Shoulder-related injury

[samikd]

Hello,

I used to work out at the gym 5 times a week around 5 months ago. On this one day, I had performed chest exercises. Everything went fine and the next day i went to the gym again and i noticed that my left arm was weak to the point where i couldnt lift some of the lightest weights.

I cant raise my left arm past a 90 degree angle sideways. I am able to raise my arm upwards to the front but it still doesn’t go as high as my right arm. I noticed that whether I’m raising my arm sideways or to the front, my trapezius muscle forms a knot (like a little ball) on top of my scapula (shoulder blade) beside my shoulder. I noticed that my shoulder blade was shifted upwards a little bit when comparing it to my right one. I don’t get any pains in my shoulder, i just feel that my arm is very weak.

I did physiotherapy for a about month, they said that i tore a rotator cuff muscle and my shoulder blade is compensating for the weak shoulder. But, i don’t necessarily believe in what they told me as I did not improve after all of the sessions that I’ve had with them.

Any advice?

Thank you
Sam

[JainMD]

Hi,
How old are you?
When any patient complains of “shoulder pain,” your differential diagnosis of common causes includes the following four entities like Impingement syndrome and rotator cuff disease, Rotator cuff calcific tendonitis, Biceps tendonitis and Superior labral anterior posterior (SLAP) lesions.
Your symptoms of not able to raise your arm above your level of shoulder on left side suggest that this might be due to biceps tendonitis, rotator cuff tendonitis, or rotator cuff calcific tendonitis.
Does your shoulder ever give way?
Did your shoulder previously have pain, but is now only stiff?
How long have you had your shoulder pain and have you tried anything to help it?
I think your symptoms are suggestive of rotator cuff injuries.
I would recommend you to get a MRI to see for anatomy and any pathology which would become more obvious.
Keep me informed if you have any queries.
Bye.

[samikd]

Hi,
I am 21 years old, I dont have any pains and I did not have pain previously. It is shoulder weakness where i cant have my arm raised for too long and I cant lift any heavy objects. Once i try to raise my arm, my trapezius muscle forms a ball right beside my shoulder. I have had this shoulder weekness for 5 months, i tried doing a month of physiotherapy but it did not help.

[JainMD]

Hi,
How are you feeling?
I think at this moment I would suspect an injury to rotator cuff or a nerve compression.
I would like you to do a MRI study and also NCV and EMG study.
NCV and EMG study to look for any neuropathy or myelopathy if they exists.
Please continue to do physiotherapy and take analgesic if required.
Keep me informed if you have any queries.
Bye.

[samikd]

Hello again, here are pictures of my shoulder x-rays linked below.

http://img401.imageshack.us/img401/8266/x1yw1.jpg
http://img401.imageshack.us/img401/2151/x2cm4.jpg

Please let me know if theres something wrong.

Thank you.

[JainMD]

Hi,
How are you feeling?
I have seen your x-ray and there does not seem to an overt injury to your shoulder. I would like to see if any other vies is being taken. I would also like to see if MR study is being done.
What is your clinical state now?
If a MR study is not done, then it would wise to get an MR study.
Keep me posted.
Bye.

[samikd]

Hi,

Ive been noticing slight pains sometimes on top of the shoulder, in the AC joint area. An MRI has not been done yet however my doctor as suggested an ultrasound, as he said they are similar. I should be doing one in a few days. Should I insist on an MRI rather than an ultrasound? or maybe get both done?

Thanks.

[JainMD]

Hi,
I would like to see a MRI done as most of soft tissue and bone pathology would be clear with help of MR study. Ultrasound is similar but less obvious.
I would have recommended a MRI study to be done.
If the doctors are not ready then you should be getting ultrasound first and then wait for opinion from the doctor and if it is still unclear then kindly get MRI done.
Keep me posted if you have any queries.
Bye.