Pain in shoulder and wrist while doing push ups

Patient

Q: I've been practicing push ups recently because I'll be leaving for the military soon. At first I didn't have any problems, but now on every rep when I go down and then up I feel like a pinched nerve sensation in my left shoulder and wrist.. it doesn't necessarily hurt but it is very uncomfortable and effects being able to perform push ups.. what is going on? I've heard it might be a back thing and could go to a chiropractor or possibly a nerve in the arm.. I only feel this while doing push ups, I don't get it while lifting weights or pull ups or any other physical activity...thanks for your help. Nic in CA

Doctor

A:    I would like to bring to your attention that there is a very well described entity in the medical literature called: Overuse Syndrome, which can affect any part of the body that is over stressed with movements or activities in a repetitive way, including occupational, recreational, even habitual activities. Repetition is part of the definition of overuse injury. The concept is that overuse injury is associated with repeated challenge without sufficient recovery time, and this is true for Volleyball, Running, Jogging or any other sport or activity in which you exceed the guidelines and your own limits or capacities. Overuse injuries or repetitive motion injuries make up over 50% of all athletic-related injuries seen by doctors. Simple everyday actions, such as throwing a ball, scrubbing a floor, running or jogging, can lead to this condition. The most common types of repetitive motion injuries are tendonitis and bursitis. The healing time is different for each patient, and also depends on the severity of the initial injury. According to your description, most likely you had a sprain of the wrist, generally requires Protection (splinting and avoidance of painful movements and activities), Rest, Ice the first 24 hours and then local heat (hot moist compresses or paraffin baths), anti-inflammatory medication (i.e.: “Aleve”) so you will be able to come back progressively to your daily routine in about 4-6 weeks. It is recommended that you keep using the wrist brace and avoid movements and activities that put additional stress on the wrist. But if the limitation of the movements, pain, and inflammation continues you should be evaluated by hand specialist and probably you will need to get some X-rays, CT scan or MRI taken to rule out some other causes of wrist pain and limitation. Same recommendations apply to your shoulder.

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