 weeks, longer after an AC joint sprain
Drive	Often within 1 to 2 weeks, once you can steer and brake safely
Reach overhead	Grade 1 often 1 to 3 weeks; grade 2 often 3 to 6 weeks
Lift	Light loads within days to weeks; heavier lifting often 4 to 12 weeks by grade
Desk work	Often within a few days
Manual work or sport	Often 2 to 6 weeks for mild sprains; 6 to 12 weeks or more for severe ones

If you have had surgery, your surgeon’s protocol comes first.

Call your local emergency number or go to the emergency department if

Out of shape: the shoulder looks deformed or you cannot move the arm at all after the fall.
Circulation: the arm or hand turns cold, pale or blue.
Front of the collarbone: pain where the collarbone meets the breastbone with trouble breathing or swallowing.
Neck injury: severe neck pain after the fall or crash, or numbness or weakness in both arms or the legs.

See a doctor today if

Weakness: you cannot lift the arm away from your side.
Skin over a bump: the skin is tight, pale or broken over a bump at the top or front of the shoulder.
A numb patch: numbness over the outer upper arm or in the hand.

Get it checked soon if

Not settling: pain and movement are not clearly better after 2 to 3 weeks.
Slipping or catching: the shoulder feels like it shifts, catches or clunks.
Growing stiffness: the shoulder is getting stiffer week by week.