Shoulder Problem

[darius3000]

Hello.
I'm a 37 yo man who played a lot of tennis this past summer.
I'm afraid it's all caught up with me.
left shoulder does not feel right. I can raise arm over head just fine, but when I do flyes there's pain there.
I also have pain in the tailbone area from time to time.

I have good insurance. I would like to avoid going to a doctor that just tells me to go to someone else. I can go to a specialst without a referral from a PCP.
What type of doctor should I see? I would really like to know what's wrong with me.

Thanks!

[Boss Man]

It depends.

If it's a nervous issue, then possibly a Neurologist might be in order.

If you have a muscle problem, then you need a Sports Therapist or Physiotherapist perhaps, who could potentially maniuplate the area, as it might be some kind of muscle sprain, or mild tear, possibly also in a Ligament or Tendon.

I doubt it would be some kind of muscle tear, unless their was clear discolouration of the Shoulder area.

What you can do to some extent, is self diagnose, I.E. trying to work out how this may have occured, I.E. trip or fall, poor weightlifting technique, bad sleeping position etc etc, so you can ascertain if there are circumstances you can correct, to avoid re-injury or impingement, though if it's an unforseen mishap, it's not likely to happen again.

This may be a prudent course of action, as anyone you consult with to help you get through this, may treat the problem, but if it was preventable, I.E, it happened moreso because of you, rather than external factors, they may not diagnose, either through negligence or on purpose, causal factors, leaving you vulnerable to repetition of the problem again, at some point in the future.

The other possibility is it might be Bursitis.

The body has little fluid filled sacs, called Bursa, that help to promote smooth movement of Joints, which can get inflamed, leading to problems with range of motion of an affected area.

The Shoulder area, has around 3-4 of these Bursa sacs, around the Rotator Cuff, a group of 4 muscles, the Teres Minor, Infraspinatus, Supraspinatus and Subscapularis, with corresponding Tendons, that promote bi-directional rotation and forward and lateral movement.

Were this a Bursitis problem, I would assume you'd only inflamed somehow one of the Bursae, though it's possible you might have inflamed more than one.

So what you would really need to do, is go to a Doctor to assess what it is, because should it need specialist treatment, they should be able to tell you who to see, as just going to one person, who specialises in one field, may be a mistake that you might have to pay for, if you get a paid for consultation, that diagnoses an issue outside of the individuals working field.

I would often suggest at this point, doing something like RICE, (Rest, Ice, Compression Elevation), possibly in conjunction with something like NSAIDS; Ibuprofen being an example, but it may be something that methodology doesn't correct, so again a Doctor might stress that as a possibility, which may mean no specialist involvement at all.

Worst case, outside scenario, it might require an invasive procedure, but that should always be a last resort, in cases where non-invasive options are permissible.

[swanso5]

joe defranco is in jersey isn't he?

contact him, he'll know a good one

stop doing flies

[ultimatehlth]

Hey darius3000,

Boss Man is spot on. The prudent way to start is RICE and NSAIDS.

Hang your arms to your sides, palms in. With your arms straight, try raising your arms up until your biceps touch your ears...any pain (top outer edge of shoulder)? Now raise your arms out in front of you at shoulder height, thumbs up. Quickly and forcefully turn your arms inward until your thumbs are pointing down. If neither caused you any pain then it is likely not bursitis. Bend your arm behind your back and feel around the front of the deltoid and upper arm. Push firmly into the exposed tendons. If you feel pain compare other side. Pain here is a tendinitis issue. I recommend finding a Osteopath or Physiatrist, both are MD's that specialize in physical medicine and natural healing.

[Boss Man]

Boss Man is spot on. The prudent way to start is RICE and NSAIDS.

Although just to clarify, in this instance as stated in earlier post, I didn't suggest that as a primary option, owing to the clouded nature of the issue.

I eluded to such a protocol / modality, being more prudent after medical consultation, so as to make sure, that it would be a workable option in the circumstances. Especially if the person ended up having to purchase some kind of NSAID product, and then discovered it's effects were blunt to nil, as that's wasted money.

Were a medic of some kind to suggest such a modality, then RICE + NSAIDS would be clearly be prudent.

Not trying to poo-poo anything you said, just needed to reclarify that point, so the individual didn't potentially do something of little worth.

[darius3000]

Hello gentlemen and thank you for the responses. This evening, I did the tests the kind pers. trainer suggested and I passed them. But as I hold out left arm perpendicular to torso and then turn the arm in both directions, I can feel how something deep within shoulder seems "unhinged". I'm wondering if it could be due to the nature of job. I physically must walk between 4 buildings a day, walking many feet per day, and I've been carrying heavy bags much of the time. I'm wondering if the shoulder issue could have been brought on by that. Again, it feels as if the shoulder is not positioned right. It's not severe pain, but pain enough that I cannot risk doing presses with heavy weight.

Hope this helps. I'm getting a bit worried.
Darren

Boss Man is spot on. The prudent way to start is RICE and NSAIDS.

Although just to clarify, in this instance as stated in earlier post, I didn't suggest that as a primary option, owing to the clouded nature of the issue.

I eluded to such a protocol / modality, being more prudent after medical consultation, so as to make sure, that it would be a workable option in the circumstances. Especially if the person ended up having to purchase some kind of NSAID product, and then discovered it's effects were blunt to nil, as that's wasted money.

Were a medic of some kind to suggest such a modality, then RICE + NSAIDS would be clearly be prudent.

Not trying to poo-poo anything you said, just needed to reclarify that point, so the individual didn't potentially do something of little worth.

[swanso5]

what tests did you do?

[Packard]

If nothing is broken then first call would be to a physiatrist.

See: http://www.aapmr.org/condtreat/what.htm" onclick="window.open(this.href);return false;

These are medical doctors that prescribe physical therapy. The physical therapist would then fill the prescription.

They have a lot more training than physical therapists.

They are not quick to recommend surgery. If surgery is required they will refer you to someone.

For many years physical therapists in the USA could not work directly with the patient, they had to have a prescription to perform the physical therapy. That changed in New York about 15 years ago. But what hasn't changed is the fact that physiatrists have far more training and are medical doctors. The bar is set quite a bit higher to become a MD than to become a PT.

[Boss Man]

I concur. A Physical Therapist would be a logical step to persue. You might have possibly also done something called Subluxation, which is a partial dislocation of a joint. Not having any way to personally interact with you, or knowing precisely what this possibility makes the person feel or permits them to do, I cannot be 100% certain of this, but I mention it so as not to rule it out.

You might even benefit from looking up something called Ehlers Danos Syndrome, which I believe is a condition that promotes Subluxing to some degree, but I believe is also chronic, so it wouldn't go away.

This stuff isn't meant to freak you out, but to highlight and make you aware of another potential possibility. I very much doubt you have any intial stages of E D S, or indeed have subluxed, but better to be aware than not.

Good luck and hopefully you can get yourself sorted out pretty soon. You don't need these issues over Christmas, especially if you're on Turkey carving duties, as it may make things difficult for you to do and most peoples Christmas dinners, pretty luke warm .

[darius3000]

Hello again. The tests I did were listed in a previous post. I'm bummed b/c I can't do pushups without feeling some discomfort in left shoulder. I fear something is wrong deep within. Again, I think I may have done this to myself from all the heavy carrying of bags I've done since the beginning of September.
Thanks everyone for your suggestions.
Darren

I concur. A Physical Therapist would be a logical step to persue. You might have possibly also done something called Subluxation, which is a partial dislocation of a joint. Not having any way to personally interact with you, or knowing precisely what this possibility makes the person feel or permits them to do, I cannot be 100% certain of this, but I mention it so as not to rule it out.

You might even benefit from looking up something called Ehlers Danos Syndrome, which I believe is a condition that promotes Subluxing to some degree, but I believe is also chronic, so it wouldn't go away.

This stuff isn't meant to freak you out, but to highlight and make you aware of another potential possibility. I very much doubt you have any intial stages of E D S, or indeed have subluxed, but better to be aware than not.

Good luck and hopefully you can get yourself sorted out pretty soon. You don't need these issues over Christmas, especially if you're on Turkey carving duties, as it may make things difficult for you to do and most peoples Christmas dinners, pretty luke warm .

[swanso5]

The tests I did were listed in a previous post.

this one?

But as I hold out left arm perpendicular to torso and then turn the arm in both directions

is that all he did and said it was fine?