JeffG Asked :
I am a healthy 46 year male who injured my right tricep lifting weights at the gym a week and a half ago. I wasn’t able to move my arm far enough to even use a fork for 3 days. My arm was swollen and sore, but I used ice and then wrapped it in an Ace bandage off and on for days.
It seemed to be getting better until yesterday when I noticed that my arm and my hand were both swollen. It wasn’t red or hot, just puffy and soft, but slightly uncomfortable. This morning the swelling was worse so I saw my doctor. She thought is might be a small blood clot so I had x-rays and a sonogram on on my arm to look for a clot. Nothing was found, but my right arm and hand are still swollen even though my tricep stopped hurting days ago.
Do you have any idea what could be causing this and any recommendation for treatment?
This question was posted under the Swollen Arm and Swelling of the Hand article.
Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.
Dr. Chris Answered :
A lot depends on how you were taking care of your injury after you strained your tricep muscle. It is important to remember for future reference that it is better to immobilize the affected limb when it is strained until the muscle heals. Strapping, where adhesive bandages are placed on the skin along the course of the affected muscle, is different from bandaging an area and this is what could have been done at the time to give the muscle support. Bandaging, especially if too tight, will reduce blood flow and lymphatic drainage and it is best to consult with a physical therapist before treating severe muscle injuries on your own.
The fact that you are not experiencing any pain and the range of motion is normal now means that the muscle strain has eased and there is no reason to suspect a torn muscle, tendinitis and so on. These can all contribute to widespread swelling in the region. This swelling that you are experiencing could therefore be due to a number of other reasons.
You may have strained other muscles in your upper limb and not have noticed it because you were so focused on the tricep muscle injury which was obviously worse. Alternatively you may have tried to compensate for the injured tricep muscle by overworking the other muscles of your arm and hand. Continued use of the other strained muscles can lead to swelling. The fact that it is not red, hot or paining may indicate that there is no current inflammation or even an infection like cellulitis. However this should not be ruled out entirely until your doctor says so.
The swelling therefore could be related to lymphedema where the lymph fluid is not adequately draining from the upper limb. There are numerous causes for this and your doctor will need to conduct further investigations to confirm this. Refer to the article on Swollen Lymph Nodes and Lymphedema.
Discuss your case with your doctor. If you have used any ointments as a muscle rub or attempted massaging the limb at the time of the injury, it is important to mention this to your doctor. These actions could have caused some soft tissue injury which led to the swelling.
Immobilizing your upper limb in a sling may be a good idea although with lymphedema, the lack of motion could aggravate the swelling further. Avoid hot/cold therapy, massage, manual lymph drainage and other therapies until you have received the green light from your doctor.
You age, irrespective of your fitness level, raises many concerns about other conditions but this is best left for your doctor to identify. Your doctor seems to have been quite thorough in her approach thus far but you will need to have a follow up consultation with her so that she can continue her investigation.