When Should I Have My Painful Shoulder Checked Out?

Minnesotans and transplants thereof tend to be of fairly hardy stock and are reticent to seek formal care if something hurts; with the common appreciation that it should go away. As a physical therapist that has cared predominately for shoulder issues for nearly 30 years, there are some key indicators that should serve as “Red Flags” and thus initiate a trip to the doctor or physical therapist (yes, there is direct access in MN). Ignoring such signs and symptoms can allow for an easily treated issue to evolve into a multi month project to deal with the moderate impairment that can arise. The following signs and symptoms should prompt formal care.

Pain at Night

If you are awaken via weight bearing on the involved shoulder and/or pain is greater than a 5 on a 0 to 10 pain scale (0 is no pain, 10 is unbearable). If left shoulder/torso/arm symptoms are unrelenting, a trip to the internist to rule out cardiac based pathology is also advised.

Distractive Pain During the Day

If pain does not allow you to concentrate on the task at hand. This may arise with prolonged time at a computer where arms are positioned in a mid-range for an extended period.

Mobility Loss of Greater than 25%

The following are three simple tests that one can administer in less than 10 seconds to formally assess the quality of shoulder mobility. A deficit of greater than 25% due to tightness or pain greater than 3 out of 10 should prompt professional assessment.

1. Shoulder Elevation: Standing in front of a mirror, raise both arms overhead reaching for the ceiling.
2. Shoulder External Rotation: Interlock fingers with palms touching the back of your head. Swing both elbows backward until a mild stretch is appreciated.
3. Shoulder Internal Rotation: In alternate fashion, slide your thumb up your spine.

Studies have found that approximately 30% of the population will suffer from some type of shoulder ailment over the course of their lifetime. This scenario is further amplified by the fact that in the U.S. the majority of sports are upper extremity focused. Don’t be a Minnesotan; get that irritable shoulder checked out.