NASA-STD-3001 Medical Technical Brief - Shoulder Injury - Overview & Treatment Guidance - OCHMO-MTB-006

Oct 13, 2026

Shoulder pain is a frequent musculoskeletal complaint and can threaten stability, mobility, and long-term astronaut performance, with dislocation risk and an estimated ~20% prevalence of accompanied disability. Astronauts experience higher rates due to rigid EVA-suit biomechanics, making early detection and treatment essential to reduce permanent impairment and avoid surgery. The brief provides evaluation timing guidance and a physician-led decision flow plus space-medicine injury pathophysiology covering common shoulder disorders.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages10

Reading Time4 min

AccessFree to download

Executive Summary

Guideline Decision Flow Diagram

Pathophysiology

Common Shoulder Injuries in Space Medicine

History and Physical Examination

NASA-STD-3001 Medical Technical Brief Shoulder Injury Overview & Treatment Guidance OCHMO-MTB-006 Executive Summary Shoulder pain is among the most common musculoskeletal complaints in the general population, after low back pain. Being the joint with the greatest range of motion, the shoulder often compromises stability for mobility and relies heavily on ligaments and muscles for steadiness and proper function. Because it lacks bony stability, it is the most common joint in the body to have dislocations, and the prevalence of accompanied disability is approximately 20% . Astronauts in particular have experienced a significantly higher number of these injuries from shoulder overuse as a result of the rigid biomechanics of wearing extravehicular activity (EVA) suits during training activities. These injuries may often adversely impact the performance of crew members making early detection and treatment a priority in order to minimize long term and permanent disabilities in addition to preventing the need for surgery. Guideline Decision Flow Diagram The evaluation of shoulder injury should occur upon initial symptoms at any point during an astronaut’straining, pre-flight and post-flight missions. This flow diagram is meant to aid in the management of shoulder pain. The ultimate judgment for the course of action of a patient with shoulder pain is made by the physician in light of the presenting circumstances. Ho AM, Goitz HT, Goitz RJ. Examination of the Shoulder. In Hand Surgery Update IV. Eds. Trumble TE, Budoff JE: American Society for Surgery of the Hand, 903-916, 2007. NASA-STD-3001 Medical Technical Brief Shoulder Injury Overview & Treatment OCHMO-MTB-006 Guidance Pathophysiology Common Shoulder Injuries in Space Medicine Numerous shoulder injuries have been reported in space medicine and the most common ones are summarized below. Note, these guidelines are not meant to stand alone as a means for establishing a firm diagnosis but rather to aid in the management of shoulder pain. 1. Glenohumeral Joint Osteoarthritis: This condition is a result of degenerative changes leading to loss of joint space resulting in shoulder pain. There is a loss of passive and active mobility that is often debilitating. In addition, instability, crepitus and a “catching” feeling are often reported. Pain usually prevents sleep and morning stiffness is often reported but usually found to improve throughout the day. The population usually affected is those greater than 40 years of age. 2. Rotator Cuff Tear: This involves the tearing of any of the four muscles that make up the rotator cuff either from an acute traumatic injury (common in patients younger than 40) or as a result of chronic overuse causing wear and tear (usually in those greater than 40) . This condition prevents patients from doing overhead activity and exacerbating pain is often reported at night. Patients are unable to externally rotate the arm (infraspinatus involvement) and experience weakness or pain during the empty-can (supraspinatus involvement) or lift-off (subscapularis involvement) maneuvers. 3. Biceps Tendinitis: This is a condition where the tendon around the long head of the biceps muscle is inflamed causing pain to the anterior shoulder. This often occurs as a result of sudden overuse and pain is exacerbated by overhead movement. Palpating the bicipital groove often reproduces pain. It often occurs in conjunction with impingement syndrome or rotator cuff tear. 4. Superior Labral Anterior Posterior (SLAP) Lesions: This involves injury to the superior aspect of the labrum, the cuff of cartilage that extends from the glenoid cavity, where the biceps tendon attaches. As a result, symptoms often mimic impingement syndrome, biceps tendinitis, and AC joint pain, thus a high level of suspicion is necessary for diagnosis. Lesions usually result from trauma, such as falling onto outstretched arms or sudden upward or pulling motion of the shoulde

FAQs

When should shoulder injury evaluation occur for astronauts?

Evaluation should occur upon initial symptoms at any time during astronaut training, pre-flight, and post-flight missions.

Who makes the ultimate treatment course judgment for shoulder pain?

The ultimate judgment for the patient’s course of action is made by the physician based on the presenting circumstances.

What is the purpose of the medical technical brief?

The brief shares clinical knowledge and best practices derived from NASA-STD-3001 for reference only, not to deliver direct medical care recommendations for individuals.

Oct 13, 2026

Upload by RuangKosong