An accident or bad fall can cause you to dislocate your shoulder joint. But many shoulder injuries are due to overuse and involve your tendons, ligaments and cartilage.

When you repeatedly move your shoulder in the same way, it can put stress on all the structures that keep your joint in place. This is why athletes are at risk for shoulder injuries. Shoulder problems are especially common among pitchers, tennis and squash players, rowers, golfers and swimmers.

But people of all ages and activity levels can develop shoulder pain. In fact, age is a big risk factor. The older you are, the more wear and tear you put on your shoulder joint.

Your rotator cuff keeps your arm in your shoulder socket. Made up of muscles and tendons, it attaches the top of your arm bone to your shoulder blade. As its name suggests, it helps you rotate and raise your arm.

Falling on an outstretched arm or suddenly lifting something too heavy can cause a rotator cuff tear. But most rotator cuff injuries happen because of wear and tear. Overuse can weaken the tendons over time.

A small rotator cuff tear can heal with rest and physical therapy, whereas a large one often needs surgery.

The main rotator cuff tear symptoms include:

• Pain when lifting and lowering your arm
• Pain at night, especially when lying on your shoulder
• Shoulder weakness and inability to lift objects
• Popping or cracking sound in your shoulder when you move it

Because your shoulder is a complex joint, other things can go wrong, too. Carilion shoulder surgeons often see conditions related to:

• Shoulder instability: This may feel like your shoulder may want to slip out of place. If your shoulder is too unstable, the joint can dislocate.
• Shoulder impingement: This is when your shoulder muscles rub against your shoulder blade, usually because of excessive overhead arm motion. Impingement causes tendonitis (inflammation of tendons) and bursitis (inflammation of the sac that protects your rotator cuff).
• Shoulder stiffness: Also called frozen shoulder, this can happen after an injury if your shoulder is immobile for too long. It leads to pain and decreased range of motion.
• Shoulder sprains and strains: Many sprains (ligament injuries) and strains (muscle injuries) will heal on their own with rest.

Our orthopaedic doctors are experts at diagnosing and treating the whole range of shoulder injuries. We’ll do a medical exam, testing your range of motion in your shoulder. For severe rotator cuff tears, instability, fractures or dislocations, we will use imaging to help us get an accurate diagnosis.

Non-surgical treatments for shoulder pain

Mild sprains or tendonitis improve with rest and home care. Ice the area that hurts to reduce swelling and take ibuprofen (Advil) or naproxen (Aleve).

Even rotator cuff pain can get better by taking a break from the activity that’s causing the pain. For acute injuries or shoulder pain that doesn’t improve with home care, schedule a visit with our shoulder specialists.

Depending on your diagnosis, we may prescribe:

• Lifestyle changes: We can talk to you about habits or activities that might worsen your shoulder pain. For athletes, this can mean taking a break from a sport.
• Medicine: We may have you take over-the-counter anti-inflammatory medicine. In some cases, we’ll prescribe stronger anti-inflammatories.
• Injections: Steroid injections directly into your shoulder joint can help with pain from a range of shoulder conditions. The pain relief can last as long as 3 months or even longer.
• Shoulder exercises: We may give you a series of shoulder-strengthening exercises to do on your own.
• Physical therapy: Your doctor may refer you to work with a physical therapist, who will design a specific program to treat your shoulder condition.

Rotator cuff surgery

Your doctor may suggest surgery to repair your torn rotator cuff if:

• Your tear happened because of a recent acute injury
• Your symptoms haven’t improved over the last 6 to 12 months
• Your rotator cuff tear is large (more than 3 cm)
• You’re struggling to use your shoulder, and it’s impacting your life

If you’ve completely torn your rotator cuff tendon, the surgeon may suggest surgical repair. We have other techniques we use for partial tears.

We perform arthroscopic surgery when possible. This type of surgery uses tiny instruments and requires only very small incisions. People with larger, more complex tears may need an open repair or tendon transfers, which means a larger incision.

Your surgeon will discuss which technique is best for you.