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I'm 54-years old and still like to get out on the ice and play broom ball or a little pick up game of ice hockey. Last season, I fell onto my elbow and felt a squishy sensation in my shoulder. Now I can hardly lift my arm up and hold it there without pain and weakness. What should I do?

If you haven't already seen either your primary care physician or an orthopedic surgeon, that might be your first step. A clinical exam and some imaging tests (X-rays, MRI) will probably help identify the problem.

A traumatic injury through the elbow to the shoulder can cause damage to a number of different structures in the arm. The doctor will make sure there isn't a fracture that hasn't healed. The muscles, ligaments, and shoulder capsule will need to be examined.

The most common shoulder injury from this type of fall is a rotator cuff tear. Painful and weak motion suggests a major tear in one or more of the four muscles of the rotator cuff. Painless and weak is more typical when the tendon has ruptured completely.

The rotator cuff covers the shoulder and helps stabilize the head of the humerus (upper arm) in the shoulder joint. Sometimes other injuries accompany a rotator cuff tear. This is impossible to tell without further testing.

Sometimes a specific rehab program can give good results. But in some cases, surgery is needed. Again, a medical exam is needed to know for sure the cause of your symptoms and the best course of action.

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