Shoulder pain and rotator cuff damage; sports that cause it and conservative treatment plans to avoid surgery


What exactly is a rotator cuff and what does it do? The rotator cuff is a network of four muscles that come together as tendons to form a covering around the head of the humerus (major arm bone). The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. A torn rotator cuff will weaken your shoulder, and reduce your range of motion. Daily activities, like combing your hair or getting dressed, may become painful and difficult to do if you suffer a rotator cuff injury.

According to the Mayo Clinic, rotator cuff tears are most common in people over 40. Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk. Repetitive motion puts stress on the shoulder and can lead to this type of injury over time. Athletes participating in sports such as baseball, tennis, football, swimming, weight lifting, rowing, or golf stand at greater risk for shoulder and/or rotator cuff injuries.

When the rotator cuff tendons are injured or damaged, the bursa can also become inflamed and cause pain. Whenever your body suffers injury, there is an inflammatory response. Dr. Timothy Koh, an associate professor at the University of Illinois whose research focuses on tissue repair, says, “Inflammation is an important part of the healing response, but it needs to be correctly regulated—there can’t be too much, and there can’t be too little.” Completely blocking the inflammatory response will delay healing, while too much inflammation will also lead to impaired recovery.

Isometric exercises may be helpful if you injure your rotator cuff. Your doctor or physical therapist might initially recommend doing isometric exercises involving the group of muscles that helps stabilize the shoulder to maintain shoulder strength during recovery, and avoid the need for surgery if possible. Since isometric exercises are done in a static position, they won’t help improve speed or athletic performance but can be useful in enhancing stabilization, since muscles often contract isometrically to aid in stabilization. Check with your doctor before beginning isometric exercises if you have high blood pressure or any heart problems.