Shoulder’s versatility makes it vulnerable to injury

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DEAR DR. DONOHUE: I am the baseball coach at a junior college. I also teach there. Our league is small and new, and I am new at this too. My star pitcher developed a sore shoulder. His doctor told him he might have a labrum tear. I have picked you as team physician. What is a labrum tear, and how long will it keep him out of play? – R.K.

ANSWER: The shoulder is the body’s most versatile joint. No other joint can move in so many planes and perform such a variety of motions. Its versatility is its undoing. It’s an unstable joint, and subject to frequent injuries. The shoulder joint is a ball-and-socket joint. The ball is the end of the upper arm bone, the humerus. The ball fits into a somewhat shallow socket in the shoulder. There’s a rim of cartilage around the socket that gives it greater depth and provides more stability to the joint. That rim is the labrum.

Labrum tears are not rare injuries. Most of the time, they come from too much shoulder work with too little rest. The cocking and follow-through phases of throwing a ball put extreme compression on the labrum. The cocking phase is the part of the pitch where the pitcher draws the arm back and raises it to head height. The follow-through phase takes place after the release of the ball, when the arm is slowing down rapidly.

Labrum tears are painful when the arm is brought over the head. In that position, they can produce a clicking or popping noise. Sometimes, the arm hangs up for a short time when it’s in the overhead position.

Length of time for recovery from a labrum tear depends, of course, on the extent of the injury. The average time is four to six months. I don’t want to be overly pessimistic about this, but realistically, the season could be over for your star.

DEAR DR. DONOHUE: I’m 75 and have been on a walking program for about 10 years. Now I would like to take up weightlifting. My wife says that at my age it is silly and dangerous to lift weights. Is it? Can a person my age build muscles? – R.P.

ANSWER: People in their 90s can build muscle strength through weightlifting. It’s not especially dangerous to engage in it. You must, however, ask your doctor whether you are up to it.

Muscle strength reaches a peak in the mid-20s. By 50, if a person has been physically inactive and hasn’t used his or her muscles in resistance exercise or work, he or she will suffer a 10 percent or more decline in muscle strength. By age 80, without any weightlifting, there’s at least a 50 percent loss of muscle strength. The loss of strength is responsible for much of the disability that comes with aging.

A starting program for you should be one with somewhat-light weights and lots of repetitions.

Don’t expect massive muscle growth. Muscle growth is not going to be the same in a person’s 70s as it would be in his or her youth. However, muscle strength is achievable. Muscle size and muscle strength are not always related.

DEAR DR. DONOHUE: Can I take a hot shower after swimming? I have swum all my life, and I am still swimming competitively for short distances. This takes lots of practice. It’s my habit to take a hot shower after swimming. People tell me this is dangerous. Why? – B.P.

ANSWER: If the pool water is cold and the shower water is quite hot, the hot water could cause blood vessels to expand rapidly, and that can bring a drop in blood pressure. Most pool water isn’t that cold, and most shower water isn’t that hot, so the danger is not all that real. It hasn’t happened in the past. I don’t believe it will happen to you in the future.

DEAR DR. DONOHUE: What’s the benefit of massages? – F.W.

ANSWER: The good feeling they bring you is enough benefit in itself. They also increase blood flow to muscles, which repairs them, nourishes them and brings them oxygen.

DEAR DR. DONOHUE: I am 33 years old. My last four menstrual periods, which always come on time and are never painful, have been sort of strange. On the day before my period starts, I see what looks like flickering neon lights. The lights are there for about five minutes, and then they disappear. I brought this to my doctor’s attention, but he says he doesn’t know the cause. Do you? – R.K.

ANSWER: The flickering lights could be an aura of a migraine headache.

A small percentage of people with migraines experience visual phenomena before the headache begins. They see flashes of light, flickering lights or brilliant zigzag lines. The light show doesn’t last long. After it goes, the migraine sets in. This is the aura of a migraine.

Furthermore, some women’s migraines are triggered by menstrual periods. Somehow, the hormonal changes of a menstrual period set off the headache.

Putting both of these together makes me think you are having a migraine aura without a migraine headache. It happens. It’s called a migraine equivalent.

I don’t think you should go undiagnosed without having a doctor’s examination. A neurologist or an ophthalmologist would be the doctor to see.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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