Our shoulders are the most mobile joint in our bodies, allowing us to raise, bend, rotate and swing our arms. However, this mobility comes with a cost – the unique anatomy of the shoulder that allows for mobility also allows for instability, leaving us vulnerable to injury.
In fact, shoulders are among the most frequently injured joints in the body, with the main culprit stemming from the rotator cuff, the part of the shoulder that allows you to lift and rotate your arms. Over 3 million Americans each year are affected by rotator cuff problems. To maintain strength and function of your arm, it is important to address shoulder pain as soon as possible.
The rotator cuff is a group of four muscles that come together as tendons to insert into the humeral head keeping it centered in the shallow socket of your shoulder joint. Injury to the rotator cuff comes in two forms, either from injury or degeneration.
Athletes, particularly swimmers, tennis players and baseball players, and those in certain professions, such as construction workers, may be more prone to rotator cuff injury due to repetitive arm motions. And, as we get older, our risk of rotator cuff injury increases due to degeneration of the tissues and osteoarthritis. Tears are most common in those over 60.
Symptoms may vary for each person, but include:
• Pain or weakness as you raise or lower your arm
• Limited range of motion
• Pain that disrupts sleep, particularly if sleeping on the injured side
• Pain in front of the shoulder that radiates down the side of your arm
• Cracking or popping sensation when moving the arm.
A patient’s description of their pain, a physical exam, diagnostics through X-ray, MRI or CT help determine if the pain is the result of tendonitis, a partial tear or full tear of the rotator cuff.
The good news is most rotator cuff injuries can be treated through conservative measures, with few requiring surgical repair. However, it is important to see a physician if you are experiencing shoulder pain because, if left untreated, rotator cuff injuries can lead to permanent loss of motion and weakness, and result in degeneration of the shoulder joint itself.
• Rest – When your shoulder hurts, it’s important to refrain from repetitive motion and keep your elbow below your shoulder. Keep in mind, however, some movement of the arm is important to prevent (secondary) frozen shoulder.
• Ice, heat and anti-inflammatory medications help relieve swelling and inflammation and manage pain.
• Physical therapy – exercises can help improve range of motion and strengthen the affected area.
• Injections – if more conservative treatments fail, steroid injections often can help reduce inflammation to settle the muscles and tendons.
The key to rotator cuff injuries is that they take time to heal. Most people can successfully relieve their pain and regain mobility and strength if they are patient and remain committed to conservative treatments and to their therapy program.
Dr. Matthew Levy writes about orthopedics for the Cleveland Jewish News. He is an orthopedic surgeon at St. Vincent Charity Medical Center and practices in Solon, Independence and downtown Cleveland.