Health Q&A: painful calcium deposits sports check-up

Dr David Roche / 19 September 2014

Saga Magazine's Dr David Roche answers a question on painful calcium deposit, plus how to get a fitness check-up.



Calcium deposits in shoulder: how can I manage the pain?

I have experienced debilitating pain in my shoulder for more than a year, and a scan has revealed calcium deposits in my shoulder. I take ibuprofen daily, but the pain is getting steadily worse. Can you advise me about pain management (I work full-time and drive), and what will happen in the future. Will the pain dissolve, or spread, or just become increasingly painful? It keeps me awake every night and I am at my wits’ end.

 

This condition is called calcific tendonitis and, as you describe, can be very painful. Calcium deposits build up in one of the tendons of the shoulder, causing pain in itself but also contributing to inflammation and swelling such that the tendon catches on other structures in the shoulder, further exaggerating the pain. The deposits in the tendons (usually the supraspinatus tendon) can be detected on x-rays and ultrasound scans.

You may well need more powerful analgesics than simple ibuprofen so consult your GP. Physiotherapy is useful to maintain function in the shoulder as it often stiffens considerably in these circumstances. A steroid and local anaesthetic injection into the area of the painful tendon is a useful strategy if simple pain relief does not work and in some circumstances the calcium deposit can be injected under ultrasound guidance and then the calcium sucked out using the syringe.

Finally, if all else fails, surgery can be used to remove the deposit and free up the tendon, this is referred to as a subacromial decompression and is performed through a small incision and the use of an operating endoscope (arthroscope).

Where can I get a specialist sports check-up?

I have always been a keen cyclist and regularly use my static bike with a heart-rate monitor. I warm up, hold my ‘target’ heart rate for 30 minutes, then wind down. For my target rate I have followed the beats-per-minute formula of aiming for 80% of 230 minus one’s age (eg 136 bpm for a 60-year-old). Do these calculations work for someone well past 60 (I’m 79). I would also like a general check-up, for which I’d be happy to pay. How can I find a specialist sports doctor to do this? I’m worried that my GP would just play safe and counsel easing up.

 

If you are capable of this sort of exercise at 79 years then you are very fortunate and to be congratulated. Your body will be used to the regime so continue as long as you can. The body is less able to take on demanding new patterns of exercise as you get older so it pays to stay with exercise you are used to.

There are a variety of calculations for target heart rates, all leading to approximately the same figures. Age is part of the calculation so it automatically adjusts as you get older. It is, however, only a guide and is an average over a large population. Exercise abilities vary enormously so it does not pay to follow the calculation too slavishly. You may be comfortable at higher heart rates than predicted by the formula, if so and you can maintain it for thirty minutes then go ahead.

A general check up would be reasonable and most private hospitals provide such a service. You do not need a specialist sports physician for this, they are very unlikely to be doing such medicals. Measuring your exercise ability with specific tests at your age would be meaningless, you are doing well and as long as you are comfortable then continue. Not all GPs would recommend that you ease up, for example I would not.



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