Shouldering Summertime Fun

Summer is finally here! After the winter we had, it's time once again to be outside. For many of us, that means swimming, volleyball, golf, kayaking, tennis, and other fun outdoor activities.

But, did you know that the repetitive motion of raising the arm overhead in these activities — as well as just tossing a Frisbee or a baseball — can increase your chance of a shoulder injury? Tendonitis, muscle strains, and even more serious problems, such as dislocations or muscle tears, can occur.

It doesn't matter if you're a pro athlete or a weekend warrior; if you've been enjoying these summer sports and start to feel an ache in your shoulder, it's important to know how to keep it from getting worse.

"These types of activities do predispose people to labral tears and rotator cuff injuries," says Dr. Arun Ramappa, Chief of Sports Medicine and Shoulder Surgery at Beth Israel Deaconess Medical Center.

The labrum is an area of soft tissue in the socket part of the shoulder joint. Raising the arm repeatedly can sometimes cause the labrum to be caught between part of the shoulder blade and the upper arm bone, possibly forcing it to tear. Some symptoms of a labral tear include:

• An aching in the shoulder joint or the upper arm
• A "catching" or "loosening" feeling of the shoulder with any movement
• Pain with certain activities involving shoulder movement
• Little to no range of motion in the shoulder

The rotator cuff connects your upper arm bone to your shoulder blade and is made up of muscles and four tendons, all of which help you raise and rotate your arm. Some symptoms of a rotator cuff injury include:

• Recurrent, constant pain and tenderness in the shoulder, especially when reaching overhead or lifting things
• Weakness in the shoulder, especially when lifting the arm
• Pain while lying on the affected side
• Limited range of motion in the shoulder joint

Of course, no one wants to interrupt their summer fun, so the tendency may be to ignore the pain and "play through." However, according to Dr. Ramappa, that will only aggravate the problem.

If you start to experience these or similar symptoms that persist, it is important to stop the activity and see a doctor. Your doctor will do an exam to understand the extent of injury and may order imaging tests, like an MRI, to see if there are tears in any muscles or tendons.

Is surgery the only option for shoulder injuries? In many cases, the answer is no.

"Very often physical therapy is the initial treatment," says Dr. Ramappa. "Depending on the kind of injury, we will talk with the patient about specific exercises to improve flexibility, build balance, and increase muscle strength. Physical therapy could take a few weeks to a few months — it depends upon the severity of the patient's injury."

Doctors also occasionally recommend corticosteroid injections, as these can often help alleviate symptoms.

"Some injuries don't respond to conservative treatment, and that's when we consider surgery," says Dr. Ramappa, who performs hundreds of surgeries each year. "Other, generally more serious injuries, like labral tears and rotator cuff tears, often need surgery."

Getting the shoulder moving after surgery is important for recovery. Most patients start moving the arm the day after surgery. Within a few weeks of surgery, patients start working with a physical therapist for active exercises.

"Surgeries are generally very successful," Dr. Ramappa says. "Though individual recovery is different from patient to patient and from procedure to procedure, many patients have returned to the activities they enjoy between four and six months after the surgery."

Here are some tips to keep your shoulders healthy and help prevent shoulder problems while you go about your summer activities:

• Check with a coach or trainer to see whether your technique while swimming, playing tennis, or hitting a golf ball needs to change.
• Start doing flexibility, strength training and shoulder stabilization exercises to strengthen the shoulder muscles.
• Remember the importance of stretching. Include it in every workout.
• If you feel pain in your shoulders and it persists, it is recommended that you stop the activity and consult your doctor.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted July 2015