Do you have pain in your shoulder when you use your arm or try to lie on your side?

Shoulder pain is hard to get rid of because we use our arms and shoulders in almost everything we do. When you injure your shoulder, it’s often painful to lie on your side at night, get dressed, or even open a door.

When the shoulder is painful, there are many possible injuries, but the most common is a strained tendon or an inflamed shoulder joint. You may have heard someone say they have an injured rotator cuff.

In this drawing, you see all four rotator cuff tendons. They are separate and distinct, yet they form an almost continuous cuff from the front to the back of the shoulder. It’s rare to injure all four.

You have four major tendons that control shoulder movement, and they frequently get injured. To effectively treat this type of shoulder pain, you must identify which one or two tendons are injured before beginning treatment.

As you can see here, muscles are attached to bones by a tendon. Muscles have great blood circulation, but tendons do not. Notice that the muscles are red (filled with blood), and tendons are white or gray with very little blood circulation, so the healing of tendons is very slow without treatment.

The most commonly injured tendon is called the subscapularis. It’s the strongest of the four. You use it to put on your coat, for a forehand stroke in tennis, and to hug and carry your baby on your hip.

A therapist with injury assessment training can figure out what’s injured with a series of simple tests that look like this. These tests identify which of the tendons are injured.

You can also injure the shoulder joint. This frequently happens in people over 40. This is often referred to as a frozen shoulder. It’s painful to lift your arm, reach out to the side, or put your arm behind your back. Lying on your side in bed is usually impossible. It gets worse and worse over a few months time.

This is my favorite injury to treat because the results are so fast and obvious.  If you leave it alone, it may heal in about a year or so, but frequently, the pain recurs and lasts for years.

Once you identify and treat this injury, most of the pain is gone within 3 or 4 weeks. Muscles and tendons weaken very quickly if you don’t use them fully.  So, part of the treatment for both tendon and joint injuries is a series of exercises that build strength and prevent the scar tissue from returning.

If you have a shoulder injury, I’d love to help you.