Recognizing Warning Signs Part II - Injuries to the Upper Body

October 7, 2003 02:47 PM

by Jim Brown, Ph.D.

In our previous Sport Science column, orthopedic surgeons from Texas and Georgia explained how to “listen” to foot, ankle, and knee problems. In this edition, a new panel of experts talk about upper body injuries.

The Shoulder
Shoulder injuries are hard to diagnose because of the complex structure of the whole area. The pain after an injury can result from damage to one area or from a combination of muscle, ligament, tendon, and bone damage. Acute injuries cause immediate, intense pain, swelling, loss of mobility, and deformity.

"If the shoulder completely 'goes out' (clicks, catches, or loses mobility), get to a doctor,” warns Atlanta orthopedic surgeon, Gary Levengood.

Overuse injuries almost always involve four muscle groups that make up the rotator cuff. The symptoms - pain when the arm is held out and away from the body, pain when you try to make a circular motion, tenderness in the front of the upper arm, and pain at night - develop gradually.

"If your shoulder continues to ache two-three days after a tennis match, softball game, swim meet, or any other activity in which an overhand motion is used," adds Levengood, "you should seek medical advice. The same thing applies if swelling has not gone down after 24-48 hours."

Try to maintain a range of motion if you have an overuse injury. A "frozen shoulder" makes treatment and rehabilitation even more difficult.

The Elbow
"In elbow (and shoulder) injuries," advises Edward G. McFarland, M.D., an orthopedic surgeon at Johns Hopkins, "worry about swelling that doesn't go down, loss of the range of motion, and weakness. In cases of a traumatic injury, assume that something is broken or torn until proven otherwise."

Although tennis elbow (pain on the outside of the elbow when the palm is up) is very common in racket sports, only about half of all players with the condition seek medical attention. If you are in the other half, Robert P. Nirschl, M.D., a Virginia orthopedic surgeon, recommends a week or two of light activity followed by rehabilitative exercises.

For All Injuries
"Watch the behavior of your symptoms, regardless of the injury," states physical therapist, Don VanVolkenburg, "When an injury takes very little time or exercise to aggravate, that's a sign to back off, see a physician, or both. The same applies to the time it takes for pain to subside. If the pain goes away within a half hour or so after an exercise session, it's probably not severe. If the discomfort lingers, something is wrong."

"There are several indications that something other than routine pain or soreness is occurring," concludes McFarland. "The first is pain that wakes you up at night. That is not normal. The second is pain that gets progressively worse. The third is tingling, numbness, or weakness. Finally, pain or swelling that doesn't respond to ice or anti-inflammatory drugs should be evaluated by a physician."

© HMS Publishing, Inc.

Jim Brown will be contributing new content to this site on a monthly basis. If you have a question for Dr. Brown please feel free to email him at sportsmed@mindspring.com.

 

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