Robert Rupp: Managing shoulder pain, rotator cuff injuries

Shoulder pain is often related to rotator cuff injuries. The rotator cuff stabilizes the ball of the shoulder joint in the socket and is involved with daily shoulder movements. Repetitive lifting and/or sporting activities can cause injury to the rotator cuff, or it may degenerate as a person ages without a specific trauma and/or injury.
Pain associated with the rotator cuff is often a deep joint pain aggravated with overhead or reaching activities of the affected arm. Night pain is also a typical characteristic of rotator cuff injury, and a severe rotator cuff injury may result in loss of shoulder strength and motion.
Shoulder pain that does not improve after a period of rest and protection should be evaluated by a medical professional. This evaluation may include testing motion and strength of the joint — and often imaging such as X-rays or an MRI scan. A medical evaluation is important to rule out other common causes of shoulder pain such as arthritis or referred pain from the neck.
There is a spectrum of rotator cuff injuries from inflammation to partial thickness tearing to full thickness tearing. Treatment of rotator cuff inflammation includes rest, protection and sometimes over-the-counter medications such as Tylenol or anti-inflammatory medications.
An anti-inflammatory steroid injection is also used as needed for more immediate pain relief. Physical therapy is often recommended to optimize balance of the shoulder muscles and range of motion.
Partial thickness tears may heal if they are small, but larger partial thickness and complete rotator cuff tears are often surgically repaired via a minimally invasive shoulder arthroscopy to promote healing and help restore normal rotator cuff function. Recovery after a surgical repair typically requires use of a shoulder sling followed by gradual increase of shoulder function through physical therapy.           
Maintaining shoulder motion with stretches and optimizing the strength and balance of the muscles that control the shoulder joint, including the muscles of the arm, the shoulder blade and the chest wall, may help prevent rotator cuff injuries.

DID YOU KNOW?
Each one of these muscles is part of the rotator cuff and plays an important role:
• Supraspinatus. This holds your humerus in place and keeps your upper arm stable. And helps lift your arm.
• Infraspinatus. This is the main muscle that lets you rotate and extend your shoulder.
• Teres Minor. This is the smallest rotator cuff muscle. Its main job is to assist with rotation of the arm away from the body.
• Subscapularis. This holds your upper arm bone to your shoulder blade and helps you rotate your arm, hold it straight out and lower it.

— Source: WebMD, wb.md/3AF7Xk7

Dr. Robert Rupp is a board-certified orthopedic surgeon and program director of the Lake Tahoe Sports Medicine Fellowship. He is a sports medicine specialist treating shoulder, hip and knee conditions in Carson City, Incline Village and at the Center for Orthopedics & Wellness in South Lake Tahoe. To learn more about orthopedic services available, call 530-543-5554 or go to bartonorthopedicsandwellness.com.