January 2005

I have noticed that for the last month or two I have pain on the outside of my upper arm just below the shoulder.  It is not present all the time, but hurts most when I try to reach overhead or behind me, or often times at night when I sleep.  Is this something that will go away on its own?

You have asked a very familiar question regarding a condition which we see and treat very frequently.  The symptoms you are describing are typical symptoms we discover with patients who have injured their rotator cuff.  The shoulder is a very complex series of joints and the rotator cuff is a very integral part of that anatomy.  The cuff can become painful from a wide variety of reasons, but without sustaining an actual injury, it is most often involved from factors involving posture, muscle weakness and/or tightness, or movements which mechanically cause stress to be put on the rotator cuff structure.  Occasionally, this can be caused by anatomical variations of the bony anatomy in the area, but that is relatively rare. 

Most frequently, treatment consists of exercises designed to strengthen and stabilize the shoulder blade (or scapula, which is the base for the shoulder) and rotator cuff, stretch tight structures which alter movement patterns, and minimize (for the short term only) the offending activities which cause symptoms to persist.

Kevin Cappel, PT