Is it a rotator cuff tear or something else?
Read below to learn common reasons for shoulder pain, and some basic exercises for treatment.
Most people have heard of rotator cuff tears, and maybe even know about impingement syndrome, but what can you really do about it? What about the other causes of shoulder pain that you may not know about? Continue reading to learn about some basic recommendations for treatment that you can do on your own.
Rotator Cuff Tears and Treatment
The rotator cuff is a collection of muscles around your shoulder. These muscles, no surprise, rotate your shoulder. They also work in harmony to help the humeral head (your shoulder) and your scapula (shoulder blade) raise your arm in many different directions.
The supraspinatus is the most common muscle torn. You may experience significant difficulty lifting your arm out to the side or overhead, pain at night, and pain on the outside of your shoulder. The pain may radiate down the upper arm. This muscle is also responsible for the Impingement syndrome diagnosis.
Picture reference: https://www.verywellhealth.com/the-rotator-cuff-2696385
Treatment
Ice or heat?
While it does help to ice immediately after an injury, the honest answer is that if the pain has been around for a while, either one can help. Try both and see which one feels the best to you.
In general, ice helps to numb and decrease swelling, and heat helps to relax the muscles to ease pain.
Apply either one for no longer than 20 minutes at a time, and keep heat or ice off of the skin to prevent injury. Can be done hourly if needed.
Exercises
Shoulder rolls: Seems simple, but small motions done repeatedly help increase blood flow to the joint, assisting with the healing process.
Do 20-30 forward and backwards rolls at least 3 times a day.
Image from HEP2GO
Shoulder blade squeezes: The key here is to bring the lower points of your shoulder blades towards each other, not shrugging your shoulders upwards. This will help to correct your posture, and can alleviate pain.
Do 10-30 repetitions at least 3 times a day.
Image from HEP2GO
Active range of motion: Grab a cane, yard stick, or your other hand to begin gently lifting the injured arm overhead. BE GENTLE! Lift to the point of slight pain, and bring it back down. Over time, you will find that you can lift the arm with assistance higher and higher. Don't worry about getting as high as the pictures below show.
A cane or yard stick can help to move the arm out to the side and overhead. Make sure to keep the thumb pointing up towards the ceiling.
It is very important to keep the shoulder moving. Not only can it help reduce the pain, but if you need surgery, the more range you have going into the surgery, the better your outcomes.
Do at least 10 repetitions in each direction, holding at least 30 seconds if able, at least 3 times a day.
Image from HEP2GO
Biceps Tendonitis or Tear
While not as well-known as the rotator cuff tearing, the biceps is still a major player in shoulder pain. Specifically, the pain will be in the front of the shoulder, and can often get worse at night. The biceps does more than bend your elbow, it also works to lift your arm out in front of you, specifically for the first 30 degrees of motion. It helps to stabilize your shoulder while you are lifting it.
Age and overuse are the common causes of inflammation and tearing. It is often associated with rotator cuff disease, overworking when other muscles are not working as they should.
The long head tendon, if completely torn, presents as a "popeye" muscle. Conservative treatment is usually sufficient, often improving function within 4-6 weeks of therapy.
Surgery is an option, especially if there are other tendon tears within the shoulder. However, surgical intervention does not seem to be better than conservative treatment in the research.
Treatment
Ice or heat?
Either! Generally speaking, ice is best if the injury occurred within 24-48 hours to help with swelling, but it can also help numb pain even after the initial onset. Heat is comforting, and can help decrease pain.
Apply whichever feels best to you for 10-20 minutes, every hour if needed. Keep either one off of the skin to prevent injury.
Exercises
Shoulder rolls: Seems simple, but small motions done repeatedly help increase blood flow to the joint, assisting with the healing process.
Do 20-30 forward and backwards rolls at least 3 times a day.
Image from HEP2GO
Low rows: Improving the strength of your upper back helps to promote good mechanics when lifting your arm and can alleviate pain
Do 10-30 repetitions at least 3 times a week. Make sure that you are fatigued at the end of the repetitions to get the most out of the exercise. Make sure to squeeze your shoulder blade back while pulling to help stabilize the shoulder. Can be done without resistance if it is painful.
Image from HEP2GO
External shoulder rotation: Helps to strengthen your rotator cuff muscles to stabilize your shoulder and reduce pain
Do 10-30 repetitions at least 3 times a week. Make sure that you are fatigued at the end of the repetitions to get the most out of the exercise. Can be done without resistance if it is painful. The towel helps to properly position the shoulder to decrease pain.
Image from HEP2GO
Biceps curls: Can be done with the assistance of your other hand. Work your way up to adding either weights or a resistance band. Make sure that your shoulder blades are squeezed together throughout the motion to decrease pain with the exercise.
Do 10-30 repetitions at least 3 times a week. Make sure that you are fatigued at the end of the repetitions to get the most out of the exercise
Image from HEP2GO
Biceps stretch: Keep the full range of your elbow by making sure to stretch daily. Maintaining your range of motion is important to staying functional.
Hold the stretch for at least 30 seconds, 2-3 times at the end of your range (can be slightly uncomfortable, but should not be excruciating). Do it at least every day, but can be done every hour if needed.
Images from HEP2GO
How Do I Get Comfortable At Night?
Increased pain at night is common. This is because as our heart rate slows, and our blood pressure drops, the blood flow decreases. The shoulder requires blood flow to heal and be comfortable at night.
The least painful position to sleep in for the shoulder is on your back while hugging a pillow. Therapists call it the 30/30/30 position: 30 degrees of flexion, 30 degrees of abduction, and 30 degrees of external rotation. This is the best position to increase blood flow to the shoulder!
This is also a great time to use heat to help increase blood flow and ease pain. Don't use an electric heat pack that does not turn off! No need to cause a fire or burn your skin while you are trying to treat an injury.
Not a back sleeper? You can adapt this position to your side, but it will not be as comfortable.
Images from HEP2GO
Have More Questions?
Find a local physical therapist near you to have your shoulder fully evaluated. In the state of Michigan, you do NOT need a physician referral to be evaluated!
Want to reach me specifically?
Call 734 - 735 - 2421 or email me at: crwellnessLLC@gmail.com
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