From Medical News Today; Medically reviewed by William Morrison, M.D. — Written by Sunali Wadehraon January 22, 2019
Damage to the shoulder may result from repetitive movements, manual labor, sports, or aging. A person may also injure this part of the body due to a bad fall or accident. Many people visit the doctor with front, or anterior, shoulder pain.
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Overhand throwing places extremely high stresses on the shoulder, specifically to the anatomy that keeps the shoulder stable. In throwing athletes, these high stresses are repeated many times and can lead to a wide range of overuse injuries.
Although throwing injuries in the shoulder most commonly occur in baseball pitchers, they can be seen in any athlete who participates in sports that require repetitive overhand motions, such as volleyball, tennis, and some track and field events.
Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid. Surrounding the outside edge of the glenoid is a rim of strong, fibrous tissue called the labrum. The labrum helps to deepen the socket and stabilize the shoulder joint. It also serves as an attachment point for many of the ligaments of the shoulder, as well as one of the tendons from the biceps muscle in the arm.
Strong connective tissue, called the shoulder capsule, is the ligament system of the shoulder and keeps the head of the upper arm bone centered in the glenoid socket. This tissue covers the shoulder joint and attaches the upper end of the arm bone to the shoulder blade.
The bones of the shoulder. Reproduced with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.
The ligaments of the shoulder. Reproduced with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.
Your shoulder also relies on strong tendons and muscles to keep your shoulder stable. Some of these muscles are called the rotator cuff. The rotator cuff is made up of four muscles that come together as tendons to form a covering or cuff of tissue around the head of the humerus.
The biceps muscle in the upper arm has two tendons that attach it to the shoulder blade. The long head attaches to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process. These attachments help to center the humeral head in the glenoid socket.
This illustration shows the biceps tendons and the four muscles and their tendons that form the rotator cuff and stabilize the shoulder joint. Reproduced and adapted with permission from The Body Almanac. (c) American Academy of Orthopaedic Surgeons, 2003.
In addition to the ligaments and rotator cuff, muscles in the upper back play an important role in keeping the shoulder stable. These muscles include the trapezius, levator scapulae, rhomboids, and serratus anterior, and they are referred to as the scapular stabilizers. They control the scapula and clavicle bones — called the shoulder girdle — which functions as the foundation for the shoulder joint.
Muscles in the upper back help to keep the shoulder stable, particularly during overhead motions, like throwing. (Note: this illustration has been drawn in such a way to show the many layers of muscle in the back.) Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
When athletes throw repeatedly at high speed, significant stresses are placed on the anatomical structures that keep the humeral head centered in the glenoid socket.
The phases of pitching a baseball. Reproduced and adapted with permission from Poss R (ed): Orthopaedic Knowledge Update 3. Rosemont, IL. American Academy of Orthopaedic Surgeons, 1990, pp 293-302.
Of the five phases that make up the pitching motion, the late cocking and follow-through phases place the greatest forces on the shoulder.
When one structure — such as the ligament system — becomes weakened due to repetitive stresses, other structures must handle the overload. As a result, a wide range of shoulder injuries can occur in the throwing athlete.
The rotator cuff and labrum are the shoulder structures most vulnerable to throwing injuries.
In a SLAP injury, the top (superior) part of the labrum is injured. This top area is also where the long head of the biceps tendon attaches to the labrum. A SLAP tear occurs both in front (anterior) and in back (posterior) of this attachment point.
Typical symptoms are a catching or locking sensation, and pain with certain shoulder movements. Pain deep within the shoulder or with certain arm positions is also common.
(Left) The labrum helps to deepen the shoulder socket.
(Right) This cross-section view of the shoulder socket shows a typical SLAP tear.
Repetitive throwing can inflame and irritate the upper biceps tendon. This is called biceps tendinitis. Pain in the front of the shoulder and weakness are common symptoms of biceps tendinitis.
Occasionally, the damage to the tendon caused by tendinitis can result in a tear. A torn biceps tendon may cause a sudden, sharp pain in the upper arm. Some people will hear a popping or snapping noise when the tendon tears.
(Left) The biceps tendon helps to keep the head of the humerus centered in the glenoid socket. (Right) Tendinitis causes the tendon to become red and swollen.
When a muscle or tendon is overworked, it can become inflamed. The rotator cuff is frequently irritated in throwers, resulting in tendinitis.
Early symptoms include pain that radiates from the front of the shoulder to the side of the arm. Pain may be present during throwing, other activities, and at rest. As the problem progresses, pain may occur at night, and the athlete may experience a loss of strength and motion.
Rotator cuff tears often begin by fraying. As the damage worsens, the tendon can tear. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears in throwing athletes occur in the supraspinatus tendon.
Rotator cuff tendon tears in throwers most often occur within the tendon. In some cases, the tendon can tear away from where it attaches to the humerus.
Problems with the rotator cuff often lead to shoulder bursitis. There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.
During the cocking phase of an overhand throw, the rotator cuff tendons at the back of the shoulder can get pinched between the humeral head and the glenoid. This is called internal impingement and may result in a partial tearing of the rotator cuff tendon. Internal impingement may also damage the labrum, causing part of it to peel off from the glenoid.
Internal impingement may be due to some looseness in the structures at the front of the joint, as well as tightness in the back of the shoulder.
The muscles and tendons of the rotator cuff. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
This illustration shows the infraspinatus tendon caught between the humeral head and the glenoid. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
Shoulder instability occurs when the head of the humerus slips out of the shoulder socket (dislocation). When the shoulder is loose and moves out of place repeatedly, it is called chronic shoulder instability.
In throwers, instability develops gradually over years from repetitive throwing that stretches the ligaments and creates increased laxity (looseness). If the rotator cuff structures are not able to control the laxity, then the shoulder will slip slightly off-center (subluxation) during the throwing motion.
Pain and loss of throwing velocity will be the initial symptoms, rather than a sensation of the shoulder “slipping out of place.” Occasionally, the thrower may feel the arm “go dead.” A common term for instability many years ago was “dead arm syndrome.”
As mentioned above, the extreme external rotation required to throw at high speeds typically causes the ligaments at the front of the shoulder to stretch and loosen. A natural and common result is that the soft tissues in the back of the shoulder tighten, leading to loss of internal rotation.
This loss of internal rotation puts throwers at greater risk for labral and rotator cuff tears.
This photograph shows abnormal positioning of the scapula on the right side. Reproduced with permission from Kibler B, Sciascia A, Wilkes T: Scapular Dyskinesis and Its Relation to Shoulder Injury. J Am Acad Orthop Surg 2012; 20:364-372.
Proper movement and rotation of the scapula over the chest wall is important during the throwing motion. The scapula (shoulder blade) connects to only one other bone: the clavicle. As a result, the scapula relies on several muscles in the upper back to keep it in position to support healthy shoulder movement.
During throwing, repetitive use of scapular muscles creates changes in the muscles that affect the position of the scapula and increase the risk of shoulder injury.
Scapular rotation dysfunction is characterized by drooping of the affected shoulder. The most common symptom is pain at the front of the shoulder, near the collarbone.
In many throwing athletes with SICK scapula, the chest muscles tighten in response to changes in the upper back muscles. Lifting weights and chest strengthening exercises can aggravate this condition.
The medical history portion of the initial doctor visit includes discussion about your general medical health, symptoms and when they first began, and the nature and frequency of athletic participation
During the physicial examination, your doctor will check the range of motion, strength, and stability of your shoulder. He or she may perform specific tests by placing your arm in different positions to reproduce your symptoms.
The results of these tests help the doctor decide if additional testing or imaging of the shoulder is necessary.
Your doctor may order tests to confirm your diagnosis and identify any associated problems.
X-rays. This imaging test creates clear pictures of dense structures, like bone. X-rays will show any problems within the bones of your shoulder, such as arthritis or fractures.
Magnetic resonance imaging (MRI). This imaging study shows better images of soft tissues. It may help your doctor identify injuries to the labrum, ligaments, and tendons surrounding your shoulder joint.
Computed tomography (CT) scan. This test combines x-rays with computer technology to produce a very detailed view of the bones in the shoulder area.
Ultrasound. Real time images of muscles, tendons, ligaments, joints, and soft tissues can be produced using ultrasound. This test is typically used to diagnose rotator cuff tears in individuals who are not able to have MRI scans.
Left untreated, throwing injuries in the shoulder can become complicated conditions.
In many cases, the initial treatment for a throwing injury in the shoulder is nonsurgical. Treatment options may include:
Arthroscopy. Most throwing injuries can be treated with arthroscopic surgery. During arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the shoulder joint. The camera displays pictures on a television screen, and the surgeon uses these images to guide miniature surgical instruments.
Because the arthroscope and surgical instruments are thin, the surgeon can use very small incisions (cuts), rather than the larger incision needed for standard, open surgery.
During arthroscopy, your doctor can repair damage to soft tissues, such as the labrum, ligaments, or rotator cuff.
Open surgery. A traditional open surgical incision (several centimeters long) is often required if the injury is large or complex.
Rehabilitation. After surgery, the repair needs to be protected while the injury heals. To keep your arm from moving, you will most likely use a sling for for a short period of time. How long you require a sling depends upon the severity of your injury.
As soon as your comfort allows, your doctor may remove the sling to begin a physical therapy program.
In general, a therapy program focuses first on flexibility. Gentle stretches will improve your range of motion and prevent stiffness in your shoulder. As healing progresses, exercises to strengthen the shoulder muscles and the rotator cuff will gradually be added to your program. This typically occurs 4 to 6 weeks after surgery.
Your doctor will discuss with you when it is safe to return to sports activity. If your goal is to return to overhead sports activities, your doctor or physical therapist will direct a therapy program that includes a gradual return to throwing.
It typically takes 2 to 4 months to achieve complete relief of pain, but it may take up to a year to return to your sports activities.
In recent years, there has been a great deal of attention on preventing throwing injuries of the shoulder.
Proper conditioning, technique, and recovery time can help to prevent throwing injuries. Throwers should strive to maintain good shoulder girdle function with proper stretches and upper back and torso strengthening.
In the case of younger athletes, pitching guidelines regarding number of pitches per game and week, as well as type of pitches thrown, have been developed to protect children from injury.
New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.
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Length of program: This shoulder conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health of your shoulders. Performing the exercises two to three days a week will maintain strength and range of motion in your shoulders.
Warmup:Stretch: After the warm-up, do the stretching exercises shown on Page 1 before moving on to the strengthening exercises. When you have completeds the strengthening exercises, repeat the stretching exercises to end the program.
Do not ignore pain: You should not feel pain during an exercise. Talk to your doctor or physical therapist if you have any pain while exercising.
Ask questions: If you are not sure how to do an exercise, or how often to do it, contact your doctor or physical therapist.
| Main muscles worked: Deltoids, supraspinatus, infraspinatus, subscapularis
Equipment needed: None Repetitions: 2 sets of 10 Step-by-step directions
Tip: Do not round your back or lock your knees. |
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| Main muscles worked: Posterior deltoid You should feel this stretch at the back of your shoulderEquipment needed: NoneRepetitions: 4 each side Days Per Week: 5 to 6Step-by-step directions
Tip: Do not pull or put pressure on your elbow. |
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| Main muscles worked: Subscapularis You should feel this stretch at the front of your shoulderEquipment needed: Light stick, such as a yardstickRepetitions: 4 each side Days Per Week: 5 to 6Step-by-step directions
Tip: Do not lean over or twist to side while pulling the stick. |
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| Main muscles worked: Infraspinatus, teres minor You should feel this stretch in the back of your shoulderEquipment needed: Light stick, such as a yardstickRepetitions: 4 each side Days Per Week: 5 to 6Step-by-step directions
Tip: Keep your hips facing forward and do not twist. |
 |
| Main muscles worked: Infraspinatus, teres minor You should feel this stretch in your outer upper back, behind your shoulderEquipment needed: NoneRepetitions: 4 reps, 3x a day Days Per Week: DailyStep-by-step directions
Tip: Do not bend your wrist or press down on your wrist. |
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| Main muscles worked: Middle and lower trapezius You should feel this exercise at the back of your shoulder and into your upper backEquipment needed: Use an elastic stretch band of comfortable resistance. As the exercise becomes easier to perform, progress to 3 sets of 12 repetitions. If you have access to a fitness center, this exercise can also be performed on a weight machine. A fitness assistant at your gym can instruct you on how to use the machines safely.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Squeeze your shoulder blades together as you pull. |
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| Main muscles worked: Infraspinatus and teres minor You should feel this exercise at the back of your shoulder and into your upper backEquipment needed: Use an elastic stretch band of comfortable resistance. As the exercise becomes easier to perform, progress to 3 sets of 12 repetitions. If you have access to a fitness center, this exercise can also be performed on a weight machine. A fitness assistant at your gym can instruct you on how to use the machines safely.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Make sure your elbow stays in line with your shoulder. |
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| Main muscles worked: Pectoralis, subscapularis You should feel this exercise at your chest and shoulderEquipment needed: Use an elastic stretch band of comfortable resistance. As the exercise becomes easier to perform, progress to 3 sets of 12 repetitions. If you have access to a fitness center, this exercise can also be performed on a weight machine. A fitness assistant at your gym can instruct you on how to use the machines safely.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Keep your elbow pressed into your side. |
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| Main muscles worked: Infraspinatus, teres minor, posterior deltoid You should feel this stretch in the back of your shoulder and upper backEquipment needed: Use an elastic stretch band of comfortable resistance. As the exercise becomes easier to perform, progress to 3 sets of 12 repetitions. If you have access to a fitness center, this exercise can also be performed on a weight machine. A fitness assistant at your gym can instruct you on how to use the machines safely.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Squeeze your shoulder blades together when you pull your elbow back. |
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| Main muscles worked: Biceps You should feel this exercise at the front of your upper armEquipment needed: Begin with a weight that allows 3 sets of 8 repetitions and progress to 3 sets of 12 repetitions. As the exercise becomes easier, add weight in 1-pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 3 sets of 8 repetitions.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Do not do the exercise too quickly or swing your arm. |
 |
| Main muscles worked: Triceps You should feel this exercise at the back of your upper armEquipment needed: Begin with a weight that allows 3 sets of 8 repetitions and progress to 3 sets of 12 repetitions. As the exercise becomes easier, add weight in 1-pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 3 sets of 8 repetitions.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Keep your abdominal muscles tight and do not arch your back. |
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| Main muscles worked: Middle and posterior deltoid, supraspinatus, middle trapezius You should feel this exercise at the back of your shoulder and into your upper backEquipment needed: Begin with a light enough weight to allow 3 to 4 sets of 20 repetitions without pain. As the exercise becomes easier to perform, add 2 to 3 pounds of weight, but do fewer repetitions. Progress to 3 sets of 15 repetitions at each weight increment, with the maximum weight approximately 5 to 7 pounds.Repetitions: 3 sets of 20 Days Per Week: 3 to 5Step-by-step directions
Tip: Use a weight that makes the last few repetitions difficult, but pain-free. |
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| Main muscles worked: Middle trapezius, serratus You should feel this exercise in your upper back, at your shoulder bladeEquipment needed: NoneRepetitions: 10 Days Per Week: 3Step-by-step directions
Tip: Do not tense up in your neck. |
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| Main muscles worked: Middle trapezius, serratus You should feel this exercise in your upper back at your shoulder bladeEquipment needed: Begin with a weight that allows 2 sets of 8 to 10 repetitions and progress to 3 sets of 15 repetitions. As the exercise becomes easier, add weight in 1-pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 2 sets of 8 to 10 repetitions.Repetitions: 2 sets of 10 Days Per Week: 3Step-by-step directions
Tip: Do not shrug your shoulder toward your ear. |
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| Main muscles worked: Middle and lower trapezius, Infraspinatus, teres minor, posterior deltoid You should feel this exercise at the back of your shoulder and into your upper backEquipment needed: Begin with a weight that allows 3 sets of 8 repetitions and progress to 3 sets of 12 repetitions. As the exercise becomes easier, add weight in 1-pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 3 sets of 8 repetitions.Repetitions: 3 sets of 8 Days Per Week: 3Step-by-step directions
Tip: Control the movement as you lower the weight. |
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| Main muscles worked: Internal rotation: anterior deltoid, pectoralis, subscapularis, latissimus. External rotation: posterior deltoid, infraspinatus, teres minor You should feel this exercise in the front and back of your shoulder, your chest, and upper backEquipment needed: Begin with a light enough weight to allow 3 to 4 sets of 20 repetitions without pain. As the exercise becomes easier to perform, add 2 to 3 pounds of weight, but do fewer repetitions. Progress to 3 sets of 15 repetitions at each weight increment, with the maximum weight approximately 5 to 7 pounds.Repetitions: 3 to 4 sets of 20 Days Per Week: 3 to 5Step-by-step directions
Tip: Use a weight that makes the last few repetitions difficult, but pain-free. |
 |
| Main muscles worked: Infraspinatus, teres minor, posterior deltoid You should feel this stretch in the back of your shoulder and upper backEquipment needed: Begin with weights that allow 2 sets of 8 to 10 repetitions (approximately 1 to 2 pounds), and progress to 3 sets of 5 repetitions. As the exercise becomes easier, add weight in 1-pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 2 sets of 8 to 10 repetitions.Repetitions: 2 sets of 10 Days Per Week: 3Step-by-step directions
Tip: Do not let your body roll back as you raise the weight. |
 |
| Main muscles worked: Subscapularis, teres major You should feel this stretch in the front of your shoulderEquipment needed: Begin with weights that allow 2 sets of 8 to 10 repetitions (approximately 1 to 2 pounds), and progress to 3 sets of 5 repetitions. As the exercise becomes easier, add weight in 1-pound increments to a maximum of 5 pounds. Each time you increase the weight, start again at 2 sets of 8 to 10 repetitions.Repetitions: 2 sets of 10 Days Per Week: 3Step-by-step directions
Tip: Do not let your body roll back as you raise the weight. |
Tendons attach muscles to bones. Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the shoulder, you may lose some strength in your arm and have pain when you forcefully turn your arm from palm down to palm up.
Many people can still function with a biceps tendon tear, and only need simple treatments to relieve symptoms. If symptoms cannot be relieved by nonsurgical treatments, or if a patient requires complete recovery of strength, surgery to repair the torn tendon may be required.
Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid. A combination of muscles and tendons keeps your arm bone centered in your shoulder socket. These tissues are called the rotator cuff. They cover the head of your upper arm bone and attach it to your shoulder blade.
The upper end of the biceps muscle has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process.
Biceps tendon tears can be either partial or complete.
In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes when lifting a heavy object.
The long head of the biceps tendon is more likely to be injured. This is because it is vulnerable as it travels through the shoulder joint to its attachment point in the socket. Fortunately, the biceps has two attachments at the shoulder. The short head of the biceps rarely tears. Because of this second attachment, many people can still use their biceps even after a complete tear of the long head.
When you tear your biceps tendon, you can also damage other parts of your shoulder, such as the rotator cuff tendons.
There are two main causes of biceps tendon tears: injury and overuse.
If you fall hard on an outstretched arm or lift something too heavy, you can tear your biceps tendon.
Many tears are the result of a wearing down and fraying of the tendon that occurs slowly over time. This naturally occurs as we age. It can be worsened by overuse – repeating the same shoulder motions again and again.
Overuse can cause a range of shoulder problems, including tendinitis, shoulder impingement, and rotator cuff injuries. Having any of these conditions puts more stress on the biceps tendon, making it more likely to weaken or tear.
Your risk for a tendon tear increases with:
After discussing your symptoms and medical history, your doctor will examine your shoulder. The diagnosis is often obvious for complete ruptures because of the deformity of the arm muscle (“Popeye Muscle”).
Partial ruptures are less obvious. To diagnose a partial tear, your doctor may ask you to bend your arm and tighten the biceps muscle. Pain when you use your biceps muscle may mean there is a partial tear.
It is also very important that your doctor identify any other shoulder problems when planning your treatment. The biceps can also tear near the elbow, although this is less common. A tear near the elbow will cause a “gap” in the front of the elbow. Your doctor will check your arm for damage to this area.
In addition, rotator cuff injuries, impingement, and tendinitis are some conditions that may accompany a biceps tendon tear. Your doctor may order additional tests to help identify other problems in your shoulder.
For many people, pain from a long head of biceps tendon tear resolves over time. Mild arm weakness or arm deformity may not bother some patients, such as older and less active people.
In addition, if you have not damaged a more critical structure, such as the rotator cuff, nonsurgical treatment is a reasonable option. This can include:
Surgical treatment for a long head of the biceps tendon tear is rarely needed. However, some patients who develop cramping of the muscle or pain, or who require complete recovery of strength, such as athletes or manual laborers, may require surgery. Surgery may also be the right option for those with partial tears whose symptoms are not relieved with nonsurgical treatment.
Procedure. Several new procedures have been developed that repair the tendon with minimal incisions. The goal of the surgery is to re-anchor the torn tendon back to the bone. Your doctor will discuss with you the options that are best for your specific case.
Complications. Complications with this surgery are rare. Re-rupture of the repaired tendon is uncommon.
Rehabilitation. After surgery, your shoulder may be immobilized temporarily with a sling.
Your doctor will soon start you on therapeutic exercises. Flexibility exercises will improve range of motion in your shoulder. Exercises to strengthen your shoulder will gradually be added to your rehabilitation plan.
Be sure to follow your doctor’s treatment plan. Although it is a slow process, your commitment to physical therapy is the most important factor in returning to all the activities you enjoy.
Surgical Outcome. Successful surgery can correct muscle deformity and return your arm’s strength and function to nearly normal.
By Len Canter | Article Featured on US News
The rotator cuff refers to a group of four distinct muscles and tendons that connect to each shoulder and stabilize the humerus, the upper arm bone. These muscles are engaged when you move your shoulder, and work together to give you the needed range of motion to toss a ball or reach for an object on a high shelf.
Baseball pitchers and other athletes aren’t the only people who experience rotator cuff injuries. The American Academy of Orthopaedic Surgeons estimates that nearly 2 million Americans see a doctor about a rotator cuff problem every year. Strengthening this group of muscles can help enhance the stability of this important joint and help you avoid injury.
Alternating arm and leg lifts: Position yourself on all fours. Your arms are straight, with hands directly below your shoulders and your knees directly below your hips. Tighten your core muscles and simultaneously extend your left leg and your right arm straight out so that they’re both parallel to the floor. With control, lower them, and repeat 10 to 15 times. Then repeat the sequence with your right leg and left arm.
Stability ball pushups: Take pushups to another level by doing them with your hands on a stability ball. From the same position on all fours, place your hands on the ball, shoulder width apart, with your upper arms pressed against your sides. Straighten your legs, with toes flat on floor. Keeping your body in a straight line from head to feet, straighten your arms, pushing your body away from the ball. Hold briefly, then bend elbows to return to the start position. Repeat 10 to 15 times.
New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.
Article Featured on Verywellhealth.com
Rotator cuff surgery is a common treatment for a torn rotator cuff. Most rotator cuff tears are treated without surgery, but there may be situations where surgery is the best treatment. In some cases, surgery is considered immediately after an injury, while in other situations, surgery is only the last step when all other treatments have failed.
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In the majority of cases, most shoulder injuries should not require surgical intervention. However, a major tear in the rotator cuff – the tendon and ligaments that are attached to and enfold the head of the arm bone or humerus – does usually require surgery. While the procedure can be performed with minimal invasion using an arthroscope, there is usually an extensive recovery period which can last for up to six months. The reason for this is that it takes some time for the tendon to heal and to re-attach properly to the bone. The recovery period will, of course, vary from patient to patient and depend on the severity of the tear.
Article Featured on US News
Two out of every three people will experience a shoulder injury or problem at some point in their lives.
One reason: When it comes to training, the anterior, or front, deltoid muscle gets almost all the attention, while the medial and posterior deltoids get the cold shoulder.
For a study sponsored by the American Council on Exercise, scientists from the University of Wisconsin La Crosse evaluated popular shoulder exercises to see which were most effective.
Popular Deltoid Strength-Training Exercises
While no single exercise can work all three parts, start building a shoulder workout with two that target most of the muscles. Build up to three sets of eight to 15 reps each. At first, you may only be able to lift very light dumbbells, but with consistency, you’ll develop strength over time. When you can complete three full sets, it’s time to increase your weight.
For the seated rear lateral raise, sit on the edge of a bench, feet flat on the floor, a dumbbell next to each foot. Bend over to bring your torso as close as you can to your thighs. Hold a weight in each hand with elbows bent slightly so that each weight is against the outside of each calf. Slowly lift your arms out to the sides and up to shoulder height; your back should stay straight and not move. With control, slowly bring the weights back to start. Repeat up to 15 times.
For the dumbbell shoulder press, stand with feet hip-width apart, knees slightly bent. With a dumbbell in each hand, raise your arms out to the sides until level with your shoulders. Bend your elbows so that your forearms make 90-degree angles with your upper arms, then rotate wrists so that palms are facing forward. This is the start position. Slowly straighten your arms up toward the ceiling. Then with control, lower them to start. Repeat up to 15 times.
Always start a shoulder workout with exercises that target the posterior deltoids because they’re the weakest of the group. As a reminder, strength train no more than three times a week, allowing 48 hours between sessions, and always after warming up the body with light cardio activity.
More information
The American Council on Exercise has an extensive library of deltoid exercises and how to do them safely.
New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.
Shoulder pain can develop from a variety of sources, such as tendinitis, arthritis, torn cartilage, and many other medical conditions and injuries. One other common cause of shoulder pain is a pinched nerve in the upper spine, also known as cervical radiculopathy.
A nerve can become pinched when bone spurs form around the spinal discs. These discs are the “shock absorbers” between the vertebrae in your spine. Bone spurs are new formations of bone that grow when discs start to weaken with age.
As you get older, the vertebrae become compressed and the discs become thinner. Bone spurs grow around the discs to strengthen them, but that new bone growth can put pressure on the nerve root in the spine.
If a pinched nerve is causing your shoulder pain, you’ll need a thorough physical exam of your neck and shoulder to diagnose the problem. However, there are signs that may help steer you and your doctor in the right direction.
A pinched nerve usually causes pain in one shoulder only. It’s also typically a sharp pain, as opposed to a dull ache or a strain that you might feel if you overworked your muscles. Pain may also worsen if you turn your head. Neck pain and headaches in the back of your head are also signs that the cause of all this discomfort is a pinched nerve.
A pinched nerve may also leave you with a feeling of “pins and needles” in your shoulder. The joint may also feel numb or weak when you try to lift something. In some cases, symptoms extend from the shoulder down the arm to the hand.
A spine specialist may be able to tell which nerve is being pinched based on the location of your symptoms. However, a comprehensive exam is also necessary. That includes a physical exam of the neck and shoulders.
Your doctor will probably test your reflexes, sensation, and strength. You may be asked to do certain stretches or movements to demonstrate what causes your symptoms, as well as what relieves them. It’s also important that you provide details about your shoulder pain.
You should inform your doctor of when the pain first started and what causes your shoulder to hurt. Also explain or show what causes the pain to subside. Your doctor may want to know if you’ve started exercising more or increased other physical activities.
If you’ve injured your neck or shoulder, you’ll need to provide details of the injury. Because nerves in the spine affect many aspects of your health, you should also tell your doctor if you’ve noticed a change in your bowel habits or bladder function.
A thorough exam may also include X-rays or MRI scan. An X-ray can provide details of the bones in the spine, but not the nerves and discs. However, an X-ray can tell a doctor how much narrowing has occurred between the vertebrae and whether bone spurs have developed.
An MRI is often more helpful at diagnosing a pinched nerve. That’s because an MRI can reveal the health of nerves and discs. An MRI is painless and doesn’t use radiation. For pain concentrated in the shoulder, an X-ray of the joint may be performed to look for signs of arthritis or injuries to the bones.
An MRI or ultrasound (another noninvasive imaging test) can show the soft tissue in the shoulder and can determine whether the pain is being caused by injured ligaments or tendons.
If the source of your shoulder pain is a pinched nerve, your doctor may recommend physical therapy to improve strength and flexibility in your neck and shoulder. You may also be advised to limit the movement of your neck. That may be done with traction or a soft collar worn around the neck for short periods of time.
Other treatments may include anti-inflammatory pain relievers or injections of steroids in the area of the affected nerve. Steroid injections can reduce pain and swelling. If the problem is severe enough, surgery may be an option to remove the bone spur pinching the nerve.
Because a pinched nerve is a problem that can be diagnosed and treated, you shouldn’t hesitate to have that pain in your shoulder evaluated. If the pain is being caused by a different condition, you’re better off knowing what it is so you can avoid further damage and discomfort.
New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.
People of all ages get physical therapy. It can treat a variety of health problems.
These licensed health professionals get specific graduate training in physical therapy. You may hear them called PTs or physiotherapists.
At your first therapy session, your PT will examine and assess your needs. He’ll ask you questions about your pain or other symptoms, your ability to move or do everyday tasks, how well you sleep, and your medical history.
Then, they will work with you to create a treatment plan. It will include your personal goals like functioning and feeling better, plus exercises or other treatments to help you reach them.
You may take less or more time to reach those goals than other people in physical therapy. Everyone is different. You may also have more or fewer sessions than others. It just depends on your needs.
You treatments might include:
Your therapist will watch your progress and adjust your treatments as necessary.
You can do the exercises your therapist teaches you at home between sessions. This will help you stay on track and improve your fitness.
New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.