BLOG: Diagnosing my shoulder pain and how to fix it

Is your shoulder pain just a niggle or is it something more serious like a torn rotator cuff?

When you examine the make-up of the shoulder, it’s surprising there are not more muscle injuries in that area of the body.

But as Optimum Derby MD Tom Heeley explains, the chance of a tear are low because of the nature of many shoulder injuries.

“You have four rotator cuff muscles,” explains Tom. “They all originate from your shoulder blade/scapula. You have three on the back side that you can feel and one on the underside, between your shoulder blade and your ribs.

“All three on the back wrap around and attach to the outside of your shoulder and arm. When they contract, they turn your arm outwards and the fourth one, when that contracts, it pulls your arm across your body.”

They are all muscles that are well known to those people who enjoy playing sports like: tennis, volleyball, basketball and cricket, among others. You will have done well to play those sports for any length of time without enduring a shoulder injury.

But, as Tom explains, you don’t have to be playing sports to pick up an injury to this part of your body.

“When many people pick up shoulder injuries, they feel a pain in their arm when they move it from 90 to 120 degrees. In that middle ground, you will get discomfort or a little click which will be painful. It’s called the ‘painful arc’ when we test at the clinic.

Rotator cuff injury

“You will struggle with throwing because you accelerate your arm while doing so and then to need to decelerate quickly. When you do that with a shoulder or rotator cuff injury, you won’t be able to finish the motion because of the pain.

“If you think about that motion, you are asking those muscles to go through a lot of force and those three muscles around the back stop the arm keeping going and wrapping around your front! It’s a lot of effort on those three muscles.

“If it’s left and not treated, you just won’t be able to throw or do things. It’s unlikely to get better on its own.

“But your chances of actually tearing the muscles in and around the shoulder are unlikely, simply from playing sports or doing sporting-type motions.

“That is because the injury leads to you protecting the damaged area due to the pain involved. That’s most likely to lead to a weakness in that arm, neck ache as you compensate or a frozen shoulder.

“It’s a strange pain. It comes on with things like scratching your back, undoing a bra, putting a jacket on, or looking over your shoulder while reversing in a car. Through sports, it tends to come on especially if you are doing something for the first time like three games of tennis a week having not played - or throwing at cricket after not having played before.

Muscular imbalance

“And even if you take a month off playing, it is unlikely to go away because the mechanics that have caused the problem will not have changed. It’s a muscular imbalance that needs fixing unfortunately.”

Tom explains how he would go about addressing the issue if a client came into the Optimum Derby clinic.

“I listen to the mechanics of the situation. If my client plays, let’s say, cricket, and throws a lot from the boundary, you are throwing but decelerating quickly which requires force at a certain angle, different to other sports.

“I would look at how the should blade interacts with the rib cage and see if we can spot something and work to correct it and strengthen the rotator cuff while we do so.

“Rowing activities are good for rehab for example, and by managing the easy things you do in life will help it get gradually better.

“Standard recoveries could be between six and 12 weeks.”

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