Rotator Cuff Pain

Rotator cuff pain can have many causes, the result is always the same, it’s very painful. Usually the other causes include a tear, an inflammation, or scar tissue. Now in the shoulder, there’s a little capsular membrane that surrounds and protects the rotator cuff, and you recognize the beginning of rotator cuff pain, it feels like a little tingle and it always seems to be worse at night. You’d think that when you’re lying down and resting, it would be better, but it actually feels worse then. 

Sometimes it’s called bursitis, or tendonitis, and the difference between these two is that if the bursa is inflamed, that’s bursitis, and if the tendons of the rotator cuff are inflamed, well that’s tendonitis. These two elements of your rotator cuff structure, the bursa and the tendons, tend to move together in a way that keeps them from creating a friction factor on your shoulder. But if the bones in your rotator cuff in the shoulder become too close together, they’ll start rubbing together and this will kind of scratch the bursa and the tendons between the two bones and make them inflamed.

The first thing you should do is see a doctor. There’re so many different little elements that can go wrong when there are different bones and different tendons and bursa involved, that’s it’s best to know exactly what the problem is before you start treating it. And if the rotator cuff pain becomes so bad, your arm will become virtually useless, the pain will be so much that you can’t move it.

Now, as we mentioned, it starts with a bit of a tingle, and then this pain on the top of the shoulder and just at the top of your arm, which eventually moves down the outside of your arm to your elbow. Sometimes, it causes a weakness in your shoulder, so that if you go to carry something that you normally could carry without any problem, it becomes very difficult to carry it. You can’t reach out and try to put on a shirt or a sweater or a blouse with rotator cuff pain it can be almost impossible.

Now one of the treatments in the worst possible cases, surgery may be called for, but most of the time, you can get injections of cortisone, or you can take anti-inflammatory medications. Sometimes, even physiotherapy helps. The good news is that there usually is a cure for rotator cuff pain.

Perhaps I should explain a little more of what the rotator cuff is like. It’s small, but it’s basically a group of muscles that run from the shoulder blade to the upper arm, and they run around your shoulder in a cuff of muscle, and that’s why it’s called the rotator cuff. It’s like a little cuff of muscle that allows your shoulder to move in all the different ways your shoulder could move. These muscles are kind of woven together, and they go under and over the bones. At some point in everyone’s life, they probably have a little bit of rotator cuff injury. Sometimes, it’s just a little twinge and if the cause of it isn’t repeated, it can heal itself. However, it usually is more than just a little twinge.

The big thing about the shoulder is that that joint can move 360 degrees, it’s one of the most worked joints in your entire body because of that. And it’s a lot of strain on it because if you’re doing something that involves your shoulder, you’re putting your entire body weight against it on one side, and something you’re tugging on, or lifting, or carrying on the other side. The shoulder is not a large joint, it’s just a very versatile joint. Some people are more likely to have an injury in the rotator cuff, and these include people who smoke. Smoking actually cuts down on the fibroblasts, which are healing cells, and these are particularly necessary in healing connective tissue. And since your rotator cuff is made pretty much entirely of connective tissue, the fewer fibroblasts you have, the poorer circulation you’re going to have in your shoulder, and the longer it’s going to take to heal.

If you are involved in any kind of job or hobby, or activity that has you lifting your arms over your head all the time, or pulling on heavy things, you’re causing constant repetitive activities that do wear out your shoulder. The rotator cuff is constructed for normal, and occasionally above normal activity, but not for the constant repetition of something that puts stress on it day in and day out. Athletes, of course, are prone to rotator cuff injuries simply because they are always doing activities that involve their shoulders, whether it’s tennis, or weight lifting, or baseball, or any of the other activities that athletes engage in, it does place a lot of strain on the shoulder. Another category that’s susceptible to rotator cuff injury are people over 40. Part of this is because their shoulder tendons are not as strong as they ones were, it’s a process of aging and therefore, you’re more apt to have a rotator cuff injury. Of course, if you happen to be someone over 40 who smokes, and plays tennis, you’re really at high risk of rotator cuff pain.