Shoulder Pain; How to Diagnose and Treat

Patient: I am a 15 year old guy. I started pole vaulting this year. For the past 5 weeks of so, I have had a lot of pain in my shoulder. I have stopped pole vaulting and am recieving heat, massage, ice, and electrical therapy at my school trainer for a couple of weeks. This restored some of the range of motion to my shoulder. I feel pain if I externally rotate and then abduct my arm, the pain is only from about 50 degrees to 90 degrees and then i feel a pop in my shoulder as i raise it farther and it doesn’t hurt. My school trainers said I had an inflamed supraspinatus, but have worked that out so far. THey have started me on a rehab strengthening program for my shoulder that involves straight arm planks, reverse flies, TYI’s, and others. I still have a lot of pain when i try to do some movements such as pushing above my head, rotating my arm externally and raising it, and holding myself on a pull up bar. I have looked up shoulder impingement and think it sounds pretty similar to what I have, however I do not have pain when i sleep on my injured side, or usually not when resting. What do you think I should do because I have a canoeing camp that is 7 weeks long starting in 1 month and I want to be healthy for it.

Doctor: The supraspinatus muscle assists the deltoid muscle in abduction of the upper arm (moving the upper arm away from the bo dy). It is possible it has not completely healed yet since you still have pain when raising your arm, doing pull-ups, etc. Since you have been on rehab already and you are also doing the supportive measures (heat, ice, massage, electrical therapy), you may be on your way to recovery. Just continue doing what you are doing, eventually the inflammation will subside. You may also ask your physical therapist or consult a rehab specialist to make sure it will be safe for you to canoe. From my point of view, canoeing would involve more of forward and backward motion of the upper arm (not raising your arm above shoulder level) so I it may not have a very significant straining effect on your supraspinatus muscle. The supraspinatus muscle is supplied by the suprascapular nerve; this nerve is a branch of the spinal cord from the neck. When the suprascapular nerve becomes impinged (compressed), one may experience pain together w/ weakness and numbness of the upper arm. One may not be able to raise the upper arm above shoulder level. Since you are only experiencing pain associated w/ movement, especially when you try to put your weight on your arms (pull ups) or raise your arm above shoulder level, it is unlikely you have a nerve impingement. If you want to be sure, you may go to a rehab specialist and ask for tests to rule out nerve impingement. Xrays are usually not helpful because it will only show the bones; MRI is superior because it shows the bones, nerves, cartilages, etc. I do hope this helps. Take care always.