Question
I sustained an impact-injury to the shoulder on the 19th of October last year (2007). I checked myself in to The A&E the next day to get x-rays of the affected area, only to be told that the injury was not skeletal, and thus would heal in an ambiguous while. The night i sustained the injury, i was shivering almost till morning (perhaps the transpiration of these convulsions may help you to determine the implications of the injury). At the time, i could not even lift my 25-30 degrees without experiencing major pain in my shoulder area. Nevertheless, since then, it has healed rather impressively, and i am now able to lift my arm all the way above my head without feeling the pain. However Doc, some morning i wake up and can still feel the pain in the area in question, and am not able to lift weights, (military press' or lateral raises), without feeling the pain. My questions are, 1) How long do you think it will take for these pains to be gone, (i.e. till the muscle will completely heal)? 2) Considering the time i have had to heal, has the reparation not taken too long? 3) is it safe to train although i am still experiencing these pains? 4) if still injured, will it affect my muscle growth? 5) what precautions/steps can i take to ensure healthy muscle reparation/growth. Thank you very much Doc, Khan...

Answer
Dear Khan,

Well although I have no idea what the original injury was, it seems as though your main symptoms are ongoing deltoid pain when performing resistance exercise.  This can be due to the fact that there is torn muscle fibers in the deltoid muscle or tendon, you could have scar formation that needs to be broken down, or just simple muscle spasms.

An accurate diagnosis of what the problem is will determine the most appropriate course of action.  Having stated that, I can tell you that simple muscle tears usually completely heal in 6-10 weeks post injury because muscle has a high reparative capacity and sufficient regenerative capacity.  However, extensive damage results in scarring and atrophy of the fiber bundles, which can lead to prolonged pain at the scar tissue site.  I would encourage you to have the shoulder re-examined again, but by a musculoskeletal expert such as a physiatrist, chiropractor, or sports orthopedist to address the issue.  You should expect muscle testing, and palpation of the tissue with pressure to see if spasm or abnormal scarring exists.

I would caution you to be careful with your lifting so that you do not make the problem worse.  You should never train in painful movements.  Soreness is okay, but specific pain is a warning sign.  You may want to stop lifting until you can get some myofascial work in the tissue to see if local pain can be reduced.  This is often very effective if scar tissue or spasm is present, and a massage therapist can do this effectively.

Good Luck Khan,

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net