Is There a Shoulder Fix?

Q. While playing tennis, I felt a sharp pain in my shoulder. Now it aches, and I have trouble lifting things with it. Can you tell me what I could have done to my shoulder and what type of treatment that I should pursue?

A. Shoulder injuries are becoming more common as the Baby Boomer population ages. Overhead sports, including tennis, are unfortunately frequent causes of shoulder injuries. These injuries can range from mild strains to severe tears in the rotator cuff. Additionally, other structures, including the biceps tendon and the labrum, can also be injured.

The description of “sharp” pain in the shoulder likely represents a new (acute) injury. Some acute injuries can occur in the setting of underlying degenerative problems. Weakness in the shoulder can be secondary to inflammation and pain, but could also represent the tearing of a rotator cuff tendon. These tears are frequently partial tears, but occasionally can be complete.

Initial treatment should include using ice for 15 to 20 minutes two to three times per day, over-the-counter anti-inflammatory medications, and gentle range of motion exercises while the pain and inflammation subside. Over-the-counter medications should be used with caution if you have other health problems. If the pain and especially the weakness do not improve within five to seven days, I would recommend an evaluation by either your primary physician or an orthopedic surgeon. Additionally, I would recommend an evaluation if the shoulder begins to get stiff.

Not all tendon tears require surgery and many respond well to conservative management. This type of treatment typically includes physical therapy, anti-inflammatory medication, and occasionally injections to decrease pain and inflammation.

Complete tears of the rotator cuff usually require surgical repair. Due to recent surgical advances, these tears can now be repaired arthroscopically (small incisions with a special camera and instruments). This typically results in less pain, less scar tissue, and improved mobility following surgery. Proper rehabilitation following surgery is critical to a successful outcome.

J.A. Dorizas, M.D.

Wellspring Sports Medicine and Orthopaedics

1755 Gunbarrel Rd., STE 102

Chattanooga, TN