“My shoulder doesn’t hurt, unless I try to use my arm” How to Solve Nagging Shoulder Pain

Jan. 6, 2017

I’m working with a patient right now who had shoulder pain a couple months back (let’s call him “Norm”).

So far, Norm’s rehab is going pretty smoothly. He has good flexibility, has stopped taking his pain medications and is back to working light duty at his truck driving job.

But he has a problem…here’s what he just told me:

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“My shoulder feels fine, as long as I don’t use my arm. But as soon as I try to reach or lift something, I get pain down the outside of my arm.”

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At this point, Norm sounds like a lot of patients we initially start treating who have shoulder pain. He’s recovered well from his surgery, but now he’s experiencing a very common presentation of shoulder pain.

 

When he reaches out, particularly to the side or across his body, he gets a jolt of pain in his shoulder that extends down the side of his upper arm.

Does this symptom pattern sound familiar?

With a couple quick tests, I confirmed that Norm has irritation of his rotator cuff muscles, as well as something we call “impingement”, which basically means when he puts his arm in certain positions, his top rotator cuff muscle gets pinched, causing pain.

So now that we know what’s causing Norm’s shoulder pain, what can we do about it?

To answer that question, let’s take a look at some common mistakes people make when treating shoulder pain.

Common Mistakes When Treating Shoulder Pain

• Mistake #1: Doing too much too soon. In Norm’s case, he was feeling pretty good, so he was able to return to work driving a truck. And at home, he’s trying to use his arm as much as possible. The problem here is that several of his work and home activities are still causing pain. Here’s a simple strategy at this point: if the activity or movement hurts while you do it, then stop doing it! May sound simple, but it’s a powerful approach at this stage in Norm’s recovery.
• Mistake #2: Pushing through the pain. Although Norm definitely needs to work on his shoulder and rotator cuff strength, it does him absolutely no good to perform painful exercises. When asked, he told me that he’s doing his rotator cuff strengthening with his exercise bands at home on a daily basis. Given his pain, this is too frequent. The solution: cut back to 2-3 days/week, and only perform pain-free exercises. This may mean that he needs to cut back his level of resistance and/or his reps.
• Mistake #3: Masking the pain with medications. My suspicion is that this is where Norm’s rehab started to go off track. Early in his rehab, he was taking pain medications, which is normal following surgery. So while he’s initially able to work hard during PT and not feel much pain, when he stops taking his pain medications, he’s now going to get accurate input from his body. And like most people, he’s not going to want to slow down his progress, and he’s very likely to keep pushing things too fast. Here’s his solution: keep the “3 Phases of Recovery” in mind and be willing to step back when needed. In Norm’s case, even though he’s trying to advance into the 2nd phase and focus on strengthening, he may need to slow down and focus on the 1st phase (pain reduction), before ramping up his exercises.

As you can probably tell, overcoming nagging shoulder pain can actually be quite tricky.

If you’ve been struggling with any type of shoulder pain for more than about a month, it’s very likely you’ll run into the same problems Norm encountered.

Lucky for you, we’re here to help!

So if you’d like to determine what’s really causing your shoulder pain (the root cause) and if we can help you eliminate it once and for all, please give us a call so we can set you up with a FREE 30-minute session with one of our PTs.

During your free 30-minute “discovery visit”, we’ll help you understand exactly what’s going wrong with your shoulder, so you can make the best decision about what to do about it.

Just call us at 509.892.5442 so we can get you right in!

Best,

Luke