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I Have Shoulder Pain — Is It My Rotator Cuff?

Just about every 40+ athlete I know (and a whole lot of sedentary folks, too) has had shoulder pain at some point. Some are able to eliminate it through non-surgical means, but a surprising number decide to simply live with it, or jump straight to the surgical route.

While I’m not opposed to surgery, it’s important to understand that your shoulder “broke” for a reason. The best thing you can do to prepare for or avoid surgery is address the root cause of your shoulder pain first.

Shoulder Anatomy Primer

It’s important to first understand how your shoulder actually works. I know this can be dry, but I’ll try to keep it as engaging as possible!

Front view of the supraspinatus lifting and lowering the arm. Credit: Young Lae, Moon M.D.

Many people think of the shoulder as a ball and socket joint. But, it’s more accurate to visualize it as a golf ball on a golf tee. The arm bone is not truly inside the joint. It’s held on top of it by a complex series of muscles and connective tissue in order to create an enormous range of motion. (Look, for example, at the range of motion of your hip joint versus your shoulder. Aren’t you glad that your shoulder has a larger range of motion in order to reach over head, swing forward and back, etc.?)

Rear view of the infraspinatus and teres minor externally rotating the shoulder. Credit: Young Lae, Moon M.D.

While this highly mobile joint is handy — ha! see what I did there? — it can also be problematic, because the muscles holding your arm in the joint have a pretty tough job. Add to that the fact that the joint itself moves, too. Whereas your hip joint is part of your stable, immobile pelvis, the shoulder blade to which the arm bone attaches is also mobile. Needless to stay, this is a highly complicated joint.

What Is Your Rotator Cuff?

Front view of the shoulder. (Picture the ribcage in front of the shoulderblade in this view. Credit: Jmarchn/ CC BY-SA

Many people diagnosed with a rotator cuff injury aren’t even sure where or what their rotator cuff is. If you’re going to make informed decisions about your health, it’s important to be on equal footing with your care provider!

The rotator cuff is the group of muscles and their associated tendons, which attach the arm bone into the shoulder joint. All of these muscles originate from the shoulder blade, and some attach to the front of the arm bone, whereas others attach to the back of the arm bone.

Rear view of the shoulder. Credit: Jmarchn / CC BY-SA

This means that sometimes you feel rotator cuff pain in the front, even though the muscle that’s actually causing the problem is more of a back-body muscle. The vast majority of the problem-muscle actually lives behind your ribcage. Just a small portion of it wraps toward the front of the arm bone. That might seem like a minor distinction, but it’s helpful to understand, as it will inform what exercises or changes we make to alleviate rotator cuff pain.

What Causes Shoulder Pain?

In addition to rotator cuff pain, there can be pain in the bursa of the shoulder, also known as bursitis. This is where the cushioned, fluid-filled sac that protects the soft tissue of the shoulder from the bones becomes irritated or inflamed. Additionally, inflammation or damage to the bicep or chest can also seem like shoulder pain.

And perhaps the most prevalent shoulder pain I see: Inflammation and tension in the upper trap, or the area where the shoulder meets your neck where you’re constantly asking your partner to massage.

How to Get Rid of Shoulder Pain

The most valuable thing most of us can do to eliminate shoulder pain is get the shoulder blades stable and where they belong.

Since we now understand that the shoulder joint is attached to your highly mobile shoulder blade, it follows that stabilizing the shoulder blade to support motion in the arm would help reduce dysfunction in the shoulder joint, right? Here are 3 things I have my clients with shoulder pain practice:

  • Rows and other back exercises to make the mid-back stronger and better able to hold the shoulder blade in place.
  • Self-myofascial release (essentially, rolling with a tennis ball) the muscles on the outside of the shoulder blade, to reduce tension in the muscles that could contribute to inflammation or pulling in the tendons.
  • Stretch the front of the chest and shoulder, which tend to round the arms forward, again, creating more pull on the tendons of the rotator cuff.

The benefit of all of these things is that, yes, they help alleviate issues in the rotator cuff, but they also help with all of the other types of shoulder pain discussed above.

If you have shoulder pain, I’d love to talk through what a healthy exercise regimen might look like for you, and offer a few free tips. Book a free, no-obligation consult right here.

Free E-book on Managing Pain

With special sections on low-back pain and herniated discs, plantar fasciitis, hip pain, and four secrets to smarter stretching.

Pain ebook cover

Free E-book on Managing Pain

With special sections on low-back pain and herniated discs, plantar fasciitis, hip pain, and four secrets to smarter stretching.

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