Rotator Cuff Pain: Everyday Doctor's Still Get This Wrong!

rotator cuff shoulder Aug 26, 2023

Your shoulders play a vital role in your daily life, from reaching for your morning coffee to throwing a ball with your kids.  Recognizing the signs of a rotator cuff issue is essential for timely intervention, effective treatment and most importantly… getting you back to do the things that define you. 

Now, there are several issues that can occur at the neck and shoulder that might cause a similar pattern of pain, and that can be confusing. So in this blog, we will dive into some common signs and symptoms of rotator cuff problems, empowering you in your quest for recovery.


Understanding the Rotator Cuff

Before we dive into the signs and symptoms, let's briefly understand what the rotator cuff is. The rotator cuff is a group of four muscles and the associated tendons that attach to the shoulder blade the upper arm. This group of muscles rotate the shoulder, create stability, help raise the arm, and allow for smooth and controlled movement. When these tendons or muscles get injured or irritated, a range of issues can arise.


Common Signs and Symptoms

No one sign or symptom is a clear indicator of rotator cuff pain, instead, we look for clusters of things that point to rotator cuff and away from other structures such as nerves.

  1. Shoulder Pain: One of the most prominent signs of a rotator cuff issue is pain in the shoulder and arm. The pain may be dull, aching, or sharp, and it's often felt in the front or side of the shoulder and can radiate down the side of the arm. The pain might increase when you lift your arm or perform specific movements like reaching, throwing or lifting weights overhead.
  2. Limited Range of Motion: If you notice that you're having difficulty raising your arm, reaching overhead, or performing activities that involve arm movement, it could be a sign of a rotator cuff problem. This one is not as specific to rotator cuff pain and could relate to any number of shoulder issues. What is more specific is if your shoulder feels like it catches or there is pain at a certain and consistent point while raising your arm.
  3. Weakness in the Arm: Rotator cuff issues can lead to weakness in the affected arm. This weakness can accompany pain, but it may also come without it. You might find it challenging to lift objects or perform activities that require you to rotate your shoulder. This could be as simple as closing the car door or throwing a ball. You may also feel that the shoulder just feels unstable when doing things overhead, especially when there is any kind of load in your hand.
  4. Nighttime Discomfort: Some individuals experience increased pain or discomfort at night, especially when lying on the affected shoulder. Some people will say that laying on the opposite side is also painful because of the stretch placed on the rotator cuff. You might have to put your arm on a pillow or sleep on your back to sleep comfortably.
  5. Clicking or Popping Sensation: If you feel or hear clicking, popping, or grinding sensations when you move your shoulder, it could be due to a rotator cuff issue. But there are certainly other things that can lead to clicking or popping. One thing we tell our patients is that popping that does not cause pain is not something that you need to be afraid of. Some clicking is completely benign.
  6. Pain When Reaching Behind the Back: If you experience pain or discomfort when reaching behind your back, such as when tucking in your shirt or fastening a bra, it could be a sign of rotator cuff problems. This motion can stress the tendons and muscles of the rotator cuff.
  7. Muscle Atrophy: In more severe cases, you might notice a visible decrease in the size of the muscles around the shoulder joint. This is more of a sign of a serious rotator cuff issue such as a tear in which the tissue can no longer activate, leading to atrophy. This would also indicate that there has been a rotator cuff issue for quite some time.


Signs That It Might Be Something Else

When it comes to the body, pain in any one location can mean a lot of different things. Here are some alternatives and how to tell if maybe that's what you're experiencing.

  1. Numbness and Tingling: numbness and tingling down the arm is caused by an irritated nerve and although it may present in the same way as rotator cuff pain, you will likely notice that neck movements or positions cause the change in symptoms. Shoulder movements may also create numbness and tingling but that is because when you move your arms, the nerve is moving and gliding and has the potential to become irritated.
  2. Pain that radiates down the arm and past the elbow: it is not typical for rotator cuff related pain to radiate past the elbow. What’s more likely is a neck problem that is sending pain down the arm.
  3. Pain that changes with neck movements: Same as before, pain in the arm that is directly effected by neck movements or pressure is the result of neck pain with nerve involvement. This is treatable conservatively, but that looks different than rehab for the rotator cuff.
  4. Pain that doesn’t change with any shoulder movement: anytime movement does not change pain whatsoever, you should go see your doctor immediately to see if there are any, more severe, conditions present.


What NOT to Do

If you have shoulder pain, it's normal to think up worse case scenario. But you don't have to. For best results, avoid the following:

  1. Don’t assume you need surgery: A large majority of rotator cuff conditions can be improved with conservative measures such as exercise and temporary activity modification. Shoulder surgeries, in my professional opinion, are over-utilized and often increase the burden of care, increase the time needed to recover and leaves people physically and emotionally vulnerable for an extended period of time.
  2. Don’t ignore it: waiting too long to take care of a muscle or tendon issue will worsen things in the long run. It will increase the time it takes to recover, decrease recovery potential and potentially lead to changes in the muscle that cannot be reversed.
  3. Don’t push through the pain: some pain during exercise and rehab is ok, but pushing through too much pain without knowing what’s going on and without guidance on what kind of pain is ok can really set you back and put you at risk for worse injury.
  4. Don’t watch YouTube videos telling you to stretch: just stop listening to these YouTube “pros” tell you to stretch your shoulder for it to get better. Although range of motion is important, very few shoulder complaints can be fixed exclusively through stretching. It’s clickbait. The best mode of prevention, protection and recovery to tendon injuries is strength.


When to Seek Help

Recognizing the signs of rotator cuff issues is crucial, but knowing when to seek help is equally important. If you experience any of the following situations, it's time to consult a medical professional:

  1. Limited Function: If your shoulder's range of motion is significantly restricted, and it's interfering with your daily activities, a doctor's evaluation is warranted.
  2. Weakness and Numbness: Weakness, numbness, or tingling in your arm can be signs of nerve involvement, which requires prompt medical attention.
  3. Traumatic Injury: If your shoulder pain follows a fall, impact, or other traumatic event, it's crucial to get checked by a healthcare professional.
  4. Painful Clicking or Popping: If you experience painful clicking, popping, or grinding sensations along with shoulder pain, consult a doctor.
  5. Gradual Worsening: If your symptoms are getting progressively worse over time, it's best to seek help sooner rather than later to prevent further damage. 


What You Should Do

If you have a rotator cuff complaint, the primary solution is to follow a specifically designed strength plan that will allow you to build up the rotator cuff and supporting muscles. This will help to reduce pain and reduce chances of further damage.

If you’re looking for an easy, convenient, and affordable rehab option, check out our online rotator cuff rehab program. We've designed a highly effective program that will guide you step by step through the process of building your shoulders up, reducing pain, and preventing future injury.

Not sure if the program is right for you? Check out this video for a free trial treatment! 

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