Expert: Dr. Victor Dolan, DC, DACBSP - 5/15/2011

Question
Hi,

I'm a 32 year old female.  I play softball and I injured my throwing arm 5 years ago. Everytime I threw the ball I felt a burning sensation in my my arm around the tricep area. I just started playing ball again and the same pain started again within a few throws (this after 5 years!).  

I just went to the doctor and the doc felt the 'bulge' that was in my tricep and said it's a muscle spasm and told me to keep it in a sling for about 3-5 days and he gave me 2 oral meds to take (Mydocalm and Brufen for pain) and a gel to put on it.  He didn't take any x-rays or anything though, but, after looking at an answer from a previous doctor who answered the exact same question, I'm wondering if I should go to a different doctor and ask for an xray.  Also, I know what muscle spasms feel like but my tricep muscle has never appeared to spasm.  What do you think?

Thank you

Answer
sports injury, muscle injury, muscle spasm, Staten Island Sports Injury, tricep injury, scar tissue, pitching injury, throwing injury, medication to calm pain, Staten Island Chiropractic,
sports injury specialist,



Hello CD,

I am sorry to hear of your injury.  I am sorry to hear of your CHRONIC injury (initially injured 5 years ago, still hurting today).   I  do  applaud  your  continued  involvement  in  sports  and  fitness!


Let us start at the 'top'.  You say, "....I play softball and I injured my throwing arm 5 years ago. Everytime I threw the ball I felt a burning sensation in my arm around the tricep area....".  What happened 5 yrs ago?  did you throw a lot of pitches? do you remember a >snap< , >pop< , crackle , pull?  do you remember a particular pitch that hurt you?  did it build up over time?  It started 5 yrs ago,,, but how did it start-- on an underhand pitch, on an overhead throw?  
         What did you do 5 yrs ago?  What  MD or DC  did you see?  Did you have a diagnosis, did you have any treatment.  Among Medical Doctors there are Orthopedists, Physiatrists, Rehab specialists, Sports Medicine specialists; among Chiropractic Doctors there are similar credentials (see:  http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf ).  You should have gone to/ should go to an appropriate specialist.  I have a Staten Island Sports Injury practice because I hold a DACBSP specialty (see: http://www.acbsp.com/ ).

I hope you sought treatment years ago.  Treatment received back then should have minimized the problem, then and now.  Chronic problems, longstanding conditions without appropriate treatment are much more difficult to manage.  Whether yes or no, I think you should see  a sports injury specialist now.  ACBSP.COM will list chiropractic doctors with sports injury credentials close to your location.

"....I just started playing ball again and the same pain started again within a few throws (this after 5 years!)...."- either you sought no treatment years ago, or you did not receive enough or the correct treatment for this to re-occur.  With this now CHRONIC problem, you definitely need a proper exam and a regimen of appropriate treatment.  I am talking to you 'long- distance', but I do not think a diagnosis of 'muscle spasm' and some meds are going to alter a 5 year old physical complaint.

As a matter of fact, for my Staten Island Sports Injury patients- I hand out an informative sheet, this may be interesting to you:


PAIN           

Pain  is a  ‘red light on the dashboard’.   
RED  LIGHT  =   Trouble !!

Pain  is  your  body  telling  you  that  something  is  wrong.   
Think  you  should  listen??

That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?  

Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?   

Pain,  
do you cover up the pain by taking a painkiller?  

Take a painkiller,
mask the pain,
and allow a problem to progress in your body?


Pain  Killing  medication???  =    16,000  deaths   ( probably  under-reported )
                         DEATH ! ? ! ?    better   watch  out  on  those  medications!!!  

                             NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to  include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;
SIXTEEN THOUSAND DEATHS: "Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many chronically painful medical conditions. However, it is estimated that 25% of all serious adverse drug reactions involve NSAIDs, with more than 100,000 hospitalizations and 16,000 deaths occurring annually due to NSAID-induced gastrointestinal (GI) events."----- http://hhc.sagepub.com/cgi/content/abstract/13/6/468   Home Health Care Management & Practice, Vol. 13, No. 6, 468-475 (2001)  Motrin, Advil = NSAIDS

      The  American Heart Association issued a scientific statement  recommending medical doctors change the way they prescribe OTC pain relievers from a first choice  to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

      NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ).   Many times people take NSAIDS  for  the pain of Arthritis,  not realizing these drugs may make the underlying condition worse.   These medications  cover  up  the  pain,  and  cause  the  problem  to   worsen.

http://rinf.com/alt-news/business-news/prescription-drugs-kill-300-percent-more-...
= An analysis of 168,900 autopsies conducted in Florida in 2007 found that three times as many people were killed by legal drugs as by cocaine, heroin and all methamphetamines put together.    BE  CAREFUL  WITH  THAT  MEDICATION !!!
It was reported in 2000, that 700,000 U.S. citizens die as a result from medical causes (iatrogenics). Of course, other records and statistics had the number above the one million mark. Whether 700,000 or one million people, that's a lot of innocent people dying from visiting a hospital and trusting a medical doctor.= http://www.dherbs.com/articles/iatrogenics-99.html

Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for ‘Subluxation’. Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- ‘Subluxation’ – can be the cause of many symptoms and conditions.


Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.


The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.

       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine ; Invited to Colorado Springs (Olympic Training Center) to  Care for USA Olympic Athletes 2010 ; Chiropractor to the Championship NYPD Football Team, and the PSAL High School Football Champions (Curtis) ; Staten Island SPORTS Hall of Fame- Unsung Hero 2011


So,  be  very  very  careful  of  the  medications  that  you  utilize,  there  may  be  side-effects,  and  you  may  just  be  masking  a  problem  by  covering  up  the  pain,  and  not  getting  to  the root  of  the problem.  Try to correct the underlying cause, the condition- rather than just covering up the symptoms.


You go on to say, "....I just went to the doctor and the doc felt the 'bulge' that was in my tricep and said it's a muscle spasm and told me to keep it in a sling for about 3-5 days and he gave me 2 oral meds to take (Mydocalm and Brufen for pain) and a gel to put on it....".  did you let this doctor know that this problem is 5 yrs old?  A 5yr muscle spasm?  You have rested 5yrs, so you need just another week or two of rest?
          I think you need a new examination at another doctor.

"....He didn't take any x-rays or anything though, but, after looking at an answer from a previous doctor who answered the exact same question, I'm wondering if I should go to a different doctor and ask for an xray.....", an Xray may be helpful, but other diagnostic modalities may be more appropriate- perhaps an MRI, or perhaps sonography of the complaint area. Electrodiagnositic/ imaging studies of the area to assess soft tissue would be a good choice to evaluate this complaint.  An Xray only evaluates hard tissue (bone, or parhaps calcific deposits); you need a soft tissue analysis- MRI or ultrasound.
         Has this bulge you speak of been there for 5yrs?  Did this bulge appear 5yrs ago, disapear, and now return?  You may have a 'muscle spasm', BUT this muscle spasm is transient, NOT the cause of your problem, can by symptomatic of the underlying problem.

You ask, "....Also, I know what muscle spasms feel like but my tricep muscle has never appeared to spasm.  What do you think?....".  You ask me What do I think?, my answer:

#1)  get an examination by a sports injury doctor- either an orthpedic MD or DC, DACBSP
( Diplomate American Chiropractic Board of Sports Physicians ), physiatrist; some specialist.

#2)  get a proper diagnosis, which then can allow you the best approach to treatment.  

#3)  FOLLOW THROUGH on the treatment regimen recommended- often people stop treatment when the 'pain goes away', but treatment must continue until the PROBLEM is fixed, not just focusing on pain.

What do I think?  I think you now have some scar tissue left behind.  Perhaps you had some minor tears in your triceps (just based upon possibilities with your description), you did not get treated properly, and now have scar tissue ('adhesions').
         Your joints, spinal, shoulder, elbow, wrist, may need adjustment to properly align and balance the joints and muscles.  Your soft tissue probably needs some treatment; ie:  http://www.activerelease.com/ , http://www.britishsportstherapy.com/index.php?option=com_content&view=article&id... , something along these lines.

I think a visit to a sports injury credentialed chiropractor would be very helpful, with referral for appropriate studies, proper diagnosis, and efficient treatment.  A visit or treatment regimen at the DC along with treatment at a LMT (licensed massage therapist) may be your best route.

I hope this has helped you.  If you need further information, do not hesitate to REcontact me here at AllExperts.com =  http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm .

Thank you for your question.  Good Luck from your Staten Island Sports Injury expert, your
Staten Island Chiropractor,

Dr. Victor Dolan, DC, DACBSP
www.drvictordolan.net