Hi, I’m Dr. Molly with Your Goals Physical Therapy. We have all done that embarrassing thing where we slipped or tripped, and we get up real quick and we look around to see if anybody saw us. Then if we can, we keep on walking and deal with whatever drama occurred from the fall later. That is actually what inspired this particular video.
This week I got a phone call from a friend of mine who slipped in the shower. If that is not the most embarrassing thing to have to call and admit to for one and two, now you’re injured and you don’t really know what to do. That’s where my friend found himself.
I thought that I would go over the questions that they had with other people, because I don’t think that they’re alone. Their question, him and his wife, were trying to figure out if they had to go to the ER or if they could wait and maybe see somebody later . If it was possible, what they could do right now to make sure that their shoulder had the best chance of healing quickly and not having any other damage.
That’s what I’m going to answer in this video. Now, giving people advice on whether or not you should go to the ER or not, is very tricky over the internet because I am not looking at you. So this is a generalization based on the information I had with this particular story.
That will be the first question that we answer. My friend went a little bit more into detail, so let me tell you his story. His story was that he just moved into a new house and so they haven’t necessarily set everything up. He wanted to go take a shower and he slipped because there’s no mat. Which by the time I had gotten on the phone with him, they told me they’d rectified they went and ordered it.
Since he didn’t have a mat, he slipped, he fell backwards, he landed on his elbow and during that impact he got a sense that his shoulder popped forward and then came back into the joint. It felt to him as if his shoulder went in and out of joint, which has to be a very scary thing, right? If you feel like your shoulder just dislocated, it’s not fun.
When he got up, he told me he was able to move his arm. There wasn’t a whole lot of bruising or any swelling, so he wasn’t really sure if he had to go to the ER or if this was like a wait and see kind of a situation.
Now with that background I’m gonna go through and these are the questions that I asked him to kind of further evaluate whether or not I needed to suggest that he go see somebody pretty immediately or if he could kinda wait and see if the symptoms decide subsided and then go to somebody as appropriate later on.
I asked him if he saw any obvious deformities, any obvious swelling, is it getting up to a balloon bruising? Did he feel any numbness and tingling in his arm? I asked him if he heard a pop during the fall.
Just for clarification, that pop is not something that you’re like questioning. You either hear it or you don’t. It is not one of those things where you’re like, Hmm, I might have heard a pop. Most people who hear a pop from an accident, it is very loud and very shocking. If you’re questioning whether or not you heard one, you’re probably pretty safe that you didn’t because you would know if you did.
Then I asked a little bit more detail about whether like the pain moving and if he could just keep his arm and let it hang. For him, he didn’t have any obvious swelling. He didn’t have any obvious bruising that he or his wife could see, good news. There was no major changes in his shoulder altogether.
He was able to move it, but when he got to a certain point, it got a little uncomfortable and he really felt like it was gonna dislocate. That’s not a good sign. He didn’t have any numbness and tingling, which is again really, really good. He didn’t notice his arm hanging by him. So that doesn’t seem to be a problem either.
For the most part, my friend was in pretty good shape. He did get the sense that his shoulder wasn’t stable, but that was really the only symptom. If he had told me that he had numbness and tingling, if he had told me that there was something obviously deformed, if there was significant bruising. If he had heard a pop, I would’ve really strongly suggested he go to the emergency room.
Certainly if he had multiples of those, I would’ve really strongly suggested. But in his case, since nothing was really apparent and it was just a little unstable. I said, if you are not really wanting to go to the ER, you certainly can wait, but if it doesn’t get better in around three days with icing it and some of the other suggestions I’m gonna give you, then I strongly urge you to go see a physical therapist.
He asked why a physical therapist and not like an orthopedic? My answer is going to an orthopedic surgeon, they’re gonna x-ray you, they’re gonna MRI you. Maybe if they think that they need to, but then they’re gonna tell you you’re either gonna be fine in a few days, maybe hand you a sheet of paper with some exercises, but that’s gonna be the end of the visit. They’re really only consulting you to see if you’re a candidate for surgery.
Whereas if you go to a physical therapist, we look at your whole joint. Give me for an example, I’m gonna see how stable your joint is, how strong things are flexibility wise. Other things that can be affecting the joint. In this case we’re talking about the shoulder, but we’d be looking at other things that could be affecting the health of your shoulder. We’d be able to do things to help you with your position and other things, if you do have pain to get rid of that pain.
An overall assessment is gonna be a little bit more hands on, a little bit more detailed. We are still able to say whether or not you more than likely need to go in for an orthopedic surgeon consultation because surgery may or may not be likely.
We can’t make that determination because obviously we don’t have an MRI and we’re not the orthopedic surgeon, but with our physical exam, we are able to say whether or not physical therapy would be able to help you, or it may be better for you to be going to get a surgery consultation.
The nice thing is with physical therapy that day you’re gonna be getting some form of treatment. Again, even if we can’t necessarily help your shoulder in really severe cases, which happens very rarely, but in the other 75% of the cases, we are actually quite capable of treating the unstable shoulder and helping it get back to being more stable.
Since my friend was already able to move his arm and it was only at pretty high ranges that he didn’t feel stable, he was a really good candidate for physical therapy and not having to worry about an orthopedic surgeon.
I was able to kind of go over that a little bit more in detail, because why wait and go through the orthopedic and x-rays and MRIs and delay getting started on the things that are gonna help you get back to what you wanna get back to, right?
You wanna be able to get back to playing the games and sports that you want. You don’t wanna be waiting one extra step for the MRI report and all these other stuff if you don’t need to. Let’s just get right to it and start the healing process. That was my pitch to him for physical therapy.
Now of course their other question was, okay, well right now it’s not really bothering me, but this thing just happened. What can I do to make sure my shoulder is healthy and strong and I give it the best shot here?
Here are some things, ice it as often as you can think of 10 minutes at a time, you can do it every hour if you want. One of the better positions for that is with your elbow supported, which is one of my other suggestions. So if you’re just sitting and, and relaxing, either hug a pillow. So there’s like a little bit of space here between your side and your elbow. That allows your shoulder to rest and not be hiked up. Support your elbow because that helps relax your rotator cuff and other muscles around your shoulder so that they don’t have to be working. If they were injured, it gives them a little bit of a break.
Icing and support your elbow. The other thing is either subconsciously or consciously, sometimes when we hurt our shoulder, we hold it really tight to our body and we don’t let it move. As we’re walking, we’re really stiff. You don’t wanna do that. If it doesn’t hurt, then you want to let your swing.
Honestly that helps pump out the fluid that may be collecting in your shoulder, helps calm the muscles down. That rhythmic motion of just letting your arm swings, If you’re walking your arms just kind of swing side to side that really does help calm all the muscles and ligaments in your shoulder. Try to avoid the “I’m not gonna let my arm move because it’s injured position.”
Those were my suggestions. He came up with a follow up, which was, what about a sling? And I said, well if you feel like your arm needs to be supported throughout the day because it’s just getting achy, by all means sling is perfect.
I happen to know that he works at a desk, that he has an elbow rest. And I said, now if you find that the elbow rest does just as well, then that’s great. If you’re gonna be out and about and you need people to know not to mess with your shoulder, then go ahead and grab a sling and use that. But if it doesn’t hurt to let your arm hang and and, and just relax and be by your side, you want it to be in the most normal position possible. Now if he had pain, I would’ve strongly suggested to him get yourself the sling, but in my friend’s case, he just didn’t.
Those were kind of the suggestions that I gave my friend and I hope that they help you. Just to recap a little bit bit, if you slip and fall and you’re trying to decide whether or not you need to, if you have a physical deformity, if you have numbness and tingling in your hand, if you heard a pop or you see a whole lot of bruising coming out so that you know it turns really dark on your shoulder, go see somebody immediately.
Now if you can’t, if you can’t let your arm hang and it’s just really achy and driving you bonkers and you can’t move it out in any direction you need to go see somebody. Especially if you can’t even get it off your body. Like if you’re using your whole body to move your arm, you need to go see somebody for that’s not a good sign. That’s a sign that something was torn there.
Notice one thing I did not really ask about is pain. The reason I didn’t is because a lot of things can hurt, but ultimately people who have completely ruptured a tendon or ligament have absolutely no pain, they just can’t move it. That’s why in that last sentence I was like, if you can’t even move your arm off your body, that is a sign that you need to go.
Pain isn’t necessarily a hundred percent the determination on whether or not you need to go to the ER or not, because you could have absolutely no pain and have a very serious injury.
Now after listening to this video, if you are ready and have decided that you need a physical therapy consultation, I would love to be that person for you. I’d love to help you get back to your favorite activities and the links below. I will leave a button that says ask about cost and availability and if you fill that out, we will contact you at the time that you tell us to, to set up, um, that evaluation and get you started and answer all your questions that you might have about my clinic in particular.
If you’re listening to this and you’re still on the fence on whether or not physical therapy or another avenue is the right thing for you and you just like to have a conversation and, and talk to me or a physical or another physical therapist, then you can click the button below that says, talk to a therapist.
We’ll set that time up and we can chat for 20 minutes and just get all of your questions answered so that you’re more comfortable one way or the other. Maybe we’re not the best fit and I have no problems telling you that we would not be the best fit for you based on the information that you give me. Or if I do think that we might be able to help you, I will give you that information as well and explain in a little bit more detail about your specific situation, how we might be able to help you.
What started off as kind of a sad or rather embarrassing slip and fall ends up being very beneficial and very helpful for you or somebody that you may know. If you think you could share this information with somebody that it would be a benefit, please do. The more people that know this kind of information, the less anxiety there is and the less worry there is around injuries. We all have random accidents that we don’t really wanna tell people about, but the best thing is just to heal as quickly as possible and recover and get back to all the things that we’re missing out on. Bye!
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All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.
