Joe A Shaw PA-C - 2/26/2008

Question
QUESTION: About 8 weeks ago I fell off of the stoop(about 2 feet high) of my back steps landing on my left shoulder and left side. It was also very icy out. I could not move my shoulder or arm for over 2 weeks so I went to emergency and was told that I probably injured my rotator cuff, and that I should take ibu. ice and rest. My arm is still very sore with pain all of the time,sometimes shooting down my arm and into my elbow. I cannot really hold anything heavy in my hand on my left side because of extreme pain. It especially hurts in the top front part of my arm, and feels painful, tight, and weak whenever I lift it straight up in front of me. I also cannot lift my arm more than a few inches out from my left side. When I try to lift it to the side it is extremely painful in the upper front and underneath parts of my arm, feels right tight, and weak. I have not rested my arm properly due to my job, and am wondering if maybe I did something more serious to my arm, and should seek medical attention. It is getting harder to sleep through the night without the tightness, pain, and lack of comfort with my arm. Thank you.

ANSWER: Kit,
Yes you should see an ortho, I think you need an MRI. Xrays are of little value (unless you are trying to rule out a fracture)but xrays do not show muscles,tendons etc..
The rotator cuff (RTC) muscles are really 4 muscles that hold the shoulder jt in tight to the socket. You could have tore one of these muscles. If you are >45 yrs old..your chances are increased.
Since it has been 2 months and you are losing your range of motion you need to be evaluated. You dont want to get a condition called frozen shoulder syndrome.

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QUESTION: Just Curious, or maybe being an avoidance type person. Can this heal on it's own? If I take it easy and not use the arm as much as I do?

Answer
The only problem is you don't know what you got..so to speak. If it is a strain/sprain then possibly yes. But you still are in danger of getting frozen shoulder syndrome...this occurs over wks to months when a pt doesn't want to use shoulder as much b/c it hurts. Also diabetics are at an increased risk for getting this cond.
No you need an MRI and ortho eval. to at least find out what's going on w your shoulder. If there is a tear or other shoulder damage labrum(lay-brum) tear ( socket joint area )
etc..then your muscles could start to atrophy ( shrink, get weaker w non-use )