Should You Muscle Through Shoulder Pain?

Shoulders take a lot of abuse in our daily lives. We lift and carry heavy objects, reach in awkward ways, hang bags and purses from them, throw things and undoubtedly stress them with our professions and hobbies.  We take them for granted until the day comes when pain prevents us from doing what we want/need to do. 

A popular injury that involves the shoulders is rotator cuff dysfunction.  Whether in the form of tendonitis, weakness, or tears, the muscles that make up the rotator cuff are usually part of the problem.

Four shoulder blade muscles work together to make up the rotator cuff.  These muscles are responsible for all of the motions involved with throwing (lifting the elbow out to side, rotating the forearm backward, forward and extending the arm behind back).  When these muscles are working properly they do more than just allow us to throw. They help keep the shoulder in the correct position to allow for
reaching in all different directions--painfree. When a rotator cuff weakness or dysfunction develops, an imbalance of the forces at the shoulder occurs with reaching and the shoulder joint position is altered.  Over time, this causes friction on the tendons when we reach in different ways and “tendonitis” is a common result.

Similarly, since the shoulder is not being held in proper alignment, the tendons may also become “pinched” between the shoulder bones, resulting in “impingement syndrome.”  This is seen in both males and females.  I see this develop also in people who lift weights regularly to strengthen the muscles on the front of the body (chest, biceps, deltoids), but neglect the upper back and shoulder blade muscles.  A similar dysfunction develops due to the imbalance of forces at the shoulder joints. 

Another common problem involving the shoulder is “frozen shoulder” or “adhesive
capsulitis.”  This may occur secondarily to a dysfunction like the one described above, after periods of immobilization (i.e. with fracture healing) or due to an unknown cause.  In any case, significant loss of shoulder range of motion develops as the capsule of the shoulder tightens due to disuse over time.  A cycle of pain and dysfunction develops, consciously or not, in which pain with shoulder movements causes one to stop performing the painful movements.  This lack of movement and disuse allows the capsule to tighten and the surrounding muscles to weaken.  Further attempts at use of the shoulder cause more pain so, over time, lack of movement takes over and people end up with a shoulder that is “frozen.”

With traumatic injuries or slowly progressing shoulder pain, it is always beneficial
to seek treatment sooner than later.  I have seen some people fully recover within days after initiating a rotator cuff strengthening program.  This will not happen, though, if months or years worth of damage is already done.  Symptoms can still be alleviated, but the rehab will be much longer and harder.

Be kind to those hard working shoulders, be aware of pain with any shoulder
movements and be sure to seek treatment should the need arise.