DEAR DR. DONOHUE: During summers, I am very active. I play softball, swim and enter many competitive sailboat races. I am sitting things out now. I can’t move my right shoulder because it hurts and is stiff. I am right-handed. This came on overnight. I don’t remember injuring the shoulder. What do you think it is, and what can I do for it? — P.K.
ANSWER: A case can be made for frozen shoulder, medically known as adhesive capsulitis.
Frozen shoulder frequently follows an injury, and the injury doesn’t have to be a major one. All who have shoulder pain favor that shoulder. They keep it motionless to avoid pain. A motionless shoulder leads to dire consequences. Strands of scar tissue sprout from the joint capsule and lock the shoulder in place. The joint capsule is a sleeve of tendons and ligaments that hold the ball part of the upper arm bone — the humerus — in its socket. The same process can occur without any shoulder injury, and it’s blamed on an immune reaction taking place in the joint. Not only do strands of scar tissue sprout, but the joint capsule shrinks. The shoulder becomes frozen stiff.
Frozen shoulder goes through three stages, and each stage lasts about three or more months. In the first stage, the shoulder is stiff but pain is the predominant symptom. In the second stage, pain lessens but stiffness is pronounced. A person cannot move the shoulder even if he tries hard. And finally the third stage is the recovery phase. The shoulder loosens, and pain disappears. A full recovery can take a year to a year and a half.
See a doctor quickly. You need a confirmation of my provisional diagnosis. Furthermore, prompt treatment speeds healing. Pain medicines are a must, and nonsteroidal anti-inflammatory drugs are often chosen. Not only do they relieve pain, but they quiet inflammation. Moist heat to the shoulder is helpful. The doctor might advise you to have an injection of cortisone into the joint.
As soon as pain is controlled, a program of physical therapy to loosen the shoulder is in order.
Most frozen shoulders get better in time. A few require manipulation under anesthesia to break the strands of scar tissue that immobilize the joint.
DEAR DR. DONOHUE: I have a most painful elbow. It hurts on the inside part of the elbow. I call it tennis elbow, but friends tell me that’s not the place where tennis elbow hurts. I don’t play tennis, but I do play golf — a lot of it. Is there such a thing as golfer’s elbow? If there is, I have it. How do I treat it? — J.J.
ANSWER: Yes, there is such a thing as golfer’s elbow. And let me tell people that those who never hold a golf club or a tennis racket can still get either disorder.
Let’s give people a clear picture of what we’re talking about. If you let your arm hang down with the palm of your hand facing forward, you can feel a bony projection in the elbow area on the side next to the body. That’s the medial epicondyle, and it’s the place of attachment for the tendons of the muscles that bend the wrist and fingers down. During a golf swing, a golfer has to tighten those muscles to keep hold of the club. Repetitive tightening brings about tears in the muscles and their tendons at the point of attachment. That’s the basis of golfer’s elbow.
Rest is important. In the first few days, icing helps. After that, moist heat is beneficial. The always-prescribed NSAID drugs (Aleve, Advil, Motrin and many more) can be used for a week or two. If things aren’t resolving, a doctor can inject the area with cortisone to soothe it.
DEAR DR. DONOHUE: I am a novice runner. I started in the spring. I have had one leg injury after another. No other runner complains of these things. Could I be doing something wrong? — A.M.
ANSWER: Try changing your running style. Danny Dreyer, in his book “Chi Running,” recommends that people with repeated running injuries run with a forward lean so their midfoot strikes the ground first, and not their heels. This change has helped many to stay injury-free.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.
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