“My shoulder aches, I think it’s the rotator cuff”.   I hear this a lot and sometimes it’s a correct self-diagnosis.  The rotator cuff is a group of muscles and tendons that surround the shoulder joint and stabilize our amazing, flexible, shoulders.  These structures can get inflamed from overuse, can get torn from wear and tear, or even rupture at an extreme.  Most injuries are inflammatory or partial tears that heal with time and treatment.

How can I prevent issues?  Keep your upper back muscles strong.  This ensures you’ll use your big muscles more and your rotator cuff muscles for tine tuning movement.  Warm up gradually before throwing sports or any repetitive upper extremity activity including tennis, pickle ball, etc.  Gently stretch after your warm up, as well.  Know your limits and if you’ve over done it, ice the shoulder after activity for 5-10 minutes.   

Treatment might include nsaids like advil/alevel, ice as noted above, and massage therapy as well.  Relative rest is helpful for a short period if you’ve over done it.  If pain persists or you are unable to elevate your arm above shoulder height, see a qualified Sports Medicine or Orthopedic Physician.  Physical therapy is a great treatment option.  Some people benefit from injections of anesthetic and cortisone derivatives, as a diagnostic and therapeutic intervention.  Repeated cortisone injections may be ill advised, but a single injection is quite safe. 

Imaging may be helpful.  X-rays can rule out unusual conditions, look for bone spurs, or calcium deposits.  MRI imaging is more detailed and can show soft tissue tears of the rotator cuff and labrum.  But MRI is rarely needed until you’ve tried conservative treatments for at least a  month.

When you recover, go back to the beginning of this essay.  Strengthen your upper back, work on flexibility, do great warmups and some stretching to stay healthy.

 Dr. Schechter practices in Culver City and is a Sports Medicine/Family Medicine physician.  He offers shoulder exams, orders appropriate imaging, does injections that can help heal and prescribes physical therapy with referrals when needed.