Why rotator cuff injuries are the most common cause of shoulder pain

Joint Health

by Albert Diaz, MD

Jul 24, 2019

As the popularity of high-impact, strength-building exercise programs increases, the shoulder is being increasingly called upon to function as a high demand, weight-bearing joint. This has led to an increase in shoulder-related complaints among active adults.

If that’s you, read on to gain a better understanding of what is causing your shoulder pain — and what to do about it.

The anatomy of a shoulder

The “ball and socket” anatomical structure of the shoulder permits a wide range of motion, allowing your arm and hand to be placed in space where needed. But this freedom of movement comes at the expense of your joint stability, which makes the shoulder joint more vulnerable to a wide range of trauma.

A small group of four muscles, known collectively as the rotator cuff, plays a critical role in keeping the ball of your shoulder joint centered in its socket. The rotator cuff is seldom targeted in the gym, where attention is typically given to the large muscle groups — the pectorals, latissimus dorsi (lats), deltoids, biceps and triceps.

What you might not realize is that neglecting your rotator cuff creates an imbalance in the shoulder musculature and a subtle superior migration of the ball in the socket. In turn, this can lead to a pinching of your rotator cuff and its associated bursa (small, fluid-filled sac that cushions your bones, tendons and muscles near joints).

Related: Try these knee-strengthening exercises

What is shoulder impingement?

The most common cause of shoulder pain in active adults is a result of these altered dynamics and is referred to as impingement, or subacromial bursitis.

Symptoms can include:

  • Pain in the shoulder and upper arm
  • Pain that is aggravated by overhead and behind-the-back activity
  • Positional night pain that can affect sleep

Proper weightlifting technique, with the incorporation of dedicated rotator cuff exercises, can limit your risk of developing shoulder problems. One word of caution: do not fatigue your rotator cuff muscles before doing any heavy lifting. Rotator cuff exercises serve as a good cool down after the heavy lifting is done.

How to exercise with a shoulder injury

Proper technique with any type of exercise is important, but understand that even with perfect form, subjecting a non-weight-bearing joint to excessive force can lead to injury, inflammation and pain. The shoulder girdle was designed to reach high-hanging fruit, not bench 300 lbs.

Keep this in mind as you age, and try higher repetitions with lower weight, as well as more core and body-weight exercises.

Never — under any circumstances — work through shoulder pain during an exercise routine.

Similarly, if you experience shoulder pain when exercising or playing sports, rest for two weeks and try a short course of over-the-counter anti-inflammatory medication, such as ibuprofen. If pain persists after two weeks, talk to your doctor or find an orthopedist near you.

Don’t let shoulder pain slow you down. Discover how to move better today.

About the Author

J. Albert Diaz, MD, is an orthopedic surgeon on the medical staff at Baylor Scott & White Medical Center – Buda and Baylor Scott & White Clinic – Austin Downtown. Dr. Diaz specializes in treating sports-related injuries. His area of primary interest is in arthroscopic procedures of the knee and shoulder.

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