Upper arm pain from bicep tendonitis and bicep tenodesis is one of the most common shoulder issues out there, particularly for athletes.
Playing sports like football, rugby, and basketball, and similar activities can result in shoulder dislocations; wear and tear type of injuries like strains, sprains, bursitis, and impingement also can occur due to playing sports like volleyball, baseball, basketball, water polo, swimming, tennis, and more.
Basically, anything that involves lots of throwing or overhand movements can be problematic.
The causes of shoulder pain
Sudden traumatic injuries like shoulder fractures or dislocations that require immediate medical attention are often causes of upper arm pain or shoulder pain when lifting arm, so if you experience one of these you should get medical attention immediately.
There are other less acute forms of shoulder pain that are equally problematic and can become more difficult over time. Think about the types of injuries or problems that arise from repeating the same movements over time, from playing sports like basketball, football, baseball, tennis, or swimming, or even repeated heaving lifting at your job (if your work involves significant manual labor).
Repetitive stress injuries from sports like baseball, swimming, and other activities that place a lot of stress on the shoulder joints and the muscles in the upper arm also cause injuries like shoulder impingement or bone spurs that form on your shoulder joints from overuse.
This is when the shape of the bones that form the arc of your shoulder are worn away, usually as the result of throwing overhand or moving your arm in a way that involves lifting it over your head or at 90 degree plus angles.
This is essentially because the shoulder is a closely fitted joint composed of the humerus (the bone in your upper arm) and associated tendons, muscles, and bursa sacs (fluid-filled sacs that cushion your bones and prevent friction).
All these components work together to make a very narrow arc of bone and ligaments – this is your coracoacromial arch. This becomes smaller when your arm is raised over your head, which can pinch tendons and cause inflammation – especially when done repeatedly.
Athletes & upper arm pain
Movements like throwing a ball overhand, swinging a tennis racket, swimming freestyle, or throwing a ball all can cause issues. What’s more, the pinching or impingement (the latter is the word you probably want to use with your doctor) can lead to rotator cuff syndrome or rotator cuff tears as well as prolonged inflammation of the tendons, shoulder bursitis, and other related problems and chronic upper arm pain, swelling, stiffness, or weakness.
However, shoulder or upper arm pain can also be the result of the aforementioned repeat stress injuries. It’s usually felt around the top of the shoulder and extends down the arm, and is particularly acute when the arm is lifted over the head or twisted – think a typical throwing motion, or lifting your arm up to swim freestyle or do a backstroke.
If the inflammation is extremely severe, however, it’ll be present all the time and can be worse at night. It may even wake you up from a deep sleep or prevent relaxation all together.
Diagnosing the cause of upper arm pain and related shoulder issues
Most causes of shoulder pain or upper arm pain can be diagnosed by an orthopaedic surgeon through a medical history and physical exam; other x-rays, MRIs, and arthrograms may be ordered as well.
Many shoulder problems can seem minor at first, but the longer you let things linger without treatment, the longer they may take to heal and the worse your upper arm issues or shoulder joint issues can become.
Accordingly, if you are experiencing unusual or extreme pain in the area between your upper arm and shoulder joint, then you should consult with a doctor as soon as possible. Even if it is relatively minor or seems to be so at the time. An ounce of prevention is worth a pound of cure in this regard (as it is with most things).
Know that if you have unrelated but other significant medical conditions, that will affect your treatment plan and subsequent follow-up rehabilitation.
What contributes to upper arm pain
Overuse, weak muscles, improper or poor technique, and overly strenuous training all can cause upper arm pain; that said, over use is considered to be the most common cause of upper arm pain and issues like shoulder bursitis, bicep tendonitis, and impingement.
Previous injuries can also contribute to the problem and can be degenerative issues, meaning they get worse over time. Calcium deposits can also build up in the shoulder and cause tendonitis and associated pain.
Joint shoulder instability (particularly in the late teens or early twenties) can also cause pain in the upper arm or shoulder. These can be a result of how the joint developed, or from a strong force or major injury that caused your shoulder to dislocate or sublux, resulting in shoulder dislocation and therefore pain when you move it.
If your upper arm hurts when you raise it or lift it, then you should see your orthopaedic surgeon to discuss possible treatments, which may include rest, icing the joint, special exercises, or more significant physical therapy / physiotherapy or even surgery.
Symptoms of upper arm pain may include but are not limited to tingling, numbness, weakness, stiffness, swelling, general tenderness, a limited range of motion, and even swollen lymph glands.
Treating your shoulder or upper arm pain
Resting and avoiding activities that caused the upper arm pain to begin with is the first step, of course, so athletes will likely need to take a break from their sport(s) of choice.
Keep in mind that you can probably still work out if you don’t use the affected shoulder though – so it is likely that not all physical activity is off limits (speak to your doctor with any questions).
That said, keep in mind that you have known nerve damage, you would avoid repetitive movements and take frequent breaks if you have to perform them at all.
Icing your upper arm for several times per day may also be advised, particularly after any activity that might cause additional pain or inflammation. Compression bandages, elevating your arm above your heart level to reduce swelling, and other at home treatments may help you prior to surgery or to even avoid it all together.
Specific exercises or physical therapy or physiotherapy may be advised to improve muscle and tendon flexibility and strength, with treatments like ultrasound, phonophoresis, iontophoresis, friction massage, electrogalvanic stimulation, and soft tissue mobilization used treat scar tissue in the tendons caused by the chronic inflammation.
Oral anti-inflammatories, cortisone injections, and even local anesthetics may be used as well, perhaps in conjunction with physical therapies to relieve the pain and soreness. Sometimes this may prevent the need for shoulder surgery; however, a repeated need for medication to alleviate pain may indicate a need for surgery.
When your upper arm pain requires surgery
For example, if your upper arm pain is the result of shoulder impingement, bone spurs, calcium deposits, or similar conditions, you may require surgery. In many cases, this may be arthroscopic surgery which is minimally invasive and only requires a small number of incisions.
In fact, sometimes it can even be performed as an outpatient surgery with the associated minimal recovery time. That said, more extensive injuries or problems like a complete rotator cuff tear, damage from conditions like arthritis, and previously failed shoulder treatments or even surgeries will require a more extensive treatment plan or even a complete reconstruction of the affected shoulder joint.
Returning to sports after an upper arm injury
If you have dealt with a shoulder joint issue or aching arms and shoulders, know that time is a major factor for healing most injuries or shoulder injuries can take a long time to heal, sometimes months or even years. So, once you do return (after speaking to your doctor), understanding what you should do to protect your shoulder and upper arm and prevent future shoulder pain is essential.
Warming up, performing the proper stretching and strengthening exercises, and making sure to work your shoulder joint through the full range of motion before throwing a ball, going swimming, or engaging in other activities that might affect your shoulder is perhaps the most important thing you can do.
Starting slowly and avoiding difficult shots, throws, or strokes (in the case of basketball, baseball, or swimming respectively) is recommended. Doing daily range of motion exercises to help keep joints flexible and prevent further bursitis, tendonitis, and impingement is also generally recommended.
What should you do for upper arm pain?
After reading this, know that if you have significant or acute upper arm or shoulder pain, see your doctor as soon as possible (including going to the emergency room if need be).
However, if you have chronic pain in your upper arm, shoulder, or anywhere between your elbow and shoulder joint, start by consulting your doctor and asking for a referral to an orthopaedic surgeon with expertise in shoulder joint issues.
Your shoulders and arms are a complex system and require the experience of an expert to make sure that any pain is alleviated and that you will be able to continue playing the sports and doing the activities that you love.
