Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I used to be a pretty good ball player but I haven't picked up a baseball in 25 years. During a family reunion, I was the pitcher for our team. Oh boy -- my shoulder has been pretty ouchy ever since. Do I wait it out or is it better to see someone right away? I can't decide.

Answer:

You have nothing to lose by getting an exam and diagnosis. For most musculoskeletal aches and pains, rest and recovery is all that's needed. But with a little age behind you and a pattern of overuse, there may be need for a more specific treatment approach. And usually, early diagnosis and treatment yield better results. One of the most common shoulder injuries adults face is a rotator cuff tendinitis or tear. The rotator cuff is a group of four tendons and muscles that surround and support the shoulder. Degenerative changes that accumulate over time may not be noticeable until an extended period of activity and then, just as you say: ouchy. Another common injury from a combination of age-related factors and overuse is the labral tear. The labrum is a fibrous rim of cartilage around the edge of the shoulder joint. Because the shoulder has such a wide range of motion, the shoulder socket can't be too deep. But if it's too shallow, there is an increased risk of shoulder dislocation. The labrum gives a little lip to the socket to help balance out the need for mobility with the need for stability. Small tears or frayed edges of the labrum develop over time. Most of these pose no problems or cause any significant symptoms even in middle-age. But if the labrum is torn away as occurs with a SLAP tear (SLAP stands for superior labral anterior-posterior),then sharp,aching pain develops deep in the shoulder. It's worse when you try to lift heavy objects, lift something overhead, or push an object forward (e.g., pushing open a heavy door). Sometimes patients have both injuries at the same time making the diagnosis difficult. But a skilled orthopedic surgeon can evaluate your shoulder and narrow down the diagnostic possibilities. Treatment will depend on what he or she finds. Many times, a period of rest and pain relievers or even antiinflammatories is all that's needed. If your symptoms have not decreased by the end of six weeks and gone away completely in three months, then you may be a candidate for surgery. But cross that bridge if and when you get there. For now, see a doctor, get a diagnosis, go from there. Jay D. Keener, MD, and Robert H. Brophy, MD. Superior Labral Tears of the Shoulder: Pathogenesis, Evaluation, and Treatment. In Journal of the American Academy of Orthopaedic Surgeons. October 2009. Vol. 17. No. 10. Pp. 627-637.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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