A Comprehensive Guide to Shoulder and Clavicle Injuries for Stunt Performers

This guide is designed to help stunt performers better understand the shoulder and clavicle, typical soft-tissue injuries that may occur, and how to manage them. While this guide is not a substitute for professional medical advice, it aims to provide insight into injury identification, management, and prevention. Let's begin with the basics, then move into injury identification and some advice...

Understanding the Shoulder and Clavicle
The shoulder is a complex structure composed of bones, muscles, tendons, and ligaments. The clavicle, or collarbone, connects the upper part of the sternum to the scapula (shoulder blade).

Key components of the shoulder joint include:

• Rotator cuff:
  A group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) and their tendons, responsible for stabilizing and moving the shoulder.
• Deltoid muscle:
  The large, triangular muscle that covers the shoulder joint and allows for arm abduction.
• Biceps and triceps: 
  Muscles responsible for flexing and extending the arm, respectively.

Typical Soft-Tissue Injuries
Common shoulder and clavicle soft-tissue injuries include:

• Rotator Cuff Strain or Tear:
  A strain or tear in one of the rotator cuff tendons or muscles can occur from sudden impact, overuse, or excessive rotation. Symptoms may include pain in the front or side of the shoulder, weakness, and limited range of motion.
• Contusion or Bruising:
  A direct hit to the shoulder or clavicle can cause bruising, swelling, and tenderness. Pain typically increases when the area is touched or the arm is moved.
• Biceps or Triceps Strain:
  Forceful impact or overuse can cause a strain in the biceps or triceps. Pain may be felt in the front or back of the shoulder and can be accompanied by muscle weakness or difficulty moving the arm.
• Shoulder Dislocation or Subluxation:
  A dislocation occurs when the humerus (upper arm bone) comes out of the shoulder socket, while a subluxation is a partial dislocation. Both can result from forceful impacts or twisting. Symptoms include severe pain, swelling, and an inability to move the shoulder

If you experience difficulty in Arm 'Abduction': Help to Identify the injured Muscle(s) or Tendon(s) 
If a performer has difficulty raising their arm to the side (abduction) beyond 45 or up to 90 degrees, the most likely injured muscles or tendons are:

1. Supraspinatus muscle/tendon:
   One of the four rotator cuff muscles, primarily responsible for initiating abduction of the arm. Injuries to the supraspinatus can result from overuse, trauma, or impingement due to its location beneath the acromion (bony projection on the shoulder blade).
2. Deltoid muscle:
   The large, triangular muscle that covers the shoulder joint and is the main muscle responsible for arm abduction. An injury to the deltoid muscle could lead to difficulty lifting the arm out to the side. Common causes of deltoid injuries include direct trauma, overuse, or strain during forceful movements.

Injury Identification and Management: Help to assess an injury

• Determine the location and intensity of pain
• Check for swelling or deformity
• Test range of motion and strength

If pain is severe, or if there is significant swelling, deformity, or inability to move the arm, seek professional medical attention. For less severe injuries, follow the RICE protocol:

1. Rest: Avoid using the injured shoulder for at least 48-72 hours
2. Ice: Apply ice to the affected area for 20 minutes every
3. Compression: Use an elastic bandage to minimize swelling
4. Elevation: Keep the injured arm elevated above heart level

To speed up recovery and ensure proper healing, we advise you consult a healthcare professional for appropriate rehabilitation exercises and advice on when to resume activity.


Injury Prevention and Rehabilitation
To prevent injuries, incorporate exercises that target the rotator cuff, deltoids, and surrounding muscles. Focus on improving flexibility, strength, and stability.  Stunt Performers need good muscle strength around the shoulder joints and must keep in mind that linear exercise

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Some exercises to consider:

• External and internal rotation exercises with a resistance band
• Shoulder press
• Lateral raises
• Scapular retraction exercises

For rehabilitation, follow your healthcare professional's advice and gradually progress through a range of exercises to restore strength, flexibility, and function.

Further Resources and Learning To deepen your understanding of the shoulder and clavicle anatomy, function, and injuries, consider exploring these resources:

• Supraspinatus Muscle: Anatomy, Function, and Pathology
• Supraspinatus Tendonitis: Symptoms, Causes, and Treatment
• Deltoid Muscle: Anatomy, Function, and Pathology
• Deltoid Strain: Symptoms, Causes, and Treatment
• Shoulder Joint: Anatomy, Function, and Pathology
• Khan Academy: Muscles of the Arm and Shoulder

Understanding the shoulder and clavicle, common soft-tissue injuries, and injury management techniques can help stunt performers self-assess and manage injuries effectively.

While self-diagnosis can be challenging, and consulting a healthcare professional is always the best course of action, increasing your knowledge of the anatomy and function of the muscles involved in the shoulder and clavicle can help you better communicate your symptoms and concerns to a medical professional and also aid your own research into management and rehab activities.


Further advice on some things all performers should consider and make use of:

1. Warm-up and Stretching
   Emphasize the importance of a proper warm-up and stretching routine before any stunt performance or training session. Warm-up exercises increase blood flow, loosen up muscles, and prepare the body for physical activity. Dynamic stretches that target the shoulders, such as arm circles, shoulder rolls, and cross-body arm stretches, can help reduce the risk of injury.
2. Ensure you understand and follow Proper Technique and study Body Mechanics involved
   Understanding and applying proper body mechanics during stunts can help prevent injuries. For example, when falling or rolling, learn to distribute the impact force evenly across the body rather than concentrating it on the shoulder or clavicle. Work with a professional stunt coordinator or instructor to learn correct techniques and execution of stunts.
3. Protective Gear
   Using appropriate protective gear, such as shoulder pads or braces, can help minimize the risk of injury during stunts. Make sure the gear fits well and does not impede movement or performance.
4. Know Your Limits
   Recognize your physical limits and avoid pushing yourself too hard during training or performances. Overworking can lead to fatigue and increase the risk of injury. Allow for adequate rest and recovery between training sessions.
5. Nutrition and Hydration
   Maintaining proper nutrition and staying hydrated can promote overall health and aid in injury prevention and recovery. Ensure you consume a balanced diet rich in vitamins, minerals, and macronutrients to support muscle and joint health. Stay hydrated by drinking enough water throughout the day, especially during training sessions or performances.