The shoulder is an incredible joint that allows movement in many different ways. Because of the shoulder, we can scratch our head, reach between our shoulder blades, and touch our back without pivoting anything but the shoulder. This tremendous motion is possible because the joint lacks large ligament support. For this same reason, however, the shoulder can become unstable and more vulnerable to injury. Much of the shoulder stability comes from the rotator cuff muscles and tendons that attach the muscles to the bones.
Shoulder pain is often an indicator of rotator cuff tendon weakness. Injury to the rotator cuff tendon attachments can cause pain when reaching for things above the shoulder. There may even be referred pain to the back of the shoulder. Large amounts of swimming or overhead work necessitates raising the arms thousands of times, which can cause wear and tear of the rotator cuff tendons. Years of sleeping on the shoulder causes the rotator cuff tendon to become lax, because this pinches and compresses the rotator cuff muscles, making them weaker.
In many cases, therapies such as exercise, chiropractic, and physical therapy, can resolve rotator cuff injuries, like tendonitis. It is common, however, for injuries to linger beyond a couple of months, since the blood supply to the tendons is poor, leaving it with a disadvantaged healing ability. Regenerative treatments directing a renewed blood supply to the area are useful in these cases. Prolotherapy, including Platelet Rich Plasma are options worth considering because they induce the natural healing cascade to repair tendon damage. If rotator cuff weakness is not corrected, shoulder range of motion will decline, especially in people over age 60. Finding therapies that improve joint stability and range of motion can help shoulders stay strong and pain-free.