Shoulder Pain and Rotator Cuff Problems: Causes, Self-Care and When to Get It Checked

You reach up to a high shelf, or grab the seatbelt behind you, and a sharp ache catches you at the top of the arm. At night, rolling onto that side wakes you up. Shoulder pain is one of the most common reasons people come to see us, and the rotator cuff is often part of the story.

What is the rotator cuff?

The shoulder is a shallow ball-and-socket joint. That shape gives it a huge range of motion, but it also means the joint relies on muscles to keep it steady. The rotator cuff is a group of four small muscles and their tendons that wrap around the top of the arm bone. They hold the ball centred in the socket while bigger muscles lift and move the arm.

When the cuff gets irritated or overloaded, you may notice:

• A dull ache on the outside of the upper arm, sometimes spreading toward the elbow
• Pain when reaching overhead, behind your back or out to the side
• Pain lying on the sore side, or a deep ache at night
• A feeling of weakness when lifting or carrying

Why does it happen?

Most rotator cuff problems build up slowly. The tendons adapt to the work we give them, but they adapt slowly. When overhead or reaching work ramps up faster than they can keep up, they get sore. Common causes include:

• Fall chores. Raking leaves, cleaning gutters, pruning trees and hanging holiday lights all put the arms up and out for long stretches.
• Desk posture. Rounded shoulders and a forward head change how the shoulder blade sits, which can crowd the tendons when you lift your arm.
• Sport and the gym. Swimming, throwing, racquet sports, paddling and overhead lifting, especially after a break.
• Age. Tendons naturally change over time, so cuff problems become more common after about 40.
• A fall or sudden pull. Landing on an outstretched arm or catching something heavy can strain or tear the tendon.

Other things can cause similar pain, including bursitis, arthritis, frozen shoulder and pain referred from the neck. That’s why a proper assessment matters if it isn’t settling.

What can I do at home?

Most shoulders do better with gentle, regular movement than with complete rest. Give these a fair try for a couple of weeks:

• Keep it moving, within comfort. Avoid holding your arm still against your body for days. Stiffness can make things worse.
• Try pendulum swings. Lean forward with your good hand on a table and let the sore arm hang. Gently swing it in small circles for 30 to 60 seconds, a few times a day.
• Change how you reach. Use a step stool instead of reaching overhead, keep loads close to your body, and break up raking or gutter work into shorter sessions.
• Sleep smarter. Lie on your good side and hug a pillow, or lie on your back with a pillow under the sore arm.
• Ease the ache. Ice or heat for 10 to 15 minutes may help. Use whichever feels better.
• Check your desk. Bring your keyboard and mouse close, rest your forearms, and sit back so your shoulders can relax.

When should I get it checked?

Book an assessment if your shoulder hasn’t improved after two to three weeks, if it keeps you up at night, or if you’re losing the ability to lift your arm or reach behind you. Early care can help keep a sore shoulder from turning into a stiff one.

Get medical care right away (see your doctor, or go to emergency) if you have:

• Sudden, severe shoulder pain after a fall or injury, especially with a deformity, swelling or bruising
• Sudden weakness where you can’t lift your arm at all
• A hot, red, swollen shoulder, or shoulder pain with a fever
• Numbness, tingling or weakness in the arm or hand that’s getting worse
• Shoulder or arm pain with chest pain, shortness of breath, sweating or nausea (call 911)

How we help with shoulder pain

Our team looks at the whole picture: your shoulder, shoulder blade, neck and upper back, plus your work, sport and sleep. Then we build a plan to settle the pain and get the shoulder strong again. If your main problem is stiffness, our earlier post on rehab for frozen shoulder has more on that condition.

Physiotherapy

Physiotherapy is a common first step for rotator cuff problems. Treatment focuses on exercises that gradually build cuff and shoulder blade strength, plus hands-on care to restore movement. Our physiotherapists also use IMS and dry needling for tight, painful muscles around the shoulder. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy, patient education and pain management. Kanu Priya, MPT has over 10 years of experience and uses manual therapy, dry needling (IMS), exercise prescription and functional rehab. Ivy Elling-Quaintance, MPT uses evidence-based exercise and movement, and has a particular interest in athletic injuries and injury prevention.

Massage therapy

Registered massage therapy can ease tight muscles across the shoulder, chest and upper back, which may make it easier to move and exercise. Craig Lawrence, RMT has practised since 2006 and focuses on trigger point release. Braedan Pearce, RMT has worked extensively with neck, shoulder and arm pain, using myofascial release, trigger point release, stretching and home care exercises. Alex Baan-Meiklejohn, RMT combines stretching with Swedish massage and trigger point therapy, and enjoys working with active people.

Chiropractic

Our chiropractors assess how your neck, upper back and shoulder work together, and treat the surrounding joints and muscles. Dr. Tessa Bryan, DC uses soft tissue therapies, instrument-assisted techniques, cupping, RockTape and therapeutic exercise. Dr. Matthew Bryan, DC has a passion for working with athletes. Dr. Alexia Grelson, DC and Dr. Krisjan Gustavson, DC round out our chiropractic team.

Shockwave and laser therapy

For tendon pain that’s been hanging on, shockwave therapy is an option. It’s a non-surgical treatment that sends mechanical pulses into the sore tissue to stimulate the body’s healing response. Sessions take about 15 minutes, and a course is usually 3 to 6 sessions. Class IV K-Laser therapy is another option that may help ease pain and stiffness.

Book an appointment

If shoulder pain is making it hard to reach, lift or get a good night’s sleep, we’d be glad to help. We bill most insurance plans directly, so you can focus on feeling better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.