I fell forward off my bike and hurt my shoulder. The doctor who examined me poked, pushed, twisted, and pulled my arm to find out what was wrong. Isn't there any easier way to diagnose a problem like this?

Not always. Soft tissue injuries are much harder to identify than a simple broken bone, which shows up on X-ray. The shoulder complex is made up of more than just the basic shoulder joint. There are tendons, ligaments, and cartilage that can be damaged in an accident like yours.

The acromioclavicular (AC) joint is often injured. This is where the collarbone (clavicle) joins with the acromion, a bony projection off the shoulder blade. There are several good tests for AC injury, but a recent study showed other shoulder tests can be positive when the problem is in the AC joint.

Since doctors rely on clinical tests to decide treatment, we may have to endure some extra prodding and pulling. Successful treatment is based on finding the exact problem. The initial discomfort is important in the final outcome.