Last Saturday Labor Day weekend, I was riding my bicycle on a sidewalk when an idiot on a gasoline engine powered mini bike came barreling around a bend straight down the middle of the sidewalk. He made no attempt to move to the side and we almost collided head on. I was able to swerve to the right and would have been fine if not for a bush right next to the walk that I sideswiped, which caused me to fall hard onto the sidewalk on my left side.
My shoulder was hurting badly enough the next day that I decided to go to the ER, as much to see if we could still do a trip we were about to take that involved kayaking, as for the pain. I was hoping for a magical steroid shot to the shoulder or something that would take the pain away so we could salvage the trip. I did get a shot in the shoulder, but it was some non-steroid painkiller that did next to nothing. After x-rays and a doc exam, he said I had nothing broken and probably had a strain or micro-tear to my rotator cuff. He said it would likely resolve on its own but gave me an ortho referral if it didn’t get better in a few days.
The shoulder did seem to get better: at first I couldn’t lift my arm straight out to shoulder height when I went to the ER. For a couple days I used my left arm as little as possible, which is tough because I’m left-handed. Now, a week later, it’s maintaining at the point where I have a full range of motion, it just hurts medium-bad to move my arm in certain ways. Pain in my left side is actually quite a bit worse than my arm now, but I’m not too worried about that since, can’t do much for bruised ribs, and they’re not as complicated as a rotator cuff.
So, to get to the ‘looking for advice’ part— how long and how much lingering pain should I go before deciding whether or not I should see an ortho? I’m not hearing or feeling a clicking or grinding sensation that Dr. Google tells me is a sign of a significant tendon tear. An occasional small pop, but I get that in my good shoulder too. Should I use my arm normally, not favor it? The ER doc said to listen to my body and I could do anything as long as I’m not in too much pain. It hurts enough to be annoying but not enough to prevent me from doing normal things. The worst is probably driving- reaching back to get the seat belt and turning the steering wheel. Should I look into physical therapy exercises online? You’re not a doctor, or if you are you’re not my doctor, but I’m just looking for some general long term self care advice, and I imagine a lot of us have injured our shoulders.
Physical therapy. Online yes it is available to me through my health providers Corewell app.
I discovered it when I had knee pain and was looking to schedule a dr appt. I got a call back from a PT and after questions she determined I could follow a program of exercises and education on the app. If I had questions or needed assistance I could call them to switch out exercises etc. I progressed through a 6 week program pain free today!
Shoulders are complicated since there are lots of components to make it work right. If you’re feeling pain, other muscles try to compensate. Those other muscles end up doing things they’re not designed for, and things can get out of whack. It’s probably a good idea to get a professional’s opinion. It may get better on its own, but it could also get wonky in a way that might affect your shoulder in the long term. You’ll probably get a PT program designed to strengthen the weakened muscles with movements to ensure the muscles activate the way they are supposed to.
I’m rehabbing a couple of minor tears through PT. If want to try on your own, you can find good shoulder and other PT videos on Bob and Brad’s PT YouTube channel. I found several very helpful videos there to add to the exercises given to me by my ortho and the physical therapist.
You didn’t mention your age. If you’re willing to share that, I think it could be relevant.
When I was younger, I would suffer and do my best. As I’ve aged (I’m in my 60s) and accumulated more injuries (and have better insurance) I am much quicker to contact a doctor to get a real diagnosis. This leads to better, quicker favorable outcomes, especially with joint issues. I felt some pain in my knee a few weeks ago in the middle of a hike. After a week of rest with some reduction of pain I went to my doctor and asked for an MRI. I got the results this week, complex tear in my medial meniscus. I scheduled an appointment with my Orthopedist the day after I got the results.
I don’t heal as quickly or as thoroughly as I used to when I was younger. Quick medical consultation is now my first course of action.
I’m glad to have avoided an office visit $$$ and in person PT also $$$. Yes it’s covered by insurance AFTER my deductible of 18k. Kid you not. I’m already on payment plans for previous medical adventures.
Medicare for all in my lifetime please.
Best part of the online PT is the program remains available to me anytime in the appp. I still do the exercises. Lunges dead bugs squats plank
I hurt my shoulder in karate class many years ago, landing squarely on the tip with my whole body weight, trying to flip. Nothing was broken, nothing was obviously torn. Range of motion came back fairly quickly but the damn thing ached for probably 6 months. And this was in my 20s!
The shoulder is a crazy complicated joint. PT is always very helpful for doing the right exercises for your particular injury. PT can also be expensive so online videos are great (shout out to Bob & Brad!) as a supplement or a replacement. Everything is slower to heal as you get older.
Also, rest, ice and anti-inflammatories as you can handle them (ibuprofen, naproxen) if you’re having a flare up, or post-exercise.
I’m not a fan of the online videos; it’s better to do it under the watchful eye of a trained professional. It’s hard to see yourself & even harder for an untrained person to see themselves & know when they aren’t doing a certain exercise correctly, whether that’s correct posture/positioning, or taking the range of motion far enough vs. too far, etc. Once I had them watch me & correct me once, then I was good to do it on my own but on more than one exercise, it was don’t move so far.
Consensus so far seems to be running half and half between ‘do it myself’ PT being worth trying, and ‘just get evaluated by a pro, especially when you’re older’. Maybe a little more the latter. I myself am on the fence right now. The pain seems to have settled into a flat ‘nagging but tolerable’ state, without restricting me from doing normal stuff. And I am making an effort at doing things with my arm normally, without resorting to ‘cheats’ that favor it.
I guess I’ll wait until Monday when I’m back at work and see how it feels then before I decide if I call the ortho # or not. My job involves typing on a keyboard all day, and if I can’t do that for 8 hours I’m definitely going to need more professional help. In the meantime I’ll check out those Bob and Brad PT videos; thanks to those who recommended them!
Just turned 62– in fact, the accident happened on my birthday
I read the concensus as “Get pro help immediately unless, like many (most?) Americans you just can’t afford it. In which case Dr. YouTube is your next best option.”
I can afford it. I’m just trying to decide if I really need it. The ER doc who evaluated me Sunday did not seem at all concerned that it was very serious, and that was when I was in my worst pain, convinced going in that I had really messed up my rotator cuff. Yes, he’s an ER doc, not an orthopedic specialist. But as of now my pain is, as I said, nagging but manageable, without restricting me really from doing anything, and I don’t have the clicking or grinding sensation that Google tells me is a sign of a significant tendon tear.
I’m not trying to be stubborn, and I’m taking it seriously. Right now, like I said, I’m around 50/50 that I’ll need to see an ortho. I don’t think waiting until Monday to decide is going to make things any worse.
So, it doesn’t just depend on whether you can afford it. I’m not good at doing exercises. I don’t just mean that i tend to put them off and not do them, i also mean that i tend to do them wrong. I’ve found it incredibly helpful to have a trained professional look at me and say, “don’t hunch your shoulder when you are doing that”, or whatever.
But i think I’m worse at that than average. You might be better at that than average.
Fwiw, i am currently seeing a physical therapist for a shoulder issue, after seeing a physiatrist, who gave me a steroid injection and a script to see the PT. (The steroid injection helped a lot, and if i thought it wouldn’t get worse again, I’d be satisfied. But the benefit of those shots usually wears off. I’m hoping to get some decent PT done to address the underlying problem before the benefit of the shot goes away ) So that was my decision.
Exactly. The ER doc’s job is not to treat you holistically. His job is to do enough to free up a bed.
My wife’s back went out late one night, so badly she insisted on going to the ER. She could barely sit in the car. The ER doc examined her and gave her some appropriate meds that allowed her to function. She asked him what he thought the problem was. His response was “I don’t know, that’s not my job. My job is to treat you enough that you can leave the ER.”
Yeah, ER doctors are often excellent at their job, but shoulders are squirrelly, and diagnosing and fixing non-life-threatening problems in the shoulder isn’t their specialty. My father was a world renowned liver doctor, and very good at treating his patients. He diagnosed my brother’s appendicitis over the phone, and sent him to his local ER. But he failed to diagnose my broken wrist despite a physical exam.
The rule of thumb is to give it 3-4 weeks to see if it heals on its own. But it takes me weeks to get an appointment to see a doctor. In your situation, i would make an appointment to see some suitable specialist, and cancel the appointment if it got better in the meantime. (In fact, that’s exactly what i did, only it didn’t get better.) If you can make an appointment quickly, you might want to wait another week before scheduling something.
I get it. But it’s not as if it was a ‘The Pitt’ type situation (a show we’re currently watching), with a perpetually overcrowded ER and docs patching people up and moving them along. It was very quiet when I went in; we got right in and I was seen right away. The doc manipulated my shoulder, then took my arm, moving it around in various ways and asking my pain level in each position. He then said it was most likely a rotator cuff strain or possibly a micro-tear, and should clear up on its own. I said “really? I thought it was pretty bad, since it hurts too much to lift my arm to shoulder height”. He said “even with me moving your arm for you, it should be much more painful than it is if it were serious”.
So my point is, yes, ER doc, not an ortho guy, but it’s not as if his attitude was “no blood? Go home”. @Telemark, I’m sorry to hear of your wife’s experience. It kind of sounds like she got a bad or burned-out doc.
But that said, you guys are definitely starting to convince me that I should get a specialized opinion.
I saw this post as I was typing my latest reply. This sounds like great advice, puzzlegal, thanks. I think I will definitely do this on Monday, unless my shoulder is miraculously all better by then.
I’m in the consult a doctor next week if it’s not completely better camp. In the meantime you could take an anti-inflammatory like ibuprofen or naproxen (provided you don’t have clotting or stomach issues that preclude them) more for the anti-inflammatory effect than pain relief. Ice packs for 20 minutes every few hours also helps with inflammation and discomfort, especially in the late afternoon and evening when you get home after asking a lot of that shoulder at work all day.
ice+anti-inflammatories over the weekend+doctor early next week is my vote.
