You go to return a serve at your weekly volleyball game and you feel it - excruciating pain in your shoulder.
That pain has been happening more often lately, and icing it just doesn’t seem to be doing the trick any more. But you’re afraid to see a physician for fear you’ll need surgery.
The good news is that surgery isn’t the only option. Nonsurgical treatments are effective in nearly 70% of sports injury cases and can be an appropriate treatment for many patients.
“Most younger people—younger than 45—probably end up getting surgery because their lifestyle is so demanding,” explains John D. Kelly, IV, MD, Director of Shoulder Sports Medicine at Penn Orthopaedics.
“For the older folks over 70, we do whatever we can to avoid the knife,” he adds.
Dr. Kelly explains four ways to fix shoulder pain without surgery:
Do physical therapy
Certain types of shoulder pain are actually better suited to physical therapy than surgery.
“If someone has had a dislocated shoulder—more than once—surgery is the best option,” Dr. Kelly cautions. “But most of the time, if the shoulder is showing just a little looseness and is a little less stable than it should be, rehab is likely the better option.”
Rehabilitation over the course of about six weeks often helps improve the muscles around the shoulder, which restores mobility.
“We work on strengthening the rotator cuff muscles, subscapularis muscles, posture, and we stretch muscles that are tight that could be causing the pain to be worse,” Dr. Kelly explains. “For patients with overuse injuries, success is at about 90%.”
Maintain your weight
What does weight management have to do with shoulder pain? The answer might surprise you.
“Research suggests that shoulder stiffness is a precursor to metabolic syndrome due to caloric excess,” says Dr. Kelly.
Metabolic syndrome is an umbrella term for a set of risk factors that spike your chance of heart disease, diabetes, and stroke, reports the National Heart, Lung, and Blood Institute (NHLBI).
Five conditions make up metabolic syndrome. However, if you have three out of five, more than likely you’ll be diagnosed with it.
The conditions include:
- Excess fat around the abdomen
- High triglycerides (high fat levels in blood)
- Low HDL or “good” cholesterol
- High blood pressure
- Elevated fasting blood sugar levels
To keep weight-related shoulder pain at bay, Dr. Kelly advocates a healthy diet and exercise.
“It’s one of the premises of our research: Lose weight and shoulder stiffness gets better,” he says.
No one should suffer in pain. In fact, Dr. Kelly says medication helps many patients manage the pain, but he’s selective about what he recommends.
“We prescribe anti-inflammatories, but we try not to use narcotics,” he says.
Steroid injections can also help treat shoulder pain. Cortisone is an anti-inflammatory that can help reduce swelling and discomfort, and is recommended after other noninvasive methods fail. Although steroid injections are an option for some patients, they are not a long-term treatment solution. If the pain persists, it’s time to speak with your doctor.
Inflammation in the body causes pain, but it can also set you up for chronic diseases.
“We’ve noticed that some of the degenerative diseases like heart disease, Alzheimer’s disease, diabetes and hypertension have an inflammatory component,” says Dr. Kelly.
The good news: Inflammation can often be managed.
“Hyperglycemia or high glucose increases your body’s inflammation, and high sugar is pro-inflammatory,” Dr. Kelly cautions. “So, if your blood sugar is even a little high, you are set up for an inflammatory condition, including shoulder stiffness.”
If you have shoulder pain, definitely address it. “Don’t ignore it,” Dr. Kelly warns. “It could be a partial rotator cuff tear that could become a full tear.”
“Also, if you have an unstable shoulder, and it dislocates more than once, that is a very high predictor that you’ll have arthritis as you get older,” he adds. “Both of those problems should receive immediate attention by a shoulder specialist.”
Penn Sports Medicine
From weekend warriors to professional athletes, the specialists at Penn Sports Medicine and the Penn Musculoskeletal Center provide comprehensive care for athletes of all ages and abilities. Our team of experts from orthopaedics and physical medicine and rehabilitation understands your drive and desire to get back in the game. These experts work together as a seamless unit to provide a wide range of treatments, not just surgery, and help you return to an active, pain-free lifestyle.