I tore my rotator cuff in a skiing accident. I still have some discomfort five months later. Can you recommend exercises to avoid surgery?
— Mark H.
Shoulder injuries account for at least 13 percent of all visits to orthopedic surgeons. Because the ball of the arm bone at the shoulder is larger than the socket that holds it, we are afforded an amazing 360-degree range of motion with our arms — a mechanical marvel that allows for 100- mph fastballs, 400-yard golf drives, dolphinlike swimming speeds, holding a blow dryer, hammering a nail or picking up groceries. Any injury to the tendons, ligaments, cartilage, cushions or muscles that hold or protect the whole glorious mechanism can inhibit the range of motion.
Many times these injuries can be avoided by simply paying attention to posture, proper body mechanics, and by maintaining the balance of strength between the muscles in the shoulder area. But even if proper form, muscle strength, and alignment are all employed, injuries still happen. And when they do, the pain and discomfort can be both relentless and debilitating.
Fortunately, surgery does not have to be your first option; in fact, it doesn’t have to be an option at all. Rest, activity modification, nonsteroidal anti-inflammatory medications and physical therapy are all classic treatments, according to Dr. Thomas F. Murray Jr., at Orthopedic Associates of Portland, Ore. “But the hallmark of an effective rotator-cuff program is therapeutic exercise.”
Since it does not sound like you have an advanced case of rotator-cuff disease, you would probably do well to be examined by an orthopedist or physiatrist. If surgery is not necessary, more than likely they will recommend that you begin exercise rehabilitation treatment with a physical therapist.
Without knowing the exact nature of your problem, prescribing a set of exercises for you would be inappropriate. A professional should be consulted to determine and analyze the aspects of your situation in order to create the proper therapy protocol.
“It is important to have a thorough evaluation performed when dealing with a rotator cuff tear,” says Amy Valenta, a physical therapist for the US Women’s National Rugby Team. “On top of strengthening the rotator cuff itself, it is important to be sure that the surrounding joints are moving properly and that the supporting musculature is firing correctly.” Most of the time, a few months of therapeutic exercise is all that is needed.
Ice or heat compresses may help settle down any muscle spasms you experience. And don’t discount the benefits of massage, which not only relax tight muscles but also help increase blood flow to the injured area. Acupuncture is another option that has found favor with many people who have shoulder pain.
Regardless of how you decide to deal with this, get moving on a solution. Disuse of an important joint like the shoulder can easily compound and then cascade to other parts of the body, creating problems in other areas such as the neck and back.
Linda J. Buch is a certified fitness trainer in Denver; linda@ljbalance.com.
