Whether you realize it or not, you rely on your shoulders every day. In addition to providing a place for a loved one to cry on, your shoulders are used for many things — from playing golf and doing yard work to carrying groceries and even folding laundry.
The shoulder has the greatest range of motion of any joint in the body, which is why it’s important for so many activities. It’s also the most complex joint you have. And the intricate mix of bones, muscles, ligaments and tendons that make up the shoulder leaves it prone to injury. When an injury happens, movement and strength can become difficult and limited.

“An injury to one area of the shoulder can have a domino effect, impacting multiple parts and significantly interfering with mobility,” explains Travis Frantz, M.D., a sports orthopedic surgeon at Texas Health Orthopedic Specialists, a Texas Health Physicians Group practice in Bedford. “While shoulder injuries are especially common among athletes who rely on their shoulders for repeated overhead movements, there are others who are considered at increased risk for injury. People who frequently use their shoulders for manual labor such as painting, construction or yard maintenance are subject to shoulder wear and tear that can lead to further damage.”

Common Shoulder Injuries and Conditions

Because of how the shoulder is constructed, Frantz says it can be damaged in a lot of different ways. “The ball-and-socket nature of the shoulder that gives you such great range of motion also leaves it rather unstable as a joint. That’s why the shoulder joint gets dislocated more than any other joint in the body.”

Repeated stress on the shoulder either at work or while playing sports can lead to tears and other injuries as well. A fall or high-impact action may also damage the shoulder joint. The conditions Frantz says he sees most in his practice include:

• Shoulder dislocation/instability. Shoulder instability can make the shoulder ball feel like it wants to slip out of place. If the ball does become displaced, it’s considered a dislocation. The condition is most common in younger people, according to Frantz, especially athletes who repeatedly throw a ball or complete a tackle.
• Separated shoulder. A fall or hard blow to the shoulder can tear the ligaments that hold together the joint where your collarbone and shoulder blade meet, known as the acromioclavicular (AC) joint. “You may see a bump form on the top of your shoulder, signaling that some damage has occurred,” Frantz says.
• Rotator cuff tear. The group of muscles and tendons in the upper arm that hold the shoulder joint together and allow for a wide range of movements is known as the rotator cuff. When injured by a strain or tear, the rotator cuff becomes very painful and may even prevent you from lifting your arm.
• Biceps tendon tear. Most tendon (connective tissue) tears begin by fraying. As the damage worsens, the tendon can completely tear. Sometimes just lifting a heavy object is enough to cause a rotator cuff or biceps tendon tear. In the case of a biceps tendon tear, the tendons that attach the biceps muscle to bones in your shoulder and elbow become torn. You may lose some strength in your arm as a result and experience pain with certain movements.
• Shoulder impingement. When you raise your arm to shoulder height and away from the body, the space between the shoulder blade and rotator cuff narrows. The shoulder blade can then rub against (or impinge on) the soft tissues and tendons in the shoulder, causing irritation and pain. Tendinitis or bursitis may also occur with impingement and greatly limit movement and function.
• Osteoarthritis. Arthritis can take many forms. In the shoulder, it is most often in the form of osteoarthritis. As a person ages, their joints and the cartilage that protects them can begin to show signs of wear and tear. When cartilage in the shoulder wears away, movement can cause pain and stiffness. “Symptoms may develop slowly in middle age and worsen over time. They may be attributed to sports, a work injury, chronic wear and tear, infection in the joint or even a previous rotator cuff injury,” Frantz says.

How to Keep Your Shoulders Healthy

There are plenty of ways to lessen the likelihood of having shoulder trouble. From limiting repetitive activity (even something as seemingly harmless as prolonged computer use can lead to problems) to being sure to warm up before you exercise.

Daily stretching can also help maintain shoulder flexibility and a good range of motion. Frantz suggests yoga, resistance bands and light weight-bearing exercises for some level of protection against injury. 

When to See a Doctor

Although the shoulder can have its share of problems, it may be reassuring to know that many patients respond well to non-surgical treatment options. Limiting activities that cause pain or stiffness in the shoulder is a good place to start for getting relief. Rest, physical therapy, medication and/or joint injections may also do the trick. Frantz does point out, however, that there are times when surgery may be the best solution for an aching shoulder.

“Certain types of shoulder problems, including repeated dislocations, rotator cuff injuries and advanced arthritis, may not respond well to exercises designed to promote strength and flexibility in the joint,” he says. “In those cases, surgery may be recommended early on. The good news is minimally invasive arthroscopic surgery is the gold standard for aiding in the repair of torn or injured tendons in the shoulder. Procedures can often be done without the need for a large incision or open wound. For those times when a shoulder replacement surgery is the best option, the procedure is now routinely done as an outpatient surgery — with the patient being back at home the same day and doing everyday activities the same night.”

“Before beginning any home remedies, it’s always best to visit with an orthopedic specialist about your joint pain or loss of mobility. We’re here to help you move more freely and live more comfortably,” Frantz adds.

Tired of living with shoulder pain? Find and orthopedic specialist near you.