shoulder pain

Hi,

I am a 67 year old male with a medtronic pacemaker since April 2013. I have no heart issues other than bradycardia from A/V block. I was never symptomatic though an electrocardiogram showed my heart rate was 25 bps. My pacemaker is a lower limit switch set at 50 bps. Over 50bps it is shut off. I have run all my life with decades of 40-50 miles per week and up to 70 miles per week when training for marathons. I now run about 30 miles per week slowly just to keep some semblance of fitness. I am interested in knowing how other runners have fared after pacemaker implants.

My immediate concern is shoulder/upper arm pain on the pacemaker side. I experience pain when reaching up or back such as when putting on a shirt etc.. Is this possibly due to the pacemaker beneath my clavicle? I have had no sudden episode of trauma to cause rotator cuff injury. If it's bursitis it has never been felt before as it has since the implant surgery. I am interested in hearing from anyone. Thank you.
Patrick Town

3 Comments

shoulders and running

by Tracey_E - 2014-01-07 06:01:30

It's possible you didn't move your arm enough during healing and now you have a bit of frozen shoulder. Therapy will help if that's the case. It could be it's close enough to the clavicle to cause pain. If that's the case, not much to do but try to avoid moves that aggravate it. I would get evaluated by a physical therapist.

There are many here who run. You can search other posts in the upper right corner. I run as part of Crossfit every day but do not call myself a runner, because I am awful at it and I hate it. :o) But I do it. My av block does not hold me back at all.

Pm's don't actually shut off. You won't pace atrial if your rate is over 50 bpm. You probably don't pace atrial much at all, if ever, so it's irrelevant where your lower limit is set because with av block our sinus nodes are generally perfectly normal.

Ventricular pacing, what we do mostly when we have av block, is reactive. The pm watches to see when your atria beats, it gives the ventricles a fraction of a second to beat. If it does, the pm just continues to watch the next beat. If it does not, it generates a signal mimicking what the heart should have done on its own, the heart responds by contracting (beating). I would be willing to bet you pace ventricle well over 50bpm. The pm is completing the broken circuit, not setting the pace.

Upper limit is what's important with ventricular pacing, not lower limit. The pm will only pace as high as your upper limit. It's often set 120-130 but can be programmed to go higher as needed. If you occasionally hit a wall while exercising and your rate is too low (like, exactly120 or 130), that is a sign your upper limit needs bumped up. If you feel good when running, then your settings are fine.

Nerves

by Theknotguy - 2014-01-07 11:01:58

They yelled at me every time I attempted to use my left arm (on the PM side). Consequently I got a stiff arm. Before rehab I had pain going up into my left jaw. Sometimes it would be accompanied with thumping in the left jaw. When I started rehab I got a lot of stretching pain in the PM pocket.

You mentioned pain when you reach up and back.

Question in my mind is if you are experiencing PM pocket pain. I still get pain in the PM pocket area when it gets compressed. There are stretching exercises I can't do in rehab because they compress the pocket. I also can't sleep on my left side because my body will compress the pocket. So that may be one explanation for part of the pain you described.

The second pain may be from the location of where the leads go into the vein under the collar bone. We don't necessarily get sensations in that area so the body may interpret that as pain. For me, stretching in the area and mild exercise helped alleviate the pain going up into my jaw. After my surgery swelling went down and I started rehab all of the pain going up into my jaw disappeared.

Another question in my mind is if you can work with a cardiac rehab unit. They would be the best to 1) be aware if you have a problem, 2) direct your exercise to either alleviate the pain or work around it.

My cardiac rehab people have been fantastic at helping me work though the pain, explaining what pain is normal and what isn't, and helping me to move forward with my rehab.

We've got people on this forum with PM's who have trained for and run marathons. So what you're attempting to do isn't unrealistic.

I hope you can get help and start running.

Theknotguy

I also developed shoulder/arm pain

by mkaz03 - 2014-01-08 09:01:12

A few weeks ago I suddenly developed intense upper arm pain on the PM side when I moved my arm a certain way - typically if pulling a towel around me in the shower or pulling a comforter when making the bed or doing a "happy dance" movement on the golf course with my left arm in the air. (Don't have too many of those to worry about!) Yet it does not bother me just to golf. Also happened in certain dressing moves. The pain was so intense it felt like an electric current for about 10 - 20 seconds. Then it would subside and all was well. But this was happening several times a day. I started physical therapy last week and after his stretches and massage it has gotten so much better. Not totally healed yet but I think the PT is definitely working. I have gained a much better range of motion although still cannot raise this arm straight up all the way. At my 3 month interrogation when I mentioned the arm pain to my cardiologist he looked at me like he did not know what I was talking about. As a result I went to my primary care doctor about it. I truly believe it is related to not fully using that arm for so long. Even after I could raise it after the initial 6 weeks I was so used to keeping it down that I probably went another 6 weeks before I realized what I was doing. Suggest you see a physical therapist. Good luck.

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