There is an astounding 30-50% of people that will suffer from some type of shoulder pain in their lifetime. Swinging a tennis racket, digging in the garden, placing a book on a high shelf, and reaching back to insert your arm into a sleeve — these are some of the movements made possible by the shoulder’s enormous range of motion. We use this mobility in so many activities that when the shoulder hurts, it can be disabling. For younger people, sports injuries are the main source of trouble, but the rest of us have more to fear from the normal wear and tear that, over time, weakens shoulder tissues and leaves them vulnerable to injury. The risk is greatest for people with occupations or hobbies that require repetitive or overhead movements, such as carpenters, painting, tennis, or baseball.
The most common cause of shoulder pain is rotator cuff tendinitis — inflammation of key tendons in the shoulder. The earliest symptom is a dull ache around the outside tip of the shoulder that gets worse when you push, pull, reach overhead, or lift your arm up to the side. Lying on the affected shoulder also hurts, and the pain may wake you at night, especially if you roll onto that shoulder. Even getting dressed can be a trial. Eventually, the pain may become more severe and extend over the entire shoulder and affect your neck and back.
If you do nothing about it, tendinitis can lead to the fraying or tearing of tendon tissue. Fortunately, rotator cuff tendinitis and even tears can usually be treated without surgery.
Rotator cuff diagnosis
Most clinicians diagnose rotator cuff tendinitis by taking a history and performing a physical examination. However, if you’ve suffered a traumatic injury or the shoulder hasn’t improved with conservative therapy, or if a tear is suspected, an x-ray or MRI may be ordered. Your clinician will also check for tenderness at a point near the top of the upper arm (the subacromial space) and look for pain as the arm is raised and moved in certain ways. Your muscle strength and the shoulder’s range of motion will also be tested. Pain with normal muscle strength suggests rotator cuff tendinitis; pain with weakness may indicate a tear.
What about a rotator cuff tear?
As we get older, tendon tissue thins out and a tear becomes more likely. Up to one-third of older people with rotator cuff tendinitis have a tear. Minor ones can be treated conservatively, like tendinitis, but major ones may require an operation. Those caused by traumatic injury to the shoulder are often repaired surgically. However, recovery tends to be slow. Many orthopedic surgeons prefer to reserve surgery for younger patients, major tears that are diagnosed early, and older people whose occupations or activities place heavy demands on their shoulders.
Physical Therapy and Shoulder Pain
Depending on the extent of your shoulder pain and your unique medical history, physical therapy may be a very effective non-surgical means of treatment. For issues like shoulder impingement, small rotator cuff tears and mild to moderate osteoarthritis, studies have shown that physical therapy can improve your quality of life, and in some cases, prevent surgical intervention.
Physical therapy treatments for shoulder pain may include: stretching, strengthening, joint mobilization/stabilization. Heat, ice, ultrasound, electrical stimulation or athletic taping may be part of your physical therapy program as well.
Your physical therapist can also provide advice on activity modification and work-place ergonomics. Your physical therapist will also work with you to create a comprehensive home exercise program that will help you maintain your quality of life beyond your therapy sessions.
Don’t live with shoulder pain, address it now so you can get back to living your life pain-free. Contact Dr. Tara Jaeger, PT at 701-412-1873 today to schedule your shoulder evaluation!