Rotator Cuff problems are the most common cause of shoulder pain I see in my clinic.
One thing I wish I could get patients to do is get their shoulder pain checked out earlier.
While some patients may have an acute injury which tears their rotator cuff , most patients have a slow progression of shoulder pain without a history of injury. There is usually difficulty with simple activities such as reaching up or behind the body. Trouble sleeping on the bad shoulder is usually the number one complaint. When weakness develops the rotator cuff tendons are no longer working properly.
The rotator cuff is a group of muscles around the shoulder blade that work together to raise your arm overhead and behind your back, such as getting a shirt on or reaching into the back seat of your car. These muscles are attached to your upper arm or humerus by tendons. It is these tendons that usually have the trouble. Over a lifetime of repetitive reaching the tendons of the rotator cuff rub against ligaments and bone “spurs” in the shoulder and wear out. Initially the bursa tissue around the tendons may just be irritated. We call this rotator cuff bursitis. Then the tendons themselves become inflamed. This is called rotator cuff tendonitis. Eventually the tendons may tear or pull away from the bone.
Tips to prevent Rotator Cuff injury
- Do regular shoulder stretching exercises
- Take frequent breaks if your work involves repetitive shoulder or arm motions
- Rest your shoulder regularly if your sport requires repetitive shoulder use
- Use ice if your shoulder is painful or inflamed
- When lifting weights for a shoulder workout, keep your hands where you can see them in your peripheral vision at all times. There is more risk of injury with moves that place your hands out of sight such as pull downs behind your head.
Rest, anti-inflammatory medicines, and physical therapy may be the first treatment tried for rotator cuff problems that are not acute. If this does not work then a procedure to repair the torn rotator cuff may be necessary. Today, most tears in the rotator cuff can be repaired arthroscopically. This involves making small incisions around the shoulder and using a camera and special instruments to sew the torn tendons back down to the bone so that they can heal correctly. This procedure is done in about an hour or two and you can go home the same day! After shoulder arthroscopy there is a rehabilitation period that may take 6-12 weeks depending on how big the tear is. It may take longer to regain your full comfort to do repetitive overhead activities such as sports.
With an acute injury that tears the rotator cuff an early repair will have a better outcome and return to lifestyle. With the more common slow progressive rotator cuff problems an early understanding of the problems and shoulder rehab program will help more than half of my patients get better without surgery.
Most people don’t realize that their upper arm pain is coming from the shoulder. Or like most of us we hope it will just go away on its on.
If you have pain around your shoulder giving you trouble and keeping you up at night, get it checked out and do something before it becomes a bigger problem.