Expert: Dr. J. Shawn Leatherman - 11/17/2008

Question
Hello! I am 17 years old and I was recently (2 weeks ago) in a bad car accident. The car flipped over twice, and though we're not quite sure which surfaces of the car hit the ground, I'm almost positive that my right side impacted the side of the car very hard.

I'm experiencing a weakness and aching pain in my upper right arm when I use it too much, and an aching pain in my ankle when I lift my toes toward the ceiling. These things haven't been checked out by my doctor, and I was just wondering if you think that they should be.

Also--I've been having pain in my upper back near my shoulder blade. It's livable, and is being treated in physical therapy, but recently it seems to have worsened.

When I did a stretch that stretched out the muscle/muscles between my shoulder blades, the pain became intense and it felt like something had clicked out of place. It felt unnatural and extremely strenuous. Is this normal? Is it worth getting x-rayed? A friend of mine thinks it could be a rib injury, but I feel like I might have noticed the pain as worse than it is when I'm not doing a particularly strenuous activity. Although, for the first week and half after the accident, I was on 600 mg of Advil at all times.

What do you think would be the best thing to do?

Answer
Dear Emily,

I do think that you should have the arm and ankle issue examined.  I would suggest that you seek out the care and advice of a physician who has been trained in auto crash injuries.  Specifically you should seek out an orthopedist, chiropractor or physiatrist with advanced credentials.  

I would also suggest that you go to the Spine Research Institutes Website, www.srisd.com and read over the information they provide.  It will give you an insight into your injuries and care options as well as they provide a physician listing service for doctors who have completed their training and certification program. You can actually type your state in a search block and see doctors who have completed the program, their office location, and phone number.

Additionally, make sure that your physical therapist knows that the pain has worsened while in therapy.  They may need to alter or restrict your current program to allow for pain to abate while focusing on other issues.  It is good that you are currently in physical therapy so that you can address dysfunction and loss of strength and flexibility.  However, do not let the physical therapist try to move vertebra in you back...they will call it manipulation.  While physical therapists are excellent in rehab techniques, they are not experts in spinal kinematics or spinal biomechanics.

If you feel something is out of place in your back and you heard a click, have a chiropractor address that. Additionally, the arm pain can be a result of damages neck structures, and this should be ruled out and addressed if found to be problematic.

Hope this helps Emily.  Please feel free to follow-up with further questions if you need to.

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