In this article, we will explore some of the most common shoulder injuries, including rotator cuff tears, arthritis, and other conditions that can affect the shoulder joint. We will also dive into treatment options that can help alleviate pain and restore function.
Written by
Angel Rigueras
Pain Management Specialist
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Written by
Angel Rigueras
Pain Management Specialist
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The shoulder is one of the most mobile and complex joints in the human body. It allows a wide range of motion, enabling us to perform countless activities like reaching, lifting, and throwing. However, this remarkable range of motion also makes the shoulder joint vulnerable to a variety of injuries and conditions.
Shoulder injuries occur frequently in sports such as swimming, volleyball, and handball, where movements are performed repeatedly over the head at high speed, or in injuries where the shoulder is impacted, such as braced falls or car accidents, where the patient is holding onto the steering wheel. From athletes to office workers, shoulder pain can affect people of all walks of life.
Understanding the causes of shoulder pain and knowing how to treat it can help individuals get back to their normal activities quickly and effectively.
Before diving into shoulder injuries, it’s important to have a basic understanding of the shoulder’s anatomy. The shoulder is a group of interconnected joints that work together to provide a wide range of motion. It is made up of:
Due to the complexity of the anatomy of the shoulder, any part of it can be susceptible to injury or inflammation. Shoulder pain can arise from a number of conditions, often involving the muscles, tendons, ligaments, or bones of the shoulder. Let’s explore some of the most common causes of shoulder pain and their associated injuries.
The rotator cuff is one of the most commonly injured parts of the shoulder. Its tendons play a crucial role in stabilizing the glenohumeral joint, making them highly susceptible to strain and damage. When injured, they can cause significant pain and difficulty moving the arm.
Rotator cuff conditions range from subacromial bursitis and tendinitis to shoulder impingement and rotator cuff tears. Patients with impingement or bursitis often experience pain, especially with overhead movements. In many cases, symptoms improve with a well-structured physical therapy program. However, if pain persists despite conservative treatment, evaluation by an orthopedic surgeon, physiatrist, and/or interventionalist may be necessary.
Rotator cuff tears can develop suddenly from an injury. They can be classified as partial-thickness or full-thickness tears, depending on the extent of the damage. Early diagnosis and appropriate treatment are essential to restoring shoulder function and preventing further complications.
Causes or mechanisms of injury:
A rotator cuff tear occurs when one or more tendons become partially or completely detached from the humeral head. While the supraspinatus tendon is most commonly affected, other rotator cuff tendons can also be involved. These tears generally result from either acute injury or significant degenerative wear over time.
A sudden, traumatic event (such as falling on an outstretched arm or lifting a heavy object with a jerking motion) can cause an immediate tear in the rotator cuff tendons or muscles. These injuries often occur alongside other conditions, such as, shoulder dislocations, collarbone fractures and Wrist fractures.
Rotator cuff tears may develop gradually due to progressive tendon wear. This process occurs naturally with aging and is often painless in its early stages. However, as degeneration progresses, symptoms may gradually develop, leading to shoulder pain and weakness.
Several factors contribute to degenerative rotator cuff tears:
Repetitive stress – Frequent overhead movements from sports (e.g., swimming, tennis, baseball, weightlifting) or repetitive tasks at work can weaken the tendons over time.
Poor posture and conditioning – Improper technique, weak supporting muscles, or imbalances in shoulder mechanics can increase strain on the rotator cuff.
Decreased blood supply – As we age, blood flow to the rotator cuff tendons diminishes, decreasing the body’s ability to repair minor tendon damage, which can eventually lead to a tear.
Bursa dysfunction – The subacromial bursa helps cushion and protect the tendons. If it fails to function properly, the tendons become more susceptible to inflammation, calcification, thinning, and eventual tearing.
Rotator cuff tears are more common in the dominant arm and may also occur bilaterally over time. If one shoulder is affected, there is a higher likelihood of developing a tear in the opposite shoulder, even if there are no symptoms initially.
Symptoms of Rotator Cuff Tears
A rotator cuff tear can cause: Shoulder pain (especially when lifting the arm or performing overhead activities) weakness in the shoulder and limited range of motion, making daily tasks difficult.
Shoulder impingement syndrome occurs when the rotator cuff tendons and the subacromial bursa (a fluid-filled sac that reduces friction) become compressed between the humerus (upper arm bone) and the acromion (part of the shoulder blade). This pinching can lead to pain, inflammation, and difficulty moving the shoulder, especially when lifting the arm overhead. If left untreated, it can lead to tendon damage or even rotator cuff tears.
Types of Shoulder Impingement
Causes and mechanism of injury
Repetitive overhead motions (e.g., swimming, tennis, baseball, or weightlifting), Poor posture (slouching or rounded shoulders), Muscle imbalances or rotator cuff weakness, Structural issues, such as bone spurs. Trauma such as falls unto an outreached arm or hitting the shoulder or motor vehicle accident where the shoulder is hit or a compressive force through the shoulder occurred as when the someone has their hands on the steering wheel and are impacted by another vehicle. Symptoms include, pain when lifting or reaching overhead, weakness in the shoulder, Limited range of motion, Discomfort that worsens with activity.
Simply defined, arthritis is inflammation of one or more of your joints. Ultimately, the inflammation leads to loss of cartilage, which is the soft lining of our joints that allows smooth and full range of motion. In the shoulder, arthritis may cause pain and stiffness that can make it difficult to lift your arm, brush your hair, reach up to a high shelf, or perform other tasks.
Although there is no predictable way to regrow cartilage — and, thus, no cure for arthritis of the shoulder — there are many treatment options available. Using these, most people with symptomatic arthritis can manage pain and stay active.
In the shoulder, two types of arthritis are common: osteoarthritis and rheumatoid arthritis.
Osteoarthritis is the most common form of arthritis, occurring when a change in the shape of the joint occurs that can lead to a host of consequences such as the cartilage that cushions the ends of bones gradually wearing down over time. Often referred to as “wear-and-tear” arthritis, this condition leads to the breakdown of the articular cartilage, which is the smooth outer layer covering the bones in a joint. As the cartilage deteriorates, it becomes frayed and rough, reducing the protective space between the bones. This results in bone-on-bone contact, causing pain, stiffness, and reduced mobility.
Osteoarthritis can affect different joints in the body, but in the shoulder, it most commonly affects the acromioclavicular (AC) joint rather than the glenohumeral (shoulder) joint.
Risk Factors for Osteoarthritis
Several factors can increase the risk of developing osteoarthritis, including:
Age – More common in individuals over 50.
Gender – More prevalent in women.
Joint Injuries – Previous shoulder injuries can cause altered biomechanics.
Muscle Weakness – Poor muscle support can lead to joint instability.
Anatomical Factors – Structural abnormalities may contribute to uneven joint stress.
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation in multiple joints throughout the body, often affecting the same joint on both sides. In this condition, the body’s immune system mistakenly attacks the synovium, the protective lining that lubricates the joints, resulting in swelling, pain, and stiffness.
Rheumatoid arthritis is equally common in both the acromioclavicular (AC) joint and the glenohumeral joint of the shoulder. Over time, this inflammation can damage not just the synovium but also the cartilage, ligaments, and bones, leading to joint deformities.
In addition to Rheumatoid arthritis, post-traumatic arthritis can develop after a shoulder injury, such as a fracture or dislocation. It can affect both the AC and glenohumeral joints. Another cause of arthritis in the shoulder can be a long-standing rotator cuff tear. When the rotator cuff is torn, it has decreased ability to stabilize the shoulder joint properly, causing the head of the humerus to rub against the acromion, leading to further damage and arthritis.
Symptoms
The most common symptom of symptomatic arthritis in the shoulder is pain, which typically worsens with movement and becomes more intense over time. The pain’s location depends on which shoulder joint is affected:
As the symptoms of arthritis progress, even simple shoulder movements may cause pain. Night pain is also common, making sleep difficult. Other symptoms may include Limited range of motion and crepitus – A grinding or clicking sensation when moving the joint, caused by roughened bone surfaces.
Frozen or Adhesive capsulitis is a disorder in which the glenohumeral capsule becomes inflamed and stiff, significantly restricting motion and can cause chronic pain. The pain is usually constant, worse at night. Usually occurs in stages, starting with pain, followed by stiffness, and eventually a gradual return of mobility. Risk factors for adhesive capsulitis include diabetes mellitus, connective tissue diseases, thyroid disease, and heart disease. It has associations as an adverse effect of specific highly active antiretroviral therapies as well.
Symptoms include intense pain in the shoulder, especially during movement, and a gradual loss of range of motion.
For 80–85% of patients, nonsurgical treatments can effectively relieve pain and improve shoulder function. These may include:
Surgical intervention is reserved for severe cases in which pharmacotherapy is not relieving symptoms. The most common procedures include, Shoulder joint replacement (arthroplasty), Hemiarthroplasty, Total shoulder arthroplasty, Open Repair (used for more complex tears), Distal Clavicle Resection/Excision (this is most common surgical procedure used to treat arthritis of the AC joint), Arthroscopic Subacromial Decompression, and Rotator Cuff Repair.
houlder pain is a common issue that can stem from various conditions, including rotator cuff injuries, impingement syndrome, and arthritis. Whether the pain is acute or the result of long-term wear and tear, understanding the underlying cause is crucial for determining the most effective treatment. Fortunately, a range of treatment options is available—from conservative approaches like physical therapy, medication, and injections to advanced interventions, including minimally invasive surgical techniques.
If you’re experiencing persistent shoulder pain, don’t wait to seek professional care. At University Orthopedic Care, our board-certified orthopedic surgeons specialize in advanced pain management and utilize the latest surgical technologies to ensure the best possible outcomes for our patients. Call us today at (866) 962-1744 or request an appointment online: Schedule your consultation.
With expert diagnosis and personalized treatment plans, we’ll help you restore mobility, reduce pain, and get back to the activities you love. Take the first step toward a stronger, healthier shoulder today.
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