I'm an idiot and I hurt myself -- please help

April 24, 2009 9:26 AM

Please help me treat my shoulder problem before I can see a doctor

I fucked up my shoulder lifting around two weeks ago. It hurts: 1) when I raise my arm up and even slightly behind my head, and particularly when I let it drop from that position 2) when I move it backwards in a circle, 3) when I lean with my weight over that elbow, and 4) when I rotate my hand inwards and raise my arm in front of me. Based on research I've done I think this has to be bursitis or an inflammation of the rotator cuff. Hope it's not a rotator cuff tear.

I can't get a real appointment with an orthopedic doctor for about a month. I managed to speak to one for five minutes on an "emergency" basis -- she moved my arm out to the side and straight up and said I had no problems. I said that I can't move my arm behind my back at all, and she said I don't need to. I said, look, it hurts to pull a t-shirt over my head. She referred me to a radiologist. Now after I get an x-ray I'm supposed to make an appointment with her, which will take a few weeks. Meanwhile I looked it up and an x-ray seems to have nothing to do with rotator cuff problems.

Also I'm in Berlin, where I can't find an orthopedic who doesn't seem to spend most of their time performing acupuncture. I have absolutely no faith in anyone's professional judgment here.

So, while you're not my doctor, I'd really appreciate any advice about how I can treat this thing in the meantime, while I'm waiting for a doctor to find time to look at my x-ray.

Obviously I'm trying to rest it. Should I try to make a sling for it, or buy a shoulder brace? I have some diclofenal gel here -- should I use that? Also, I went and looked up all the rotator cuff exercises I should've been doing beforehand, and while they're recomended for rehab, am I right to assume that I should leave them alone as long as I'm in pain? And is there anything else I should know? I'd like to avoid needing surgery as much as possible.

Any advice is appreciated.

posted by creasy boy to health & fitness (11 comments total)

I've been struggling with lifting-related shoulder/elbow pain for a couple of months now. It finally got bad enough that I saw my GP, who said it seemed like bursitis, and gave me a referral to an orthopedist, whom I'll be seeing in a few weeks. In the meantime though, I've kept lifting, and what's helped me is lots of ibuprofen (800 mg a few times a day) and shoulder dislocations for flexibility.

However, it's also stopped hurting when I've stopped lifting for a week or so.
posted by ludwig_van at 9:42 AM on April 24

Seconding ibuprofen and rest.
posted by Stewriffic at 9:48 AM on April 24

Well, in my case, I'd been taking a week off lifting for a pulled hamstring when I noticed the pain -- and since then it's gotten worse, since i keep aggravating it accidentally. And I just stopped taking iboprofen -- which I'd been taking all day long for about two weeks.

To make matters worse, I was antsy about not being able to lift, so I took up banjo, and now I have an inflamed tendon in my wrist, in the same fucking arm. My whole right side is gimpy. But I have the hamstring and the wrist under control now and they're healing. The point is that I think lifting anything or taking any more ibuprofen is out for a good while.
posted by creasy boy at 9:49 AM on April 24

Slightly different situation here - I've had ongoing back issues for months. A couple weeks ago I woke up and couldn't move my arm behind my back at all. Got an ortho appointment and it turned out to be a pinched nerve caused by a ruptured disc in my cervical spine. In my case, the best treatment has been 20-minute stretches of lying on an oversized ice pack.

Side note: how I wish I could find an insurance-covered ortho who practiced acupuncture. In the US, they just hand out copious amounts of opiates.
posted by chez shoes at 9:57 AM on April 24

At a minimum, you should be icing it frequently if you haven't been so far. As long as you allow 30 minutes or so to warm the up, you can ice as many times as you want during the day. 15 on, 30 warm-up, 15 on, etc... Try to ice at least 2-3 times a day. Gentle motion with no pain is good as well. Don't be tempted to "push through it". I'd still be on the Ibu as well, if it were me. 800-1000 mg 3-4/day. That sounds like a lot, but unless you're doing it for months it's not a problem (IANAD, but I worked in a PT clinic for 2 years -- my recommendations here are based on those of 3 20 year PTs who saw a lot of shoulder problems).

To that end, can you get in with a PT before you see the ortho? Maybe get a referral from your regular doc, or just fork over the cash for a one time visit? Get yourself a home exercise program and some solid advice on treatment, which I bet will be ice, Ibu, rest and gentle (no-pain) range-of-motion exercise.
posted by Pantengliopoli at 10:49 AM on April 24

I had this same problem. My dad had this same problem. For some reason taking calcium tablets quite frequently cured the problem. Doesn't work over night, but it worked for us after a week or two of it. - and keep up on it.
posted by Sassyfras at 10:55 AM on April 24

I've had both shoulder surgery for a torn rotator cuff with an impingement and several attacks of bursitis. Heredity is a bitch.

With bursitis, you should feel more pain around the back of the shoulder. You will sometimes have swelling on your back (not the top of your shoulder). For a woman, this would be the area of your back where your bra hooks, for example. There is tenderness if you feel around in that area. Ice or heat gives relief, along with the NSAIDS. Leaning on the elbow definitely hurts with bursitis, as does trying to shampoo your hair in the shower.

For the rotator cuff, in contrast, the pain is usually sharper, more distinct, and it is definitely on the top of the shoulder. You can lean on your elbow if it is straight, no problem, but lifting the arm, lifting and moving it behind you at the same time, or moving it behind you when it is raised at all causes that sharp spasm of pain. You should use ice, but not heat, according to one of my PT's, because you really don't want to add to the swelling. The way it was explained to me is that the area on the top of the shoulder doesn't allow for much additional space, so the more swelling, the more pressure you are putting on the point of injury, if that makes sense.

After I had surgery for the torn rotator cuff, I had three little scars from the surgery. I'm telling you this so that you can also pinpoint the injury area more accurately: the middle scar is where a vaccination mark would be, if you were ever vaccinated as a child. Then there's one on top of the shoulder and one on back on a line straight around from that vaccination-type one. Nothing is down low on the shoulder; it's more the clavicle area.

You really need an MRI, not an X-ray, if it is the rotator cuff. If it's bursitis, it should not be an issue after a week or so, unless you strained your shoulder more after that wrist injury because you were compensating for the weakness.

As soon as you can get to the doctor, start in on how you want an MRI and PT. PT really does help even if you end up having surgery. And if you can take ibuprofen, do it.

Please get to that doctor, and don't wait. I let mine go for too long, and when I went off of the ibuprofen (2400 mg daily dose!) so I could prep for surgery, a week before the operation I literally could not turn the car steering wheel.

Hope this helps.
posted by misha at 11:04 AM on April 24

OK it sounds more like bursitis then. I'll get back on the ibuprofen, ice it and keep resting. Thank you everyone so far, it's a great help. A half-hour of PT is 20 euros here, I'll start asking around for a recommendation.
posted by creasy boy at 11:13 AM on April 24

Pantengliopoli and misha have given you excellent advice. For now, use ice and ibuprofen and keep some gentle movement going, avoiding any specific moves that hurt (can you use button up shirts instead of t-shirts). Immobilization is the LAST thing you want to do. But start pushing NOW to see a doctor and get physiotherapy.

If you have problems getting ice to the specific areas, try using a tensor bandage to wrap an ice pack in the right area, or use a combination of a short sleeved and long sleeved shirt to keep one of those plastic coldpacks wedged in the right spot.
posted by maudlin at 11:18 AM on April 24

Good advice above. Also, when you start lifting again, maybe have someone else check out your form with light weight before you go loading up the bar. Injuries can happen, but two in a matter of a couple of weeks? Something might be going on there. (Or, it's a random coincidence, but still worth checking out.)

Says the guy who's taking the week off after a moment's inattention to form putting a deadlift back down did not make for a happy back.
posted by ctmf at 1:25 PM on April 24

Allright, thanks to everyone who answered...I'm not marking best answers because I appreciated everyone's input. I have an appointment with a sports doctor on the 12th and with a real orthopedist on the 18th and until then I'm icing it, stretching it gently once a day, otherwise trying to ignore it, and taking 400 mg of ibuprofen 3x a day. I tried 800 and I think it was too much, I felt rather funny. It sucks trying to get out of the bathtub without resting on both arms, I'll tell you that much.
posted by creasy boy at 9:26 AM on April 29