# A right pain in the arm



## kerndog (15 Mar 2013)

Hi - bit of a funny pain which im pretty sure is related to cycling as it gets worse after a ride or two and ive not had it before I started riding.

Its a pain in the top of my arm, I guess the beat way too describe it would be where my shoulder joins my arm... or about 10cm down from my shoulder.

Its a dull ache but it hurts more when I put the arm under stress, so lifting things etc.

I have had none of the usual aches or pains from cycling, just this rather random pain in my upper arms.

Does anyone have any idea what it might be? I guess the only thing I can think of is that im stretched out when riding on the hoods, but I feel ok when im riding, I spend some of the time with my hands a cm or two behind the hoods as I do feel a bit stretched out when right up on the hoods (I put this down to lack of fitness), and I do change hand positions as much as possible.

Thanks


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## mrandmrspoves (15 Mar 2013)

Hard to tell.... any other symptoms? Any history of trauma? 
Do you have full range of arm movement? Try putting your arms to your side. Then bending your arms at the elbow so your hands point in front of you and your elbow forms a 90º angle. Now keeping your elbow bent and at your side, try moving your arms so your hands point sideways. Try both to the right and to the left.
The above is a simple test that may indicate impingement syndrome if you find the movements difficult or painful. if no pain and no difficulty and have full range of shoulder movement I would look at bike set up next.
Impingement syndrome is easy to Google.....so I won't write more here.....but sadly I know lots about it from personal experience...


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## thegravestoneman (15 Mar 2013)

I get that! please find out what it is so I can sleep easier.

I have started sleeping with my arms above my head and wake up in the night in serious pain. I have asked my beloved to strap me down but she is getting the wrong idea.

in all seriousness though, I can say though mine started before I started before my re-aquaintence with all things peddly.


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## mrandmrspoves (15 Mar 2013)

thegravestoneman said:


> I get that! please find out what it is so I can sleep easier.
> 
> I have started sleeping with my arms above my head and wake up in the night in serious pain. I have asked my beloved to strap me down but she is getting the wrong idea.
> 
> in all seriousness though, I can say though mine started before I started before my re-aquaintence with all things peddly.


Pain at night Is common with impingement syndrome. ...sometimes helped by exercises... and posture. Sometimes relief can be gained througb steroid injections into the shoulder. Sometimes the cause is wear and tear, sometimes caused by boney spurs growing, and sometimes as in my case by calcium being deposited into the tendons. If your pain is like a bad toothache in the shoulder look up calcific tendonitis. .....its considered to normally be self limiting. ...but mine has not proved to be and I now ride a recumbent because I can no longer ride a standard bike....I am due orthopaedic review next week and now expect that I will need surgery.


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## vickster (16 Mar 2013)

I'd say as someone who is orthopaedically challenged (knee and elbow), find yourself a *good sports physio* - private, forget the NHS - get a tailored exercise programme, posture advice etc. Costs about £50 for an initial assessment and £40 for follow ups (perhaps less outside the SE). 

I have had surgery twice on the knee and once on the elbow, but always very much a last resort after physio and conservative treatment.


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## thegravestoneman (17 Mar 2013)

mrandmrspoves said:


> Pain at night Is common with impingement syndrome. ...sometimes helped by exercises... and posture. Sometimes relief can be gained througb steroid injections into the shoulder. Sometimes the cause is wear and tear, sometimes caused by boney spurs growing, and sometimes as in my case by calcium being deposited into the tendons. If your pain is like a bad toothache in the shoulder look up calcific tendonitis. .....its considered to normally be self limiting. ...but mine has not proved to be and I now ride a recumbent because I can no longer ride a standard bike....I am due orthopaedic review next week and now expect that I will need surgery.


I will get myself an appointment at the doctors, cheers


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## MissyR (17 Mar 2013)

This sounds very much like what i'm suffering from just now. I had to abandon my ride today because it became to uncomfortable. I have been told it has something to do with my tendons being inflamed in my shoulder socket (how they became inflamed i'm not quite sure). 

Still waiting on my appointment date for Physio to see what they say  I'm still hoping for a miracle cure as this has been going on since December!


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## HLaB (17 Mar 2013)

Ive had a few injuries to ribs and arm and thought itd be best to avoid the bike but after several week of them not getting any better; I have got back on the bike and only then have they healed. Im not saying its a panacea but I think a properly set up bike holds things in the right place.


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## mrandmrspoves (17 Mar 2013)

vickster said:


> I'd say as someone who is orthopaedically challenged (knee and elbow), find yourself a *good sports physio* - private, forget the NHS - get a tailored exercise programme, posture advice etc. Costs about £50 for an initial assessment and £40 for follow ups (perhaps less outside the SE).
> 
> I have had surgery twice on the knee and once on the elbow, but always very much a last resort after physio and conservative treatment.


Not disagreeing with you......but your non NHS physio almost certainly trained in the NHS and there are some excellent ones remaining in the NHS. Must admit I am defensive as I also work in the NHS.


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## mrandmrspoves (17 Mar 2013)

thegravestoneman said:


> I will get myself an appointment at the doctors, cheers


Good plan....and good luck! Let us know the outcome.


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## mrandmrspoves (17 Mar 2013)

MissyR said:


> This sounds very much like what i'm suffering from just now. I had to abandon my ride today because it became to uncomfortable. I have been told it has something to do with my tendons being inflamed in my shoulder socket (how they became inflamed i'm not quite sure).
> 
> Still waiting on my appointment date for Physio to see what they say  I'm still hoping for a miracle cure as this has been going on since December!


There are a number of reasons for shoulder tendonitis.....they include repetitive movement, trauma, shoulder impingement and as in my case calcium deposits in the tendons. The main problem is that the shoulder pain can affect your posture - so try to stand up straight without jutting your head forward and to avoid a frozen shoulder keep the shoulder moving.


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## vickster (18 Mar 2013)

mrandmrspoves said:


> Not disagreeing with you......but your non NHS physio almost certainly trained in the NHS and there are some excellent ones remaining in the NHS. Must admit I am defensive as I also work in the NHS.


 
Many of the experiences (knee related) I have heard of NHS physios relate to long waiting lists, short appointments and indeed often just one appointment and an exercise sheet. Or participation in an hour long class with half a dozen others who have had a number of different operations - there is no way a physio can devote enough time to each patient and be fully aware of their history and individual needs. One friend of mine had an ACL reconstruction, went to such an NHS physio class and was instructed to hop on that knee about 4 weeks post op and left to her own devices - a massive no-no!

I saw an NHS physio years ago for a shoulder problem, my experience was one 30 minute appointment and an exercise sheet....

I am not sure if my physio worked in the NHS

I think the NHS in the main is a fantastic institution, based on my own past and family member's experiences. However, for targeted sports-oriented physiotherapy, the resource is not there. This same friend is waiting for a revision of her ACLr on the NHS, she is in severe pain, takes loads of painkillers just to make it through the day and has to wait weeks for appointments and scans and will wait many months for the op even though the scans are finally done

I am sure there are superb NHS physios, but your use of the word 'some' suggests it might be hit and miss


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## kerndog (18 Mar 2013)

mrandmrspoves said:


> Hard to tell.... any other symptoms? Any history of trauma?
> Do you have full range of arm movement? Try putting your arms to your side. Then bending your arms at the elbow so your hands point in front of you and your elbow forms a 90º angle. Now keeping your elbow bent and at your side, try moving your arms so your hands point sideways. Try both to the right and to the left.
> The above is a simple test that may indicate impingement syndrome if you find the movements difficult or painful. if no pain and no difficulty and have full range of shoulder movement I would look at bike set up next.
> Impingement syndrome is easy to Google.....so I won't write more here.....but sadly I know lots about it from personal experience...


 
hi - No, no other symptoms, just a pain in the right arm, and no history of trauma to my arm recently. Mind you years ago I picked up a shoulder injury surfing but that was a long time ago, and last year I was snow boarding and had a few slams and cracked a couple of ribs but have had no pain until I started riding.

I tried what you suggested and have movement in both arms with no pain so I'm hoping it's my riding position.

Next I am going to try moving my seat forward a few mm to see if this helps... Does anyone have any suggestions as to what other changes I can make? Other than this arm pain I'm really comfortable on my bike and can do 30 miles (furthest yet) without getting uncomfortable (obviously im totally knackered but that's because Im new to this!)


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## mrandmrspoves (18 Mar 2013)

kerndog said:


> hi - No, no other symptoms, just a pain in the right arm, and no history of trauma to my arm recently. Mind you years ago I picked up a shoulder injury surfing but that was a long time ago, and last year I was snow boarding and had a few slams and cracked a couple of ribs but have had no pain until I started riding.
> 
> I tried what you suggested and have movement in both arms with no pain so I'm hoping it's my riding position.
> 
> Next I am going to try moving my seat forward a few mm to see if this helps... Does anyone have any suggestions as to what other changes I can make? Other than this arm pain I'm really comfortable on my bike and can do 30 miles (furthest yet) without getting uncomfortable (obviously im totally knackered but that's because Im new to this!)


 

Sounds like set up then..... if you feel stretched out when on the hoods it may be that you need a shorter stem - but before you spend any money......
Could your saddle move forwards a centimetre or two?
Is your saddle level or minimally nose up? (nose down will tip you forwards onto the bars)
Can you rotate your handlebars slightly so the brakes move up towards you slightly?

Any of the above may help - but I would start of looking at which one seems most likely to be effective based on your current set up, then make a small adjustment, try it adjust again if necessary, and then move on to the next most likely to be effective.
If you Google "bike fit" you will find plenty of advice that will give you guidance on basic principles to use as a starting point.
Good luck


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## fossyant (19 Mar 2013)

Best advice might be to see the GP.

Tey will recommend anti inflammatory etc. ibuprofen gel or Volterol on the affected area can help. If it doesn't clear up, go back and ask to see a shoulder specialist.

The only way they can tell is an MRI and they aren't cheap, so they will only do them if its bad. 

If it is impingement, a specialist will try a steroid injection first into the joint. You'll go back three months later to see if there is any improvement, if not you may get an MRI. If it does show bone spurs on the joint they may recommend surgery.

I had this done after a road accident, but going through the processes takes time, it took two years to get to operation stage and a further 12 months before it gave me no pain. Absolutely fine.

Impingement is common in sports people eg rugby and cycling as you do tend to fall off or over onto them. I've bashed my left shoulder a few times, and the RTA was the one that finished it off.


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## Arsen Gere (19 Mar 2013)

Physios advice I've had over the years is if it is both sides it is something you are doing, if it is one side it is probably an injury.
Either way GP's know that in time it will probably sort itself out if you stop doing whatever it is your are doing to cause the problem. So they usually tell you to stop doing whatever it is and may be chuck in an anti-inflamatory for good measure.

A physio on the other hand will spend more time with you and provide specific advice and guidance. I never go to my GP with muscle/joint type stuff and go straight to the physio. The GP is a waste of time go private and get it seen now, unless money is an issue of course, (Been there too).


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## mrandmrspoves (19 Mar 2013)

[quote="vickster, post: 2366249, member: 10217" 

I am sure there are superb NHS physios, but your use of the word 'some' suggests it might be hit and miss[/quote]
Absolutely correct..... .but the same applies if you go private!


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## vickster (19 Mar 2013)

This is true, however, you can seek advice from others, choose who to see and change if you need something else

My first physio (knee) worked at the hospital when I saw the surgeon and he referred me to the physio. My current physio (knee but more elbow) works at a practice recommended by my first physio - who wanted me to get another opinion, fresh pair of eyes. He is excellent but also seeks advice from his senior colleague - also excellent (saw him as I needed attention to get me through a particularly arduous work trip)

With physio, you need someone who has expertise in the correct joints / bits that are bothersome I think and you also need a good rapport if it's long term treatment (e.g. post op). My current physio is also a tennis coach, so my tennis elbow is completely up his street!


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