Rotator Cuff Pain

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Many times when a person has shoulder pain, you will hear reference to the Rotator Cuff.  The rotator cuff (not “cup”) is comprised of the many muscle tendons that move the shoulder joint.  Tendons attach muscle to the bones.  These tendons meet at the shoulder joint and form a “cuff” which moves and stabilizes the shoulder joint.  A problem with any one part of the rotator cuff tendons will usually cause pain with many different shoulder functions.  You may hear many different medical terms associated with the rotator cuff.

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Impingement

An impingement means some structure is being pinched inside the shoulder joint we it moves.  It is usually a nerve or tendon that is pinched.  If a nerve is pinched, it may also produce numbness, tingling or burning sensations in the shoulder, arm or hand.  Often these are described as “electric shock” like pains, quick short-lived pain, but VERY painful.

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Tear

A tear is when the tendon is torn.   There are two different types:

  1. Complete Tear: The tendon is torn all the way through.  Surgery is often indicated in this case.  Pain will occur when the injury happens, but the patient will often be pain free afterwards.  This can be very misleading and often make people delay a trip to the doctor because it “doesn’t hurt anymore.”
  2. Partial Tear: The tendon is torn part of the way through.  Surgery may or may not be needed.  This depends on the current pain level, and the movement and use of the shoulder that remains.  It also depends on your age and what activities you wish to return to.  Often physical therapy is begun to improve your movement and strength.  After a few weeks, your progress will be reassessed to see if you are making good gains towards your goals.  If not, you will be advised to return to your doctor.

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Tendonitis

Tendonitis is the inflammation of a muscle tendon.  The tendon slowly becomes worn away and aggravated with repetitive movements.  It begins to inflame and enlarge when aggravated.  Once enlarged, the tendon can no longer glide through the joint like it could before without causing pain.  The motion does not have to involve heavy lifting or difficult movements, just the same thing over and over and over again.

If left untreated, shoulders can become “frozen” or turn into Adhesive Capsulitis.  Once a “frozen shoulder” occurs, rehabilitation can b a very long and painful process.

A physical therapist can asses your shoulder and help identify your specific problem.  Physical therapy can help improve your shoulder motion, reduce your pain, and allow you to return to your normal functioning.  In many cases, physical therapy can improve your function to the point where surgery is NOT NEEDED! 

Often, I hear people say:

“I will just have to have surgery anyway, so I’m just going to do what I want until I can’t do anything.  Then I’ll have surgery.”

This is not the case! And here’s why:

  • If you keep working with an injured shoulder (or any other joint) you can damage it more.  This may make your surgery more extensive, meaning a much longer time to rehabilitate after surgery.  It may also damage your joint to the point that full motion and strength after surgery is not an option.
  • If you push through an injury, other parts of your body will compensate for your injured area.  This can set you up for hurting other areas of your body.
  • Physical therapy before surgery has been scientifically proven to improve your activity level after surgery.  It also limits the amount of physical therapy you will need after surgery to return to your normal activities.

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**Important Point to Remember**

Surgery will fix the joint, tendons, etc.  It will not return your strength and your function.  YOU need to do that on your own…with physical therapy!  And Total Body Therapy & Wellness can help.

If you are experiencing shoulder pain or a reduction in shoulder movement, see your doctor.  Health care should be sought quickly as shoulder motion tends to decrease rapidly.  contact the shoulder specialist at Total Body Therapy & Wellness for more information on how TBTW can improve your shoulder pain and “Heal Your Body, Live Your Life!”

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Blogger: Dr. Sara S. Morrison, PT, DPT, CDT, FCE, CFT, Cert DN, Cert FMT

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