Many people come to my office with pain in the shoulder. It may have started after a weekend on the tennis court, after a fall from a ladder, after digging up a root ball in the garden or sometimes, with no injury at all. We see many sports injuries like overuse from gymnastics, baseball / softball, football or swimming. The muscle / tendon structure called the rotator cuff can play into this painful situation.
The Rotator Cuff is an important part of the shoulder anatomy. A functioning rotator cuff is important for the proper motion of the shoulder joint. It helps lift and rotate the shoulder and keeps it in the right place during shoulder function. When the rotator cuff becomes injured, the shoulder often becomes painful. However, there are other things that can cause shoulder pain so an appropriate diagnosis is very important in the treatment of a shoulder injury.
Some of the other conditions which can cause shoulder pain include biceps tendon tears or other biceps injuries, labral tears or other injuries to the labrum, shoulder arthritis, adhesive capsulitis (also known as frozen shoulder) or a fracture (broken bone) around the shoulder. Also, sometimes referred pain from the neck (cervical spine) because of a pinched nerve can mimic shoulder pain. It is important to differentiate these to find out which one you have.
Let’s say you’ve had a visit with on Orthopedic surgeon and it seems that it is your rotator cuff. If your rotator cuff is sprained or inflamed, that usually is successfully treated with conservative measures. Things like exercises and anti-inflammatories will usually cure the problem. If the rotator cuff is torn, treatment will depend on the degree of the tear. I explain to my patient’s that the rotator cuff circles around the ball of the shoulder like the cuff of a shirt sleeve circles around the wrist. Usually only part of the cuff length is torn and the rest is not injured. We also talk about the thickness of the tear along the length that is injured. A tear can be partial thickness (low or high grade) or full thickness. When it is a low grade tear, many times nonsurgical options can be successful in rehabilitating the shoulder to normal function. Higher grade and full thickness tears will frequently need rotator cuff surgery to restore the function of the shoulder joint. Most of the time if surgery is needed for a rotator cuff tear it is performed through a scope (shoulder arthroscopy) and is an outpatient procedure.
As Orthopedic Surgeons our goal is to return you to what you like to do. Make sure that if your shoulder continues to hurt, get it checked out so you can stay healthy and active.