That stabbing pain you feel when you reach for the wallet in your back pocket might be traced to lifting a shovel above your shoulder after this month's snow.
Yes, it looks like you have forced the humerus against the edge of the acromion again.
Or, as you repeat every time you put away the dishes on to a high cupboard shelf, you hurt your shoulder shoveling snow.
It is the pain that keeps on giving, and sometimes won't go away for weeks, or even months, said Dr. James Bowers, an orthopedist at Meriter Hospital.
Repeatedly raising the arm, such as by shoveling snow and especially by lifting that snow-filled shovel above the level of your shoulder, is a common cause of the complaints Bowers is hearing these days.
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"It's not unusual, every year we hear from a fair number of people about shoulder complaints that begin with 'it all started when I was shoveling back in that snowstorm.' By the time they see me, a few months have gone by and the pain has not gone away," he said.
It may be old advice, but when you say "it hurts when I do this," then the cure is: "Don't do that."
"Yes, don't throw the snow so high, and the usual advice: Lift with your legs, don't bend at the waist," said Bowers. If you can push instead of lift, do that.
But what is happening?
"You are developing inflammation around the shoulder joint, developing a bursitis," he said. Or you have created an impingement, or pressure on the rotator cuff tendon. Athletes who use their arms get that injury, along with people who shovel snow. You might even develop a tear in that rotator cuff tendon.
"A sign of that is if you heard a pop, or woke up the next day and couldn't lift your arm above your shoulder level," said Bowers.
The best treatment for a sore shoulder that lingers is to rest it, take an over-the-counter anti-inflammatory drug such as aspirin or ibuprofen, and give it a little gentle stretching, he said.
If that pain lingers, or increases, get to your physician, who may prescribe physical therapy.
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But those first days are important for home care, doctors say.
"When you first feel shoulder pain, apply ice for up to 15 minutes, then leave it off for 15 minutes," advises a UW Health informational Web site. "Repeat this cycle for several hours. Wrap the ice in a cloth, Do not apply ice directly to the skin. Then, continue to ice 3 to 4 times a day for 2 to 3 days."
Julie Sherry, a physical therapist at the UW Research Park spine clinic, stressed that warming up before you start shoveling goes a long way toward reducing the potential for injury. And if you are out of shape to begin with, your chances for injury increase.
"Most of the time people aren't fit enough to do that type of repetitive movement for as long as most people are out there shoveling," she said.
"For prevention, you need to pace yourself, just slow down," she said. "A lot of injuries could be prevented by breaking up that one 45-minute episode into two or three smaller periods, with breaks in between."
That's not just a rest, she said. What it does is "reduce the fatigue in muscles that are being overused." A tired muscle will not function as well as a fresh muscle.
And there is a longer-lasting message to snow shoveling pain, too, she said.
"You look at a joint like the shoulder, or the knee, and the research out there now is that the pain in those joints is related to weakness in the core. You are doing yourself a disservice if you say your shoulder joint isn't related to the rest of your body," she said.
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-- Copyright (c) 2009, The Wisconsin State Journal/Distributed by McClatchy-Tribune Information Services.
