Question
I did post this once but can't find the response so ,being desparate,I will try again.The 1rst week in January I slammed into the boards plaining hockey and banged my left shoulder.I went for X-rays and confirmed a break at the top of the left humerus where it enters the socket.I was told it was non displaced.I wore a sling for 5 weeks.I kept moving wrist and elbow continually.The break was 9 weeks ago now.Doc says the break is visible but pretty well healed.I can lift the arm 180* with minimal pain.I do curls with 20 lbs and feel no pain at all.I do a wrist squeeze with a hand spring thingy with no pain at all.The elbow is pain free.The rotator cuff area is pain free.I can slide my arm up a wall til fully extended and though it hurt BIG time the first 4 or 5 times it hurts alot less now.The pain now is in the bicept area.On the inside and outside.It feels near the bone.Its quite bad actually.My question is if the bone is healed @ the fracture what is hurting so much in the bicept area.Is it muscle,tendon,bone?I am begging for an answer cause I aim to golf 2nd week in April (2 1/2 weeks) from now.I know that is selfish but its paid for etc and non refundable yadayadayada.but it feels so close because that is the only area of pain but crucial to swinging.My questions(and please excuse if they are dumb ones) but should I force the issue,give it a week to heal more,be aggressive,ice it or heat it)My doc has been great but I can't keep goung in there every time I wonder about it.What exercises would benefit the area.I am not sure where to find your responses on the website but you are welcome to email me I am a 55 year old man who seems to heal rather quickly.Thank you so much for your time and expertise.Brian.

Answer
Dear Brian,

I am sorry about the injury to the shoulder and upper arm.  It is impossible to give you an answer of much value from a simple email conversation, but I will give you some ideas that I have had after reading your story.

First of all, did you have an MRI of the shoulder and arm?  X-rays only show bone. It is impossible to know if there was any additional damage to the shoulder with your hockey injury without an MRI. Your MD should know if an MRI of the shoulder is warranted.  If you fractured the upper arm, then it stands to reason that you sustained significant trauma, and that other tissues that are not seen on x-ray might have been injured or torn.

Lets assume that you the soft tissues that I am referring to were injured, but not to the point of needing surgical repair.  In that case, it is going to take months for you to recover, reducing pain and improving strength over time. You could ask your MD for a referral to a good PT that can help you through the rehabilitative process.  I would never presume to tell you to work it hard or to rest it since the initial ground work of establishing a solid diagnosis of what the problem is has not been done.  Without a good understanding of what is causing you your pain, any advise regarding exercise and rehabilitation might actually make things worse for you.

So, in a nutshell, I would consider doing the following:

1) Go back to your MD.  Ask him what he thinks is still causing you to have pain. Ask him if he thinks that there might be any other internal injury that cannot be seen on x-ray, and if he thinks that an MRI is warranted.

2) Ask your MD for a referral to a PT for rehabilitation of the arm and shoulder.

Good luck,

Keith Biggs, DC
http://www.eastmesachiropractor.com