Rotator Cuff Pain

By Suzanne Seff, MBA PT

If you’re a male in your 40’s or 50’s, and have been physically active some time in your life then you could end up with a rotator cuff problem some time in the future. This is not to suggest that women don’t suffer from this ailment as well, but the majority of the patients that I’ve seen have been men. It usually begins with a twist the wrong way or an earnest effort to begin working out with a little too much weight. A little ache in the shoulder joint worsens and often this person ends up in the orthopedist’s office. The first plan of attack for most doctors is to offer the patient a cortisone shot right in the joint. Then the patient is given some muscle relaxers along with some pain relief medication. In addition the doctor will usually prescribe some physical therapy.

The rotator cuff is a catch all phrase for the four rotator muscles in the shoulder. When these muscles fall out of balance and the head of the humerus squeezes the musculature above it when the arm is lifted above shoulder height the result is what is referred to as impingement. Often pain results with specific movements of the shoulder or even when it’s at rest. A cortisone shot may relieve the inflammation but it does not cure the problem. If it’s an issue related to the muscle imbalance in the shoulder, the resolution of the problem lies in the rebalancing of those muscles that have become weakened and this will take some time to heal. In addition, a cortisone shot or two may be fine, but if the cause of the problem continues to be ignored and the use of cortisone continues, the integrity of the shoulder joint may become compromised. At what point does this compromise happen? No one is really sure about when the shoulder joint may become compromised. As a patient with a rotator cuff problem, going for a long term solution as opposed to a short term fix, may be in your best interest.

The patient will be evaluated and the best method to treat this would be an old fashioned exercise program to rebalance the shoulder muscles. Initially some heat is used, followed by range of motion exercises to keep the joint lubricated. Little by little strengthening of the shoulder blade would begin and finally the shoulder muscles would be strengthened. Ice is often used at the end of the session.

How long will it take to feel better? At least 3-4 weeks if you’re diligent with the exercises, and longer if not. If it does takes longer to feel better than a larger tear may be the culprit and a surgical repair may be in order.