By Shabi Khan, M.D.
Sports Medicine
Specializing in minimally invasive shoulder and knee surgery affiliated with Seton Medical Center

The rotator cuff helps us to raise our arm over our head and keep the shoulder stable. It is a remarkable set of four muscles and their respective tendons that cover the shoulder joint, underneath the bony arch called the acromion. No other joint in our body has as much mobility as the shoulder, and no other set of tendons and muscles does quite the same complex job as the rotator cuff.

As we get older, the natural wear and tear of our tendons may lead to shoulder pain. The vast majority of shoulder pain begins with the inflammation of the normal bursa, known as bursitis. The bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction. After an injury, instead of acting as a friction reducer, the bursa becomes swollen, actually becoming part of the problem. When a bursa is not treated properly, it can worsen and become more prone to tears.

When a tendon is torn, it pulls away from the bone of the arm. A blow to the shoulder, a sudden accident like a fall, or progressive degeneration can cause a torn tendon. Those most at risk are individuals who have a prominent acromion, bone spur or perform repetitive overhead activities, such as tennis players or construction workers.

The rotator cuff can be treated successfully by a combination of physical therapy and exercise or in more severe cases, shoulder surgery. Reducing your activitiesand/or performing specific exercises may help lessen the pain initially. However, many times, a steroid injection into the bursa will significantly reduce the inflammation.

Shoulder surgery is usually performed when your rotator cuff is torn and does not respond to the above treatments or you are experiencing weakness, loss of function and limited motion. Various techniques of shoulder arthroscopy, performed on an outpatient basis, include removal of spurs, treating unstable shoulders, bursitis and rotator cuff tears.

It is important to be proactive about the overall health of your shoulders. Once symptoms develop, I encourage you to seek medical advice to minimize the onset of progressive shoulder pain.