Question re: rotator cuff and mild exercise

Greetings,

Long time TMSer here and I appreciate all of the posts on this forum!

After a major TMS incident that lasted a year nearly 20 years ago, I've had off and on TMS pains come and go over the years but they're usually pretty easy to stop in their tracks and I'm able to prevent them from spiraling out of control after several days or several weeks. About 5 years ago, I had some minor arm pain that vexed me for about 2 months, but of course it was TMS and I got over it. That said, I'm an anxious person and usually do worry about the possibility of injuring myself.

About 1 month ago I started noticing some upper arm pain near my shoulders when I raised my arms. It started off pretty minor, but has slowly gotten worse. It's principally in my right arm, but I'd say I have about 30% of the pain in my left arm as well. I'd describe the pain as very similar to a rotator cuff / frozen shoulder injury, where it hurts my upper arm if I lift my arm backwards and upwards. For example, I cannot touch my left shoulder blade from the back with my right arm since it hurts too much.

I'm pretty sure this is TMS, but I've had real trouble getting rid of the pain this time. The reasons I think this could be TMS are:

1) I have the symptoms in both arms - what is the likelihood this would happen at the same time bilaterally?

2) My wife has been complaining of a frozen shoulder / similar type of pain in her left arm for the past 4-5 months. I was never concerned about getting it, but we talked about it a lot (we think it may be TMS but that's another topic). What are the chances I get the same injury as her?

3) While the pain is most acute in this particular muscle area in the upper arm (don't know the exact name of this area), I sometimes get referred / radiating pain in my back shoulder blade, armpit, and collarbone area. Oftentimes, when I have TMS pain in my hands or lower arms, I'll feel some radiating pain in my armpits which is a giveaway it's TMS.

4) About a week ago, I woke up in the middle of the night with a truly horrible pain in my right collarbone area. This was out of nowhere - lasted about 15 minutes and was excruciating. Eventually it went away and I realized in the morning it had to be TMS since it was so sudden and unexplained. Haven't had an incident like that since.

However, I still don't believe the TMS diagnosis 100%. Here's what's holding me back:

1) Usually I can replicate my TMS pain just by thinking about it, but in this case, that particular muscle pain really only happens when I'm moving my arm in those stretched positions. It's that muscular pain that freaks me out. The collarbone area which hurt in the middle of the night, shoulder blade thing not so much. So I'm thinking maybe there is really something physical there. It doesn't just show up but is specifically triggered by certain movements. Is it possible that on the one hand I have a real injury, but then on the other it's aggravated by a TMS issue. Also, it seemed to show up in both arms at the same time. It's not like I noticed in one arm and then it decided to jump to the other arm (which is a total giveaway that it's TMS)

2) Over the past 3 months, I've been trying to be healthier and have been exercising on our elliptical more. That has been going great (feel better overall, lost some weight), and about 1 month ago, I wanted to expand and slowly do some upper body stretches. I'm always a little paranoid about injuring myself (yes, anxiety / TMS issue here!), so I only did some very very mild Tai Chi stretches, some push-ups against the wall, and maybe 30 jumping jacks a day with my kids. But I never thought specifically about injuring this part of the body. Don't recall having any real pain associated with doing any of these exercises, but this is super gentle stuff in my opinion. Maybe I was a little sore immediately afterwards, but very mild and I never remember thinking afterwards, "Oh, I overdid it and injured myself". I probably did those exercises for just a week or so, and stopped when this pain started, even though I couldn't put my finger on what could have caused this. I was kind of getting into the Tai Chi stretching, which I found very intriguing and even checked out a book from the library. It makes sense that TMS attacks me in areas where I want to succeed and make progress.

For weeks I've been trying to find a structural reason that could've caused the pain (first I thought it was lifting a 15 pound fake Christmas tree over my head into the attic back in January), and now I'm thinking maybe it was those jumping jacks as that would explain why I have it in both arms. Also, I just learned online that apparently jumping jacks can lead to some rotator cuff injuries.

Just by reading this, I'm sure it seems like it's a TMS situation, but I think I need reassurance that the jumping jacks or lifting this small tree couldn't have truly led to a torn rotator cuff which hurts like hell. I'm definitely not muscular, am pretty inflexible and somewhat weak with respect to my upper body, but am an overall healthy and trim 45 year old male. Over the summer when I was swimming with my kids, I'd occasionally get this very intense muscle spasm in a similar area in my upper right arm, but that had to be TMS as I was able to laugh at it and it'd go away in 5-10 minutes. When I try laughing at this, it doesn't go away. It just hurts a lot. The rotator cuff rabbit hole online seems horrible - no cure, will continue to get worse and worse until you need surgery, the pain can radiate to your shoulder blades, etc. But obviously if there's a real issue I don't want to ignore it and injure myself further.

Overall, this has been an anxious time worrying about COVID and being in quarantine. I'm also kind of nervous about going to a doctor's office and/or getting physical therapy until I'm vaccinated against COVID which could be another several months. So I feel stuck.

Any thoughts or suggestions? I appreciate anyone's help or comments.

Thanks so much!

 

It sure sounds like TMS. I had shoulder pain too. When I went to the Doc and he said surgery, my so called impaired shoulder was fine the next day but the other one hurt.

 

Hi @tmser and welcome to the forum. Unfortunately, we are not medical professionals here, we're just peers who also do battle with our TMS brains and we should not be diagnosing anyone or giving assurance to anyone who has not had their symptoms seen by a qualified medical professional. As the disclaimer at the bottom of the page says, If you have symptoms, see your doctor to rule out anything serious and get proper care. No information on this site should be considered medical advice.

Your level of doubt has reached a point where you need to be responsible and take the obvious next step.

A year ago in May/June I found myself going in for x-rays of my hands, labwork, a consultation with a rheumatologist, and more labwork - that's at least four face-to-face interactions with health professionals, plus support staff - in order to confirm that I had sudden-onset RA. I kept hoping it was TMS, not because I was afraid of going to the doctor (I wasn't, even at age 69) but because I reeeeeeally wanted it to be TMS. And it wasn't. During 2020 was back for labs and in-person checkups every three months, plus two shingles shots and a flu shot, and have never been sick, and I never even worried about it, because I could see that my HMO was taking all of the recommended precautions, as was I.

Do NOT put off seeking medical help when it's obviously warranted. Use your common sense and trust your medical professionals to protect themselves from YOU - believe me, they are highly motivated to do so.

All that being said, @chopper72 's response is right on for TMS.

 

That's the devilishly hard trick with TMS. Sometimes Docs know what is wrong and sometimes they don't and guess wrong. Find the scores of accounts on here of unnecessary surgery. Sure go to the doctor but be skeptical.

 

Thank you for reading my long post and for the thoughtful reply.

Since my post, I did reach out to a TMS doctor I've worked with for an online virtual visit. Based on my history and physical presentation, he thought that there may have been some initial irritation from the exercises but nothing serious and nothing warranting an MRI or x-ray. He said it's not something that would ever require surgery. However, he thought TMS may have hijacked the injury and been complicating things. He gave me some medication for 10 days and told me to stretch to see if that did anything, and we'll have a follow-up later this week. Sort of a mixed message, but at least calmed me down from worrying that it's something that will ruin my life.

I haven't really improved but it hasn't gotten worse either. I can tell I'm still "doubting" whether it's TMS but have noticed that when my anxiety level decreases I'm much happier although certain movements will still trigger the pain which is what is throwing me off. I've been trying to focus on what's going on in my life (certainly a lot of stressors right now) and will just stay focused on that instead of this pain. As long as I know it's nothing life-threatening I'll not worry about it and hope it subsides. My wife keeps telling me it's TMS.

Thanks again for your support!

 

Watch a tennis match and see how those shoulders are used. They are back playing the next day. You cannot injure your shoulder with mild exercise.

 

And this is your brain on TMS.

 

Just thought I should follow up on my posts from several weeks ago. The pain has been getting worse every week and I can move my arms less and less. I went to see an orthopedist in person just to rule out anything more serious. He did an X-ray (nothing came up) and said he didn't recommend an MRI since they don't tell you much unless you have a complete rotator cuff tear, which he didn't think was the case. He thought I had frozen shoulder and recommended physical therapy. This is interesting and somewhat of a relief since I know that's a TMS symptom and that even if it's a "real" symptom it eventually goes away. Physical therapy will help move it around more which, whether it's TMS or not, is a must. It seems like frozen shoulder is a common TMS symptom and but I'm trying to figure out how to challenge it because it just hurts SO MUCH to stretch out the arm. I'm hoping as my anxiety level decreases and I worry less, I'll get more confidence to keep pushing it a little more.

 

This is good news, @tmser.

I have experienced rather significant relief, especially for arm/shoulder stuff, by doing visualizations (a form of mindful meditation) in which I concentrate on the healthy sensation of my other arm NOT being in pain, and imagine both arms feeling that way. It's essential to make the commitment to set aside a good solid five minutes (minimum to start, work your way up to ten or more) in which you can maintain the visualization. You will also practice relaxation and deep breathing, combined with related affirmations that promote the fact that you are safe and that there is nothing actually wrong with your shoulder.

And personally, I don't fault exercise or PT when you make a conscious choice to use it as a TOOL in order to retrain your fearful brain that nothing is wrong. The key is baby steps - don't try to do it all at once - and keep up the constructive back-talk to your brain.