Rotator Cuff Injury and Damn the Exercise
05 Dec 2008
Why is it so hard for me to have a good night’s sleep? Like most people I’m not as wealthy as I was since the stock market developed terminal cancer. But that isn’t causing my insomnia. Rather, every time I roll over in bed both shoulders remind me that they’re not in great shape. So what have I done to end up with two painful shoulders?
Several years ago I gave up tennis due to a back problem. So I decided to take up trap shooting where I can stand still. I’ve enjoyed this activity more than any sport. And for most of the time God was in heaven, the sun was shining and birds were singing.
But then I got careless. Error # 1. One day I shot double the number of rounds. That’s when excessive recoil caused a rotator cuff tear (RCT) in my shoulder. Error # 2. I should have locked up the gun for several weeks to allow healing, but didn’t. Errror # 3. Trap shooting requires quick coordination and strong arm muscles. So to improve my score I started doing pushups and did too many. The result? A torn rotator cuff in the other shoulder!
Since I enjoy sleeping and shooting, RCTs are now high on my list of medical priorities. So I’ve searched high and low for the best way to treat this condition.
What is the rotator cuff and why is it so prone to injury? One problem, the shoulder joint moves in more directions than any other. This requires a complex array of muscles and tendons to connect the humerus (the upper bone of the arm) with the shoulder blade. So placing too much stress or too much repetitive work on the rotator cuff often leads to a tear and painful nights.
RCTs can occur at any age and under a variety of circumstances. One of my friends can no longer do an overhead serve while playing tennis. A major disadvantage. Another friend decided to use his arms rather than a winch to lift supplies onto his boat and is now sleeping poorly. Jobs, such as those in the construction business, or hobbies that place undue demand on the shoulders, often trigger RCTs. And although this injury can happen at any age, they’re more likely to occur as the rotator cuff ages.
Disability depends on the severity and location of the rotator cuff injury. The main problem is pain that prohibits certain movements. One of my patients, only half joking said, "I really need a scotch-and-soda before I try to put on my coat." Reaching over the head, or behind the back, is often impossible due to intense pain. And, if there’s a major tear, muscle weakness follows.
The diagnosis is usually obvious from an examination of shoulder movements. But it requires magnetic resonance imaging or an ultrasound to determine the exact location and severity of the injury.
Initial treatment, using cold and hot packs along with nonsteroidal anti-inflammatory drugs, helps to reduce the inflammation. Cortisone injections can also be useful, but they can only be used for a limited period of time.
Unfortunately, for those left with chronic pain due to RCTs, there’s no magic medicine to prevent sleepless nights. Physical therapists can help to educate patients about specific exercises to heal the injury and to improve the strength of shoulder muscles. This often requires weeks or months to bring relief. So, tincture of time and being a patient patient, is often a large part of the treatment. In some, cases surgery is needed to repair a large tear.
Luckily for me, the use of Light Intensive Laser Therapy has largely cured my shooting arm. The other shoulder is slowly healing. Next time, I’ll take my own advice that prevention is better than cure, and temporarily put the gun aside to prevent a minor injury becoming more troublesome. The same advice applies to those who have jobs or sporting activities that require repetitive shoulder motions. And when exercising shoulder muscles, take care not to overdo it.
