“UNDERSTANDING SHOULDER INJURY, PAIN AND RECOVERY”

by :  Alex Garduque PT,STS

            You reach for a shirt or dress from your closet and suddenly “ouch” a sharp pain hits your shoulder. Or just one regular day you notice your shoulder aches… you ask yourself, “What did I do wrong?”, “Where did this ache come from”, “Will this ever go away?”. Your rotator cuff may be injured. For others, the onset of shoulder problems are not as subtle as the examples above, you may have fallen on your shoulder, it may follow a game of baseball or after a weekend of working around your house or cleaning out the garage, even following an exercise class. Your shoulder probably hurts because your rotator cuff tendons are swollen or damaged. And the older we get the more easily we get injured because of weaker muscles and tendons.

            We normally don’t think much of our shoulder until it starts hurting. Then we realize what a healthy rotator cuff allows us to do, our shoulder is a master of motion. When the rotator cuff is damaged, even simple movements can be painful.

A Healthy Shoulder

            A healthy rotator cuff gives your shoulder strength, flexibility and control. The muscles and tendons of the rotator cuff hold your upper arm bone (humerus) in your shoulder socket. Your rotator cuff also assist the large muscle covering your shoulder (deltoid muscle) with movements.

When Your Shoulder Hurts

            Pain told you that something was wrong with your shoulder. Now that you know it’s a rotator cuff problem, you may wonder what caused it. Rotator cuff tendons can become damaged or inflamed (tendonitis) in many ways. This include irritation (overuse), pinching (impingement), calcium deposits (calcification) and splitting (tears). Any of these conditions can make your shoulder weak, tender and painful.

Finding Out What The Problem Is

            Before your rotator cuff problem can be treated, your doctor ( particularly an orthopedic doctor) would need to assess your injury. This means taking a look at your health history and daily activities, then a shoulder exam including physical tests would pinpoint the cause and type of your injury. The use of imaging test would further help your doctor ascertain your injury. Those most commonly used include x-rays, arthrograms or magnetic resonance imaging (MRI).

Treating Your Shoulder Injury

            The care for your injury would normally start with conservative or non-surgical methods. If this does not promote relief, then a surgical method of correction may be approached. Your orthopedic doctor will inform you of this options but it will ultimately be you who would have to make a decision on which type of treatment to pursue. Non Surgical Method of treatment consists of prescription pain medication like oral anti-inflammatory pills, resting your shoulder and receiving treatment from a Physical Therapist. Physical Therapy treatment would normally include use of therapeutic modalities like cold and heat to reduce swelling and calm your pain, use of ultrasound to soothe sore muscles and improve blood flow to further reduce swelling and also help in the healing process. Electrical Stimulation of the muscles and nerves are also employed to decrease severe pain by using electrical impulses to block pain signals coming from your shoulder. A skilled physical therapist would also use Manual Therapy and Therapeutic Exercises to improve your shoulder muscle flexibility, strength and improve your shoulder joint’s function and mobility. But if your pain just won’t go away and your injury doesn’t improve with conservative treatments then you and your orthopedic doctor may decide you need Surgery. Surgical Intervention can treat impingements, calcium deposits or complete tears. The kind of surgical method employed by your doctor will depend upon the type, location and degree of your injury. Arthroscopic surgery entails performing repairs to your joint by inserting tiny instruments through small incisions. Open Surgery requires a single large incision to allow repairs to the joint. Combining both techniques is called Mini-Open Repair. After surgery, your shoulder will heal faster if you follow the treatment and exercise program prescribed by your Physical Therapist. Initially, you’ll probably be using cold packs and a shoulder immobilizer. Gentle supervised shoulder movement is also recommended to minimize stiffness and swelling.

Be sure to ask your doctor about receiving Physical Therapy treatment after your surgery to promote a faster recovery and prevent complications.

Smart Recovery

            Now that your shoulder is starting to feel good again, you would want to keep it that way. Always think about how your moving and using your shoulder, try not to strain it and remember exercise is one of the best way to keep your shoulder fit and strong no matter what your age. Now that you know what to do to keep your shoulder healthy, go back out there and start living the way you used to. Play again and work up a sweat, there’s no better feeling than getting your independence back.