Joe A Shaw PA-C - 3/20/2013

Question
I fell on my right side with my arm under me.  There was a little pain immediately. the following day I was unable to lift it from the shoulder without great pain in the upper arm muscle unless I used my other arm to lift it, then no pain at all.  I can move it all around using my left arm and can move my right forearm bending at the elbow without pain.  I can also carry twenty pounds with my right arm so long as I keep my upper arm close to my body and only move it at the elbow.  There is no joint pain,  The pain seems to be in the upper arm muscles.  I have no shoulder pain.  There was little change the third day and now on the fourth day it appears to be gaining a little more motion without pain.   Should I force it to move and work through  the pain?  Or immobilize it and let it heal?

Answer
You don't give your age-but you need an xray to make sure no fractures have occurred. Secondly MRI would show if there was a rotator cuff tear, the cuff is made up of 4 muscles so you can still move shoulder even with a complete tear. Generally, gentle range of motion exercises are good to keep it from getting stiff, ice 3 x day, followed by moist heat x 10min, OTC nsaids are indicated for shoulder strains, however you don't know if that's all it is or not w/o further imaging studies and exam.