Persistent Shoulder Pain After a Fall? It Might Be More Than Just a Bruise.

by Son’s Rehabilitation Medicine & Chiropractic Clinic in Seoul

Have you ever experienced a fall, been told "your bones are fine" at the ER, yet months later, the pain is still there—or even getting worse?

Recently, a female patient in her 60s visited our clinic with chronic right shoulder pain following a fall four months ago. Despite initial X-rays elsewhere showing no fractures, her pain persisted. A detailed re-examination at our clinic revealed a subtle avulsion fracture.

Today, we’ll discuss why "normal" X-rays can be misleading and why chronic pain often stems from issues beyond the bone itself.

1. What is an Avulsion Fracture?

Unlike a clean break through the bone, an avulsion fracture occurs when a ligament or tendon pulls so hard on the bone that a small fragment gets detached.

In many cases, these micro-fractures are missed in initial screenings. While the bone fragment itself may settle over four months, the trauma to the connected tendons and muscles often leaves a lasting impact on shoulder function.

2. Why Does it Still Hurt After 4 Months?

At this stage, the pain isn't necessarily coming from the "fracture" site. Instead, it is a result of secondary compensations:

  • Muscle & Tendon Changes: To protect the injured area, surrounding muscles become stiff and "guarded," leading to chronic tension and restricted movement.

  • Cervicothoracic Misalignment: Chronic shoulder pain often causes a shift in posture. We found that this patient developed subtle misalignments in her neck (cervical) and upper back (thoracic) spine, which further irritated the nerves leading to the shoulder.

  • Neural Sensitization: When pain lasts for months, the nervous system becomes "hypersensitive," causing the brain to signal pain even during minor movements.

3. Our Integrated Treatment Approach

At Dr Son Rehabilitation Medicine & Chiropractic clinic, we focus on restoring the balance between the nerves, muscles, and the skeletal structure. For this patient, we implemented:

  • Nerve Block Therapy: To calm the hypersensitive nerves and reduce deep-seated inflammation effectively.

  • IMS (Intramuscular Stimulation): Using specialized needles to target deep muscle trigger points. This releases the chronic tightness in the shoulder and the cervicothoracic region that manual stretching cannot reach.

  • Structural Realignment: Addressing the subtle shifts in the spine to ensure the shoulder can move in its correct mechanical path.

A Message from Dr. Son 

"Pain is a communication from your body. If shoulder pain persists for more than a few weeks after an accident, it is rarely just about the bone. We must look at the kinetic chain—how your neck, back, and muscles work together. Early intervention with specialized rehabilitation can prevent temporary injuries from becoming permanent limitations."

If you are struggling with lingering pain from an old injury, don't wait for it to 'just go away.' Let us help you find the root cause and get you back to your active lifestyle. 


👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

chson@daum.net

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