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How to know the difference between a sore shoulder and an injured shoulder (and what to do about each)

Posted on: September 10th, 2013 by Dr. Scott W. Trenhaile

Recently, a coworker told me that he and his wife enjoy playing tennis together, but that they rarely make it to the courts these days because of work conflicts and just the busyness of life (I think we can all relate to that).

A few weekends before, they had decided to head out early on a Saturday morning for a tennis match, so they hit around for a while, and then she proceeded to trounce him in the match.

Later that afternoon, he noticed his shoulder hurt. It was uncomfortable, a little painful, and that seemed to continue for a few days. Eventually, it went away, and everything seems to be fine now.

So many people who work in the yard, in the house, at a labor intensive job, or any number of other situations often wake up the next day after strenuous use or exercise and feel a pain in their shoulder.

The CDC reported that 9% of U.S. adults 18 years and older experienced shoulder pain in the past 30 days. That means that about 28 million people experience shoulder pain every month.

Maybe this has happened to you, and you begin wondering how long will this take to go away? Is this serious? Is it nothing to worry about? What should I do about this pain/soreness?

These are the questions we’re all asking ourselves and definitely should be asking ourselves when we experience this type of shoulder incident.

The Sore Shoulder:

Thinking about what you did and what you should be doing

You definitely need to reflect on how you came to be in your current situation. Really focus on this. What movement did you do? Were you doing lots of overhead lifting? Were you playing a really intense game of basketball? Were you chopping wood or helping your significant other around the house? Maybe your son really enjoys being thrown in the air, and today, you are really feeling it from that.

Whatever the situation with your shoulder, you should do all of these four things:

  1. Rest – it’s hard, I know, but your shoulder needs it.
  2. Ice – grab a pack of ice and lay it on for 20-30 minutes
  3. Anti-Inflammatory Medication: This will take the edge off of the pain and help any inflammation to dissipate quicker.
  4. Modify: if the pain continues, but you need to continue with life, modify your activities to accommodate the pain until you feel better.

Modifying is probably the most challenging of these because pride, ego, and stubbornness tend to get in the way. It’s difficult to acknowledge that maybe we shouldn’t do everything at the same level we normally would.

While you may be experiencing some soreness, with the sore shoulder, you should not experience any of the following, necessarily:

  1. Catching
  2. Locking
  3. Popping
  4. Waking up from pain in the shoulder during the night

In this situation, you should not experience this soreness for more than a week, given you take care of the sore shoulder and don’t exacerbate the problem, which is difficult to do.

Remember, you’re body needs time to heal and repair itself.

What will happen when you go to see a doctor?

Maybe you remember what you did to get where you are, but you didn’t experience an event, which is discussed a little bit later. In this case, your physician will ask you about the symptoms connected to your soreness.

  • How bad are your symptoms?
  • What have you already tried on your own?
  • Is it bad enough that it wakes you up at night? Again, this is a key indicator that you have more than a sore shoulder or inflammation from overuse.

Your physician may begin to think you have some bursitis (link to something), inflammation with some tendonitis.

Are you waiting too long to come in or should you wait a little longer?

Maybe you are wondering “Should I go to the doctor for my shoulder?” Maybe you are feeling the pressure from a family member or friend to go, but you think you feel fine.

If you can handle the pain and you’re not experiencing the weakness or difficulties mentioned above, then you probably just need to modify your activities a little until the soreness goes away.

Many of the people who want to see a doctor on the earlier side of the spectrum do so because they are competing in an endurance event or weightlifting competition, or maybe they are playing in a football game soon. If that’s you, you need to know that you can push your body to the limit, without causing permanent damage, because you definitely don’t want to have an injured shoulder holding them back.

Or maybe you are an excellent compensator.

[quote]It’s possible to experience cumulative trauma for years, but rather than treating the problem you just power through.[/quote]

During a physical exam, people in this group don’t want to hear that they have an injured shoulder because they may be worried about surgery or loss of mobility.

They’re asking themselves “Do I push through this?” It’s a nerve-wracking moment for them, but it’s important to remember that treatment will improve your life.

In the end, go to the doctor if pain doesn’t go away (given that you are modifying appropriately and self-treating appropriately).

The Injured Shoulder:

No need to think about what happened, you know what happened

The injured shoulder typically is something where you may or may not have an event, but the problem doesn’t resolve on it’s own. It lasts longer. You have the associated symptoms, mentioned above, that are new.

You didn’t experience those symptoms before.

Some symptoms you may also experience as a result of a shoulder injury could include:

  1. Weakness
  2. The mechanical symptoms already listed above (popping, catching, etc.)
  3. Difficulty reaching overhead, even for the most common things: shoes, hat on a shelf, dish in a cabinet.
  4. You can no longer lift an object that you used to be able to lift without any trouble.

Basically, activities of life that shouldn’t be problematic now are, and that should concern you. Your shoulder should be able to perform these tasks without any trouble.

Another key sign that you’re dealing with an injury and not slight inflammation or soreness is that the symptoms just don’t go away. Weeks turn into a few months, which escalate to half a year or a year. Then you are looking at a situation that you should probably investigate.

So if that’s you, go see your doctor. Schedule an appointment right now, in fact.

What should you be looking for before you schedule an appointment with your physician?

If it’s an incident in the gym or at work, the first thing you want to ask yourself is “Was there an event?” Some people will say they felt a pop, a ripping sensation, a Velcro-like tear, a severe burn but no pop, or perhaps it felt like something letting loose.

In this situation, you should go see your doctor. It’s not an emergency, so save yourself some money and schedule a visit with your primary physician or an orthopedic specialist within a few days.

Again, you most likely don’t need to go to the ER, but this is serious and should not be taken lightly.

Most patients know exactly when it happens. It’s a significant event.

You won’t be able to ignore the pain.

So you’ve seen two separate scenarios: the sore shoulder and the injured shoulder. Now you should be able to help yourself and those around you to know what to do when the time comes.


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