Shoulder Pain and Rehabilitation

With spring training and hotter temperatures, many Weekend Warriors take to the baseball diamond or the swimming pool. While baseball, softball and swimming are all excellent sources of recreation and exercise, they can lead to shoulder pain when proper technique, conditioning and warm-up are lacking.

Tyler Collins, MD , an orthopedic surgeon with The CORE Institute says minor shoulder sprains and strains are fairly common. He warns, however, that lingering pain and soreness lasting more than a few weeks could indicate a more serious injury, such as tendonitis, bursitis or even a tear in the shoulder.

“It’s important to distinguish between minor sprains or strains and structural damage to the shoulder in order to avoid unnecessary pain and days of lost activity,” he explained.

Common complaints following an injury include pain in the front, back or side of the shoulder that can radiate down to the elbow, but usually will not reach the forearm.

Collins says that with a sore shoulder can come tight and sore neck and chest muscles as well as shoulder weakness.

“Initially, a brief period of rest, ice and anti-inflammatory pain medicine will usually provide relief,” he said. “Using a sling is OK for a few days, but prolonged use can cause stiffness.”

Following a shoulder injury, players are generally advised to wait a week or two to see if the pain subsides. As symptoms improve, shoulder exercises and physical therapy can help restore function.

“Most exercises are easy to do at home with exercise bands or small weights,” he noted.

Of course, more serious injuries require more attention.

“Persistent pain that does not improve within a few weeks, popping sounds, large amounts of swelling or bruising are pretty good indicators of a more serious injury,” he said. “Fortunately, these types of traumatic injuries are not as common among Weekend Warriors.”

However, when more serious injury strikes, Collins suggests consulting a shoulder specialist to determine if the pain is caused by inflammation or tendonitis versus a tear or more significant injury.

He says pain that does not result in serious shoulder weakness is usually caused by inflammation and, in most cases, will improve with anti-inflammatory medicine and/or steroid injections. Physical therapy can help reduce pain and improve strength.

“Injections usually provide near complete pain relief that can last several months, but it is not recommended that patients receive repeat injections as they can actually damage some of the structures around the shoulder,” he shared.

Instead, Collins says an MRI can determine if there is more severe damage. If physical therapy and injections do not provide relief, surgery can reliably restore function and decrease pain for most shoulder injuries.

Regardless of whether surgery is needed, rehabilitation is paramount to successfully treating any shoulder injury. This initially includes stretching exercises to improve range of motion followed by lifting light weights to strengthen the small muscles around the shoulder. As strength improves, low-impact activities such as long distance swimming are good for increasing strength and endurance.