The shoulder is a complex joint. It’s a meeting of three bones and a number of muscles that converge in the area, including the biceps, triceps, deltoids, trapezius and more. Also, there are tendons that connect muscles to bones and ligaments that connect bones to each other.
All of those intricate structures means a greater chance that something can go wrong, and one of the most common causes of shoulder pain is issues with the rotator cuff. The rotator cuff is a group of four muscles and their tendons that help keep the humerus (upper arm bone) in the shoulder socket (called the glenoid) and allow the arm to be raised and moved in many directions.
Common Rotator Cuff Problems
One of the more common conditions of the rotator cuff is tendinitis, an irritation of one or more of the rotator cuff’s tendons. Tendinitis of the rotator cuff is often caused shoulder impingement, where the tendons rub against a bony structure on the scapula (shoulder blade) called the acromion process, resulting in inflammation.
Another usual problem is a rotator cuff tear. The tears occur in the tendon(s)—or muscles, less commonly—of the rotator cuff and can be partial or full. The tear often begins when the tendon or muscle frays like a piece of rope. Over time, or because of an acute injury, the tendon can partially or fully detach from the humerus (upper arm bone).
How Rotator Cuff Injuries Can Happen
Rotator cuff injuries can happen from acute injuries, such as when you lift something heavy, or from overuse. People who partake in activities that involve a lot of overhead movement—tennis, weightlifting or painting, for example—are susceptible to overuse injuries.
Rotator cuff injuries are painful, and they may keep you from raising your arm over your head. This might make everyday activities like putting on a shirt more difficult, and might take you out of your job or away from your favorite activity.
Shoulder Prehab
Strong, healthy shoulders are one of the best defenses against rotator cuff injuries. I recommend that people stick to lower weights with higher repetitions of exercises when they exercise to keep the rotator cuffs healthy. High weight and low repetition sets should be avoided, especially of the bench press and variations of the overhead press.
When you are not as concerned with maximal strength as you are with healthy shoulders, you will have a number of options and tools at your disposal. Exercise bands, light kettlebells or dumbbells, medicine balls and even your own bodyweight can all be effective tools for strengthening the shoulders and guarding against rotator cuff injury.
Treating Rotator Cuff Injuries
Many treatment methods and tools are available to treat rotator cuff injuries. Nonsurgical treatments clear up about 80 percent of cases of rotator cuff injuries. Some nonsurgical treatments include:
- Physical therapy
- Anti-inflammatory medications
- Steroid injections
- Rest
- Activity modification
Surgical treatment usually involves reattaching the tendon to the humerus with sutures. Surgery can be done as an open repair with a large incision, or arthroscopically with small incisions and a flexible camera called an arthroscope attached to a video monitor. Your surgeon will discuss the options with you and tell you why one approach may be better than the other.
I have treated hundreds of rotator cuff injuries in my practice, and I’ve written extensively on the subject for numerous medical publications. Rotator cuff treatment and injury prevention is a particular passion of mine. Please don’t hesitate to schedule an appointment with me or any of Summit Medical Group’s orthopedic specialists to discuss treatment options for your shoulder pain.
