Shoulder Pain and the Rotator Cuff

By: Dr. Rick Weinstein MD

As we get older (more mature), it is very common to develop shoulder pain. Pain may be due to specific trauma, such as lifting weights or directly hitting the shoulder, but it is much more common to develop pain without a specific injury. The most common reason for shoulder pain in adults older than 30 is due to impingement. The acromion bone, which sits on top of the shoulder, can irritate the bursa and then rub against the rotator cuff, causing impingement syndrome. This causes the development of rotator cuff tendinitis or bursitis which causes pain, typically when reaching the arm overhead. If the bursitis and tendonitis persists, this may lead to a tear of the rotator cuff.

The rotator cuff consists of 4 muscles that allow us to rotate our shoulder. The most commonly torn and injured part of the rotator cuff is the supraspinatus tendon, which sits on top of the other tendons. The problem with a tear of the rotator cuff is that if there is a complete tear it will never heal. My goal as a sports medicine orthopedist is to correct the problem in the shoulder before my patients require any surgery. Almost all patients can get back to normal activities with appropriate physical therapy and avoidance of aggravating activities.

How do we prevent shoulder problems to begin with? Typically, when we work out, we stress the large muscles around the shoulder and neglect the smaller muscles. Well-defined deltoid and pecs look great, but they are only part of the shoulder that needs to be strengthened. Simple rotation exercises with the elbow at the side are extremely important to preventing rotator cuff injuries. This should be done with very light weight initially. With any shoulder workouts with weights or machines, it is best to keep the hands in front of the head and not behind the head. Shoulder presses and latissimus pulldowns should be done in front rather than behind the head.

If you develop shoulder pain or weakness of the shoulder, do not neglect this. If it persists for more than a few days, see a sports medicine specialist. It is better to identify if there is a tear or just tendonitis early on so as to prevent needing surgery. Don’t work through pain because you may be causing significant damage. It is always better to prevent an injury rather than have to fix it!

Posted in Fitness and Health Articles, Summer 2014 Newsletter and tagged .