Sports Medicine/Muscle Tear?


Dear Dr. Arthur,

Do forgive me if I'm being too descriptive but I feel it is necessary for this kind of consultation.

I have done strenuous workouts during several periods throughout my life. Recently I have gained quite a lot of weight (~20k), and have never been this unfit in my entire life. I have started exercising again since two days ago, pushing myself to my limits.

While my whole body hurts quite badly with familiar exercise related severe muscle pains that i have always been able to tolerate, one region is on a whole different level.

-They're my right deltoids but this is not specific enough. The area is the muscle surrounding the joint that connects the arm to the torso.
-This area hurts quite severely, even when it is at rest (when i'm lying down motionless). This is not true for any other region.
-There is also slight but tolerable pain in the right shoulder region closer to the neck while at rest.
-There is no visible redness or bruising.
-Ice packs and 2x panadol extras have only had the slightest of difference.
-Though I am right handed, I have resorted to using my left hand only due to the pain.
-When I walk, i do so with the right arm as limp as is humanly possible, and with my shoulders tilted so that the right arm hangs lower and slightly off the socket.
-I feel that it cannot be joint related.

Given my description, and my lack of experience with what I believe to be my first muscle tear, how should i proceed? Is this severe enough to warrant consulting a doctor for further examination? or are there other things i should try before doing so?

Thank you for your time and guidance,

Hello Sharon!

Oh, my goodness, you say you started bulk training at the same level you ended with prior to your weight gain?  I believe you are very lucky not  to have considerable more damage in your body!. Now, let's go over the anatomy of the shoulder. The bones attaching to the shoulder are:  clavicle, humerus, and scapula bones, articular capsule ligament, teres minor tendon, plus 11 additional ligaments and tendons, not including all the muscles.  From what you describe, there probably are no fractures in or around the shoulder, but it does not eliminate a hairline fracture/dislocation of the clavicle (the bone from the shoulder to the neck).  A good possibility would be a

tear of the deltoid muscle which attaches to the scapula (the "wing" bone) in the back, all around to the front of the upper chest where the clavicle is located.  Additionally, the Rotator Cuff tendon surrounds the shoulder, and with undue stress, will tear  this tendon, which makes it very painful, and partially immobile.  There will be no major swelling nor obvious deformity, unless there is a dislocation of the shoulder.  

You stated there was no obvious swelling or deformity, so I suspect there is a major disruption of the soft tissues deep in  your shoulder.  Hence, I would strongly suggest an appointment with a good shoulder specialist for a possible MRI or CAT scan.  With injuries like this, there is bleeding inside, and around, the area which needs to be attended to immediately.

Thank you Sharon, for contacting me, and I hope you will drop me a line to let me know what is found.  I do not advise you to lift weights again until this is fixed and healed.  Please don't start with heavy weights, but use light weights, high reps, to gain back the stability you had earlier.  Also, remember, Pain is NO gain!!!

Good luck to you, and I look forward to hearing from you.

Best wishes,

Dr. Patricia Arthur

Sports Medicine

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Dr. Patricia B. Arthur, DC, MRC, CST


As a 30-year practicing Chiropractic Physician, my specialty was Sports Medicine. For 8 years I had the distinct pleasure of working with the USOC, and traveled the world to care for the athletes in the Pre-Olympic venues for the Summer Games. When I wasn't traveling, I had a private practice, and a hospital practice, in Kamuela, Hawai'i. Questions I couldn't answer usually dealt with pharmeceuticals. This was not my expertise, but the simple questions pertaining to familiar drugs I was able to digress, or refer to someone that was knowledgable in that field. Most Sports Medicine field injuries were familiar to me, but I always aired on the side of caution. In my office practice, I would tend to see more patients with the weekend injuries who would try to self-treat, only making the injury worse than it should have been! Nevertheless, I never took anything for granted, and so it was my conservative approach to the "cause-and-effect" mechanisms that were vitally important to the healing process.


Following my competitive nature, I knew Sports Medicine would always be a part of my life. After graduation from Palmer University in Iowa, the old adage taught at the school dealt only with the spinal column......anything connected to the spine was outside our scope of practice. To me, this was too simplistic, because the complex body also had arms and legs! From this point, I developed specific technigues which would encorporate the body as a whole rather than haphazard segments. There is nothing traumatic that happens to a single ligament, tendon or joint that doesn't effect a secondary, or possibly a tertiary element in that area. In order for that space to heal, all the factors must be addressed. Volunteering my time teaching referrees, coaches, and interested parents about the realities of probable sports injuries was worth a thousand words!j

American Chiropractic Association; Local Emergency Response Committee; Hazardous Materials Response Team; Urban Search and Rescue Team - Operations and Planning; Federal Corps of Engineers Committee; Earthquake Advisory Board; Big Island Wildfire Committee

Papers published focusing on the importance of proper care of sports injuries; Authored medical columns for the syndicated magazine "The People's Doctor "; Published papers in professional journals on Head Injuries in Sports; Published papers on Drug Abuse in Sports.

Robert Packer Hospital - Certified Surgical Technician - CST; Palmer University - Doctor of Chiropractic - D.C.; Wright State University - Masters in Counseling/Psychology; Wright State University - Masters In Couseling of the Severely Disabled.

Awards and Honors
Selected US Olympic Physician -1988; Graduated Wright State University with a 3.75 GPA; Graduated Palmer University with a 3.5 GPA; Faculty Appointment - Palmer University Post Graduate Education; Faculty Appointment- Hawai'i/Kapiolani Community College - Skills Team Tester;

Past/Present Clients
Cincinnati Bengals Football Team pre-season training; Summer Olympic Athletes worldwide; Kona Ironman Triathletes - Finish - line physician

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