Pesky Shoulder Pain


Baseball Pitcher

Most of us have had, or have heard of someone who has had trouble with their “rotator cuff” at some point. Rotator cuff (RC) tendinopathy is one of the most common disorders of the shoulder, and tends to be one of the toughest conditions to manage. Those suffering from RC tendinopathy tend to have a longer period of disability, a higher risk of recurrence, and can tend to undergo a variety of invasive procedures without much long term success.


So what is it exactly?


RC tendinopathy is a disorder where there is a poor response to load (either too much or too little) on the rotator cuff tendons. In other words, the tendons are not a fan of the load being placed on them and become reactive, resulting in pain and weakness. Most of the time this pain isn’t immediate or related to a specific task, but usually related to a change in overall load or activity. How much a tendon can put up with is dependent on what the tendons are used to. The tendons are creatures of habit and enjoy consistency, so if you are a relatively inactive person through the winter that all of a sudden is playing softball four nights a week in the summer, don’t be surprised if things get a bit cranky at the site.


RC tendinopathy usually presents with some limitation in your active shoulder range of motion, along with some pain and weakness in particular directions. Often times, however, your passive range of motion (e.g. joint mobility) which can be assessed by your Physiotherapy or Physician won’t be affected.


What do I do now?


Now that you suspect a RC tendinopathy, you can take the right steps in addressing it. Research has looked a variety of interventions, both conservative and invasive, and exercise seems to continue to come out on top! The best type of exercises tend to be specific to the shoulder, and fatiguing. These exercises provide better long term outcomes (3 months and on) for pain and function compared to things like cortisone injections or surgery. The idea being that the exercise provides the necessary load for the tendons to adapt and be better able to deal with the activities you want to do. This is why just resting your shoulder for an extended period isn’t a great long term solution. Although it may feel better initially, as soon as you go back to your regular activities the tendons will once again become reactive and cranky. So if you’re suspecting a RC tendinopathy, contact us so that you can get started on that exercise program right away!


#Physiotherapy #shoulder

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