Hairline fracture of the shoulder blade: what to know

The shoulder blade connects the arm, collarbone, and chest wall through several muscles and joints. A small crack can therefore hurt when you lift the arm, reach across the body, push, pull, or lie on the affected side. Bruising and muscle injury may occur at the same time, particularly after a fall or direct blow.

Assessment may include checking the skin, shoulder alignment, arm strength, sensation, and circulation. X-rays can identify many fractures, while additional imaging may be considered when pain and examination findings do not match a normal initial image. A clinician also checks for chest or neck injury after significant trauma.

Use a sling only for the period and purpose advised, because prolonged immobilisation can make the shoulder stiff. Keep the hand, wrist, and elbow moving if allowed, and avoid lifting or leaning through the arm until cleared. Ice wrapped in cloth may help swelling during the early phase.

When pain and the fracture assessment permit, guided shoulder motion is introduced before strengthening. Physiotherapy can restore comfortable reach, shoulder-blade control, and upper-back movement without forcing a painful range. Do not return to contact activity merely because bruising has faded.

Get urgent help for new shortness of breath, chest pain, coughing blood, severe neck pain, an arm that becomes cold or pale, new weakness or numbness, or an obvious change in shoulder shape. Arrange prompt review if pain is increasing, the arm cannot move as directed, or swelling and bruising continue to expand.

Ask whether the fracture is stable, how long the sling is needed, and which shoulder movements are safe. Clarify when you may drive, work overhead, lift, or exercise, and whether follow-up imaging or physiotherapy is part of the plan.