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Protecting Active Shoulders from Rotator Cuff Tears

Do you find yourself plagued with recurrent pain and soreness around the shoulder? The culprit may be your rotator cuff tendons.

Often thought of as an issue that only affects baseball pitchers, rotator cuff problems are actually far more common in active adults. Physical activities can place excessive stress on the rotator cuff tendons. These activities often involve repetitive overhead motions, sudden deceleration of the arm, or loading the shoulder with resistance in extreme positions, such as behind the back. This can lead to tendonitis, or painful inflammation and swelling of the tendons, as well as more serious problems like an actual tendon tear. Understanding what can cause rotator cuff disorders and what can be done to prevent them may help you avoid prolonged periods of discomfort and the need to take a break from your regular activities or exercise routines.

The rotator cuff is a group of four tendons that surround the shoulder joint. It plays a critical role as the main stabilizer of the shoulder. As we age, our tendons can weaken and are more prone to irritation and damage from overuse. Repetitive and forceful shoulder activities can place excessive strain on the tendon fibers and can increase the risk of tendon injury. Fortunately, most rotator cuff injuries are due to tendonitis and can be treated relatively easily with rest, physical therapy and medication. It is important to note, however, that recurrent tendonitis can lead to tearing of the tendon. For a variety of reasons, once a rotator cuff tendon is torn, it will not heal on its own and surgery is often required to restore normal shoulder function. As such, shoulder pain that lasts for weeks or months should not be ignored, as this can lead to a more serious problem in the future. Following are some suggestions to help keep your rotator cuff tendons in check:

  • Listen to your body. High-level baseball pitchers are taught to never ignore pain in their shoulders. You should do the same. If you experience pain while engaging in an activity or into the next day, take a break for several days and do something less stressful on the shoulder. This may involve modifying your activities on a long-term basis by avoiding certain weight-training exercises or swimming strokes.
  • Avoid activities that force you to place the shoulder in extreme positions, particularly if any weight or resistance is involved. This includes doing things like overhead presses behind the neck, pushups where you touch the floor with your chest, and certain extreme yoga positions. The twisting force on the tendon fibers can cause small tears, which may ultimately progress to larger tears with repetitive activity.
  • Incorporate regular low resistance / high repetition rotator cuff exercises into your regular exercise routine. Gentle and focused strengthening of the rotator cuff can go a long way to preventing injury. Check out my Rotator Cuff Strengthening Program for step-by-step video exercises you can do to strengthen the rotator cuff. These exercises can be performed for prevention or following rotator cuff repair surgery.
  • Use rest, ice and anti-inflammatories liberally. These simple measures will often completely relieve tendonitis without the need for more involved treatment. Click here for more information on how to appropriately use anti-inflammatories and here on how to distinguish between using ice or heat for an injury.
  • Don’t ignore lingering or recurrent pain. See your doctor if pain persists more than a few weeks and is not resolved with the above steps. Early treatment for rotator cuff problems generally leads to better results and will get you back on your feet quicker. Be good to your rotator cuff!


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