Shoulder Injuries Q&A

What exactly is the rotator cuff?

The rotator cuff is about four muscles with a common tendon. They have as their function primarily to internally rotate and externally rotate the arm. It’s an important stabilizer of the shoulder of throwing athletes, such as professional pitchers or quarterbacks.

Are there different levels of injury, can you sprain it as opposed to tear it?

Excellent question. The answer is yes, you can have rotator cuff weakness or tendinitis, or inflammation of the rotator cuff and you can have what we call partial thickness tears. All of those things cause some symptoms and weakness but don’t require a full open repair. The significance is that again, in a throwing athlete that has high demand on his shoulder it can upset the timing or the stabilization feature of the rotator cuff and when that function is lost it can then set the person up for additional injury. So for example, it’s very important with a professional pitcher to have them keep their rotator cuff very, very strong because weakness alone will allow things to get out of place and cause problems.

What exactly is a shoulder strain?

A strain in general just means that tissue has been stretched, and that tissue which is most often muscle or a tendon is simply stretched but not broken.

What are the symptoms to show that it’s stretched as opposed to being broken?

Usually there’s soreness that improves without any demonstrable instability. Because if tissue tears then as you violate the integrity of it there’s usually some element of either non function or significant weakness. Or in the case of a ligament say it would be a true instability.

How can you prevent a shoulder strain?

By staying in shape and doing sport specific exercise. For example, if somebody is a recreational tennis player and is proud of their serve and over hand smashes and wants to keep doing that they shouldn’t be a housewife or business man who goes out and just plays on the week end and does nothing with their shoulder all week long. They should say, “O.K., I’m using these muscles I need to keep them conditioned.” Educate them with a series of exercises designed in strengthening their rotator cuff. That would be primarily internal and external rotation, and maybe abduction.

Would warming up before exercise be a separate issue?

It’s a separate issue but a very important issue.

How does that help decrease the possibility of an injury?

Number one it raises the body core temperature and that alone allows muscles to become more stretchable. In addition a good warm up should include stretching which begins to tension the muscle and get it out to length so that if it’s a little stiff it doesn’t react well and now responds better. Very much like and airplane wing let’s say, it needs to flex and be mobile rather than stiff because being mobile it absorbs stress rather than retains because of the implication of stress.