It starts out as general discomfort, or a nagging and annoying pain. Then before you know it, it is just always kind of….there. Later, you find yourself having trouble…… putting on a jacket, reaching for things overhead, gardening, sleeping, turning the steering wheel, pulling off your shirt, reaching into your back pocket, that you can no longer throw a ball, golf, swing a kettlebell or racket, swim or paddle, pop up on the surfboard and……the list keeps growing while your active lifestyle keeps getting smaller as the pain increases.
Many patients I meet I have the “if only” scenario……..
“If only” I met you weeks, months, years or a decade ago, then hopefully you would not need this surgery, and have to be stuck in a sling for 4, 6, 8, 10 or even 12 weeks, have to sleep in a recliner for 3-6 months and…… well shoulder surgery can be tough.
The shoulder is an incredibly complicated joint. It’s freedom for almost limitless mobility sacrifices its stability. It actually is a floating joint and relies primarily on muscular, ligament and capsular support to give it its structural integrity. An aditional challenge is its interdependency on the neck. Which is why pain and injury to either the shoulder or neck often results in or exacerbates pain in the other.
Due to the demand we put on our shoulders over our lifetime, shoulder pain becomes more of a matter of when and not if you will experience it in you life- the question is just how painful, limiting or irreversible the damage will be.
We tend to see an onset of shoulder issues in women start and progressively get worse in their +40s, while men a little later in their +50s. This can be attributed to body physiology, hormonal changes, muscle loss, postural changes, and just having logged more “life” or mileage on their shoulders. Unfortunately, as we age we tend to devote less time to our fitness, and more time to sedentary jobs, travel, kids, remodeling homes…..but we still continue to demand more of our shoulders(and body) and expect that we can continue to be weekend warriors, keep up with our kids or at the pace we once did.
Shoulder & Rotator Cuff Injuries:
The rotator cuff muscles involve a group of four muscles that work together to keep you arm bone from getting pushed forward or up in the joint and damage the rotator cuff tendons. Because there is poor blood supply to the rotator cuff muscles pain and inflammation can take longer to heal and resolve when it is injured.
When injured or inflammed it can becomes a downward spiral. Due to pain and inflammation people often avoid using their shoulders and the supportive muscles atrophy and get tight, leading only to more damage to the muscles, tendons and even arthritis. The worry with complete rest and immobilization is that sometimes this may lead to a frozen shoulder, which can be an incredible painful, unpredictable 2 years of recovery. Or people just keep pushing through the pain and ignore the warning signs. Individuals that develop bone spurs(which is like having a hook or serrated knife slowly tearing into your rotator cuff or biceps tendon) in their shoulder and continue to perform vigorous overhead sports, manual labor, etc. are at risk for serious damage to the internal structures of the shoulder- especially the rotator cuff and biceps tendon.
When I do get a patient that is experiencing shoulder pain, with hands on manual therapy, incorporating exercises and educating a patient on the temporary dos and don’t- the outcomes are always promising. We have even been able to get people off the surgery schedule without having them give up the activities they love like golf, surfing, and more. I want to do backflips when they can avoid this challenging surgery, because they don’t have to put their lives on hold for such and extensive recovery(but IF they need the surgery, we still make it just as positive and successful experience- it just takes a bit longer).
My hope is that you address your shoulder pain before it continues to spiral into needing a surgery. Much better to participate in Physical Therapy and get the tools you need to stay pain and surgery free so you don't miss out on life.
Have any questions or want to learn about what you can do to keep your shoulders and neck pain free, we are happy to help, so please call to speak with one of our Specialist Physical therapist here, (805) 941-0125, or schedule a FREE phone consultation here.
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At Perseverance Physical Therapy & Pilates we help people aged 40+ stay fit, active and overcome mobility loss to be able to live the life they love without fear, limitation and depending on painkillers or procedures.
Yvonne A. Castillo, MSPT, DPT, CPT