The Most Common Cause of Shoulder Pain

As the weather warms up, we tend to get more active outside. Whether it’s gardening, walking the dogs or going to the pool, summer is a time of increased activity for most people. With that increased activity, it is common to notice new aches and pains. A frequent injury we see year-round but more often in the summer months is injury to the tendons in your shoulder, called the rotator cuff. It is the most common cause of shoulder pain we treat at Denver Health.

What is the rotator cuff and what does it do?

The rotator cuff is an envelope of muscles and tendons around your shoulder that helps you move your arm. The four tendons of the rotator cuff, subscapularis, supraspinatus, infraspinatus and teres minor, help stabilize your shoulder joint. The subscapularis lives in the front of your shoulder, the supraspinatus on top, and the infraspinatus and teres minor in the back. These are relatively small tendons with associated small muscles when compared with other muscles in your body like the large quadriceps muscle in your thigh. Due to their small size and the amount of movement performed by your shoulder joint, they are frequently injured. They are also uniquely susceptible to wear and tear as you age. It is common, and normal, for our rotator cuff to wear out or slowly tear as we age.

Starting new activities or even sleeping funny can flare up pain in your rotator cuff.

How do you know if you have a rotator cuff injury?

When the rotator cuff is injured, most patients notice difficulty raising their injured arm above shoulder level. They also frequently notice weakness with movements above their head such as putting away dishes in the kitchen or trying to wash their hair in the shower. They may also have pain at night and difficulty getting comfortable when trying to go to sleep.

Some rotator cuff injuries are very dramatic. You may hear or feel a pop with immediate pain in your shoulder when doing something active. Other injuries are more subtle. You may notice a slow increase in pain and weakness over a long period of time.

Seeing your doctor is the first step in diagnosing a potential rotator cuff injury. You need a physical exam by an experienced practitioner to assess the strength and health of your rotator cuff. You may also need imaging such as an X-ray or MRI to look closer at your shoulder.

How can you treat a rotator cuff injury?

The way you treat a rotator cuff injury largely depends on how it happened, your overall health and age, as well as your symptoms. Some rotator cuff injuries need surgery, while others do very well with non-operative treatment.

As a general rule, it is hard to surgically fix wear and tear on the rotator cuff that has occurred over time. It is also hard to operate successfully on injuries that occurred several years ago. Surgery is more likely to be recommended for injuries that occur because of a recent fall or accident and recent injuries to a previously healthy rotator cuff do the best after surgery.

Even if your injury is not able to be fixed by surgery, there are still many things we can do to help your pain and function after a rotator cuff injury. Physical therapy is very important to rebalance the muscles and tendons that you still have in your shoulder. You can also get injections of corticosteroid into your shoulder to help decrease inflammation and pain after an injury. Although rotator cuff tendons do not heal, you can be very functional and pain-free after a torn rotator cuff with the right treatment.

Overall, it is important that you see your doctor in a timely manner if you think you have injured your rotator cuff. If you are having pain of any type in your shoulder, make an appointment with us so we can check it out. In most cases no referral is needed. We are here to keep you healthy and active through all the seasons of life.