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Rotator
Cuff and Shoulder Pain
Ross Hauser, M.D.
The
most common cause of chronic
shoulder pain is not shoulder instability but supraspinatus tendon weakness, also known as
rotator cuff tendonitis. If full
range of movement in the shoulder is compromised, the supraspinatus tendon
works harder to provide the motion support needed. This tendon eventually
weakens and
laxity develops. A supraspinatus tendon problem is manifested by
pain with abduction and external rotation of the
shoulder, especially when
reaching for things above shoulder level, or pain in the shoulder after
sleeping due to compression of the supraspinatus tendon.
The supraspinatus tendon often refers pain to the back of
the shoulder. Sleeping on the shoulder causes a pinching of the rotator cuff
muscles and can lead to rotator cuff weakness. There are cases where the cause
of the rotator cuff
tendon laxity was due to years of sleeping on the
shoulder.
In most cases, traditional therapies such as
exercise and
physical therapy will resolve rotator cuff tendonitis. It is not uncommon,
however, for rotator cuff injuries to linger because blood supply to the
rotator cuff tendons is poor. Poor blood supply is a reason the rotator cuff
is so commonly injured. In chronic cases of shoulder pain due to rotator cuff
weakness,
Prolotherapy is the treatment of choice. Prolotherapy will cause the
rotator cuff to strengthen and eliminate shoulder pain. If rotator cuff
weakness is not corrected, the shoulder's range of motion will deteriorate.
Rapid deterioration can occur, especially in people over 60 years of age.
When shoulder muscle weakens, movement becomes painful.
Those who have supraspinatus tendon laxity causing pain will stop moving their
arms into the painful position. Though they may not realize it, they are
slowly but surely losing shoulder movement. What begins as a simple rotator
cuff muscle weakness easily treated with Prolotherapy, has the potential to
become a
frozen
shoulder
because of scar tissue formation inside the shoulder
that was left untreated. The scar tissue formation causing a decrease in the
ability to move the shoulder is called adhesive capsulitis.
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