### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hi I have an old shoulder surgery that I fell again 6 weeks after the surgery and the doctor said I needed to have surgery on it again. but I didn,t. i also have a heart condition. I am having pains down that arm about 1/3 of the way down. what do you think it could be from? Thank you Rlkl;Gray

### output:

Hi, as you mentioned you have an old history of surgery of the shoulder what surgery was it? Based on that it will be possible to give inputs. Also, as you said the pain is a older one I will recommend you to do some static neck exercises followed by shoulder girdle Strengthening exercises. Perform the upper limb strengthening exercises as well. Now since the old history of surgery is unknown there are two possibilities - either the pain is due to the Nerve getting pinch in the nerve or either it is due to muscle weakness of the shoulder girdle. But in either of the cases to keep into consideration I have recommended exercises for both.Also, to understand that most pains in body is due to alteration happening in the normal anatomical position of the joints. And this thing can be corrected by only performing exercises as muscles support the bones and the joints in the normal anatomical position. Also, a physical therapist will help you with ultrasound therapy and TENS therapy for pain. This is the try you can perform before thinking further on the surgery aspect. As with physical therapy there is a mass reduction in pain and also strength in the muscles. Once the joint is stabilized by the muscle post stretching the Need for the surgery is reduced. With the grace of God I wish you a good health.regards Jay In Chat Doctor. 