Not all orthopedic shoulder injuries and conditions are created equal! The shoulder is an amazing joint, allowing greater motion than any other joint in the body. This range of motion enables you to perform a variety of tasks, activities, and exercise. The design of the shoulder joint, with a “ball” moving within a “socket”, is what allows this tremendous mobility. The strength and stability of the shoulder needed for reaching and lifting overhead, as well as away from your body, is made possible by an important group of muscles called the rotator cuff. This group of four muscles is made up of:
- The supraspinatus muscle
- The infraspinatus muscle
- The teres minor muscle
- The subscapularis muscle.
These important muscles surround the shoulder joint and work as a synchronized group to keep the “ball” of your shoulder (the humeral head) within the socket of your shoulder (the glenoid). A healthy shoulder requires the rotator cuff muscles to work in sync. With many shoulder injuries, the rotator cuff muscles can become weakened, imbalanced, inflamed, & even torn, making reaching & lifting movements painful and sometimes difficult, if not impossible, to perform.
Why does my shoulder hurt?
Pain in the shoulder can result from several rotator cuff injuries or conditions.
Overuse of the shoulder can cause inflammation and pain. This inflammation may result from overzealous participation in a new activity, or an increased volume or intensity of something that has been a routine activity. Essentially, overuse strains/tendinitis are caused by going “too hard, too fast, too soon.” An improper workout progression or training schedule can result in shoulder inflammation. This can be seen in swimmers and other endurance athletes, as well as in general conditioning, weightlifting and particularly those athletes involved in high intensity interval training. Other scenarios include the “weekend warrior” who develops shoulder inflammation after spending an entire weekend painting all the rooms in the house or trimming tree limbs. A sudden increase in the amount of overhead reaching can result in rotator cuff inflammation and pain.
With acute rotator cuff injuries, there is a sudden, traumatic event that triggers the onset of pain. Acute rotator cuff injuries can result from a slip, trip or fall, or as the result of a quick jerking or lifting movement. The sudden onset of shoulder pain, with shoulder weakness, or a tearing sensation may be felt with an acute/traumatic rotator cuff injury.
Chronic degenerative rotator cuff injuries
Degenerative rotator cuff tears are a common type of rotator cuff injury. They result from every day “wear and tear”, and are common as we age. Degenerative rotator cuff injuries do not typically have an abrupt onset, but rather pain develops gradually and gets progressively worse over time.
Combined Acute injury with underlying chronic/degenerative rotator cuff damage
Often shoulder pain results from a combination of gradual degeneration of the muscles and tendons of the rotator cuff, and then an acute/traumatic injury occurs, which creates a combined, and often more complex, problem.
How will you know if you have injured your rotator cuff?
Many patients describe a dull deep aching sensation in the shoulder with rotator cuff injury. Your sleep may be interrupted, particularly if you rest on your affected shoulder. It can be difficult to wash or comb your hair as well as reach behind your back with a rotator cuff injury. There may also be a decrease in strength and endurance. If you are experiencing any of these shoulder symptoms, it is important to seek medical attention by a qualified healthcare professional with orthopedic experience.
What to expect at your orthopedic appointment.
Your appointment for shoulder pain involves a thorough history and comprehensive physical examination of your shoulder by an experienced orthopedic provider. Many times, x-rays will be ordered to look for other possible sources of shoulder pain. Based on individual findings, an MRI scan can be considered to get additional information. Treatment can initially consist of conservative management to include, rest, ice, anti-inflammatories, and rotator cuff specific rehabilitation exercises. Occasionally, an injection of a corticosteroid will be recommended along with Physical Therapy. Thankfully, the majority of rotator cuff injuries will improve with conservative management. However, depending on the severity of the injury, surgery may be necessary to restore normal strength and function of your shoulder. Surgery, most often, can be performed arthroscopically, through minimally invasive incisions using a camera and small instruments. Occasionally, for more complex cases an incision will be necessary to perform the shoulder surgery. Regardless of the treatment, it is important to follow your orthopedic provider’s instructions and rehabilitation guidelines to best recover from your shoulder injury.
To schedule a comprehensive appointment with Dr. Kevin Supple to diagnosis your shoulder pain, contact us at 336-545-5001 or request an appointment HERE. Together, we will develop an individualized treatment plan for you to Emerge Stronger. Healthier. Better.