Shoulder - Rotator Cuff Injuries

What things do you need to consider if you have shoulder pain?

First of all, you need to know that shoulder pain can be due to a variety of factors including long-term, repetitive, injuries such as those found in a baseball pitcher or a painter to acute, traumatic, injuries such as a dislocation while falling down. Shoulder pain can also be due to referred pain from the neck or organs.

Next, you need to understand that the shoulder is complex and unique due to the fact that it allows for a very large range of motion and thus needs to be stabilized by numerous soft tissue structures such as muscles, ligaments, tendons, and cartilage. You could compare the ball and socket joint part of the shoulder to a golf ball sitting on a golf tee.

       

Since there are numerous structures that make up the shoulder and provide it stability, as mentioned above, there are numerous potential problems that can occur at the shoulder joints. Let’s focus on rotator cuff injuries.

The rotator cuff is a set up four small muscles, along with their tendons, that act to move the shoulder internally and externally. Another large role that this small group of muscles plays is to…you guessed it…stabilize the shoulder.

So, when these muscles contract, they actually help keep the golf ball on the tee so to say. These muscles act from different sides of the joint which means that they must work in unison in order to be effective. An injury to any of these muscles and their tendons can mean the beginning of larger problems for the shoulder joints. Let’s take a look at how injuries to these muscles and tendons can occur.

One way injury can tear a rotator cuff muscle or tendon is through a fall onto an outstretched arm. Besides affecting the lower arm, it can jam the shoulder in a number of directions which may actually dislocate the shoulder itself. Usually once someone has dislocated their shoulder; it may give them problems further down the line. So, it is easy to see why proper strengthening of these muscles is important if you have dislocated your shoulder. If it is determined that one of the muscles or tendons has suffered a partial or complete tear, surgery is typically considered only after greater than 3 months of shoulder strengthening exercises has been done under proper supervision. When these muscles or tendons tear, the body attempts to heal the area by laying down scar tissue to bridge the gap. This scar tissue is created in a random and disorganized fashion only concerned with mending the muscle and with little regards to future function of the muscle and thus the joint.

Another way injury can occur to the rotator cuff muscles is through repetitive stress movements. These injuries are often done by wearing away at the muscles and tendons over time. Poor posture, faulty shoulder and cervical spine biomechanics, and physical deformities can all be culprits in wearing away at these crucial structures in the shoulder. The rotator cuff tendon that sits over the top of the shoulder helps to hold the upper arm down. If this part of the cuff starts to wear away or tear, the upper arm tends to ride too high near the joint and cause further wear and tear in this area to the surrounding bone, bursae, and cartilage. As explained above, the body attempts to heal structures in this area by laying down scar tissue. The area also lacks a large amount of blood supply which can mean slower healing times than other areas unless blood flow is stimulated. Gone untreated or ignored, this tissue can lead to long term shoulder pain.

Brad Zupancich, D.C. is the clinical director of Z Spine and Joint Center located within Solimar Wellness Spa in Eagan, MN -(651) 686-6686. Dr. Zupancich is a certified practitioner in the Graston Technique as well as a certified physician with the Motion Palpation Institute.

Any advice or opinions given in this article are not intended as a diagnosis or substitute for an examination from a healthcare practitioner. For more information visit www.ZSpineAndJoint.com or www.GrastonTechnique.com.