Understanding Shoulder Injuries
The word "rotator cuff" refers to a group of four muscles that hold your shoulder in its shallow socket while larger muscles move it around. The most common cause of shoulder pain is rotator cuff strains and fractures, which account for 4.5 million hospital visits per year. Injuries are classified by the amount of damage as "partial tears", "full-thickness tears" or "ruptures".
A "partial tear" is the result of one side of your tendon been partially frayed. A "full-thickness tear", sometimes called a "complete tear", is when there is a hole or slit in your tendon, much like what would be created by running a knife length-wise down a rope. A "rupture" is the most severe form of injury and it means that your tendon has been torn into two pieces.
Acute injuries such as dropping, pushing, dragging, tossing, or lifting account for less than 10% of rotator cuff tears. Repetitive strains over a long period of time are responsible for the vast majority of injuries. One of the most common reasons that people start to develop a rotator cuff tear is something called "impingement". Impingement essentially means that the section where your rotator cuff tendon lives have simply become too crowded and the rotator cuff tendon is being pinched each time you raise your arm.
People who perform repeated overhead activities are usually at the greatest risk for impingement and rotator cuff tendon problems. This usually includes athletes who play baseball, volleyball, tennis, rowing, weight lifting, swimming and archery, and jobs that include carpentry, painting, wallpaper hanging, cleaning windows and washing/waxing cars. Other forms of risk factors for rotator cuff problems include smoking, obesity, high cholesterol and prior cortisone injection.
A "tearing" or "snapping" sound and feeling is frequently recorded by patients who have experienced an acute rotator cuff injury, which is accompanied by intense pain and weakness. Most chronic strains start silently with symptoms slowly becoming more evident as the tear progresses. Pain is usually found in the front and outside of your shoulder but can also sometimes radiate down your arm.
Symptoms are usually aggravated by overhead activity and may progress to the point that you have difficulty raising your arm overhead. Pain is typically made worse at night, especially when you lie on the impacted area of your shoulder. Be sure to tell us if you suffer from significant neck pain, shortness of breath, chest pain or chest pressure.
In certain cases, young patients who have experienced an acute tear or rupture will need surgery, while the majority of others will benefit from conservative therapies like those provided in this office. Be sure to avoid painful overhead activity or carrying heavy objects.
Try not to sleep on your irritated side, especially with your arm outstretched overhead. You may benefit by sleeping on your side that has not been impacted with a pillow between your arm and trunk. Smokers should do their best to quit and find a program to help them do so, and overweight patients will recover quicker if they begin a diet and exercise program. Performing your home exercises is especially important.