Possible shoulder tendinitis after military training

Patient

Q: I have been training for the military to ace the pt test so I can get a special forces contract. During training I started to get a muscular pain in my chest. The pain is where your chest connects to your shoulder, closer to torso though. To be more specific, if it gets worse it will feel like that area has tightened up considerably. And then it would be really sore tender to the touch and to any movement that stretches it at all, even raising my arm up from my side at all. I have taken off at least eight weeks from pushing movements. I can still tell that there is a problem. I can barely feel it. But if I start doing pushing movements again I am sure it will be back completely by the third day. I have circled the general area of where it is at in the picture. If you lift your arm up to the side the part of your chest that you can grab by putting your fingers in your arm pit and thumb on the front is where it is at. Thanks for any help

Doctor

A:   According to your description of the injury and the symptoms, possibly you are having an acute lesion of the Rotator Cuff muscles of the shoulder due to overuse. This is one of the most common acute injuries of the shoulder or tendinitis. The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during weight lifting, when playing sports with a lot of throwing, after repetitive use or overuse or suffer degenerative changes with the aging process. Typically, presents with an activity related dull ache in the upper outer arm and shoulder. Activity is commonly more difficult and painful above the shoulder level (more than 90 degrees). There is little or no discomfort with below-shoulder-level activities (less than 90 degrees) such as golf, bowling, gardening, writing, or typing. But, tennis, baseball/softball, basketball, swimming, and painting are more problematic and painful.Conservative treatment of the Rotator Cuff tendinitis involves: physical therapy to control pain and keep range of motion of the shoulder, avoidance of painful movements and activities; anti-inflammatory drugs (i.e.: “Advil”, “Aleve”). Please allow enough healing time to avoid re-injury and If after follow the conservative treatment guidelines you show poor or no improvement, then, local corticosteroid injection may be considered.

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