Dr. Jon-Michael Cline to discuss shoulder pain during June 2 Walk With a Doc

Published 1:30 pm Friday, May 25, 2018

Dr. Jon-Michael Cline, a primary care sports medicine physician with Christus Trinity Clinic Orthopedics and Sports Medicine, leads the June 2 Walk With a Doc. 

He will discuss shoulder pain.

Walk With a Doc, a project of the Smith County Medical Society, begins at 9 a.m. at Rose Rudman Recreational Trail’s Copeland Road trailhead, followed by walking.

Q. What are some common causes of shoulder pain in teens and young adults?

A. As one of the most complex joints in the body, there are many causes of shoulder pain. In younger teens and adults, shoulder pain usually occurs as a result of overuse or repetitive use. Year-round participation in overhead sports can lead to these overuse injuries. Poor posture and/or weakness of the shoulder, hips and core also can lead to shoulder pain in this age group.

Q. What are the more common causes of shoulder pain in older adults?

A. A few of the most common causes of shoulder pain in older adults are osteoarthritis, rotator cuff injuries and adhesive capsulitis. Arthritis, or joint inflammation, is typically caused by wear-and-tear of the cartilage in the ball-and-socket joint of the shoulder, also known as the glenohumeral joint. Rotator cuff injuries are common in older adults. The rotator cuff is composed of four muscles whose tendons come together to form the cuff. Rotator cuff tendinitis is inflammation of the rotator cuff. This most often occurs in the setting of repetitive overhead activity and sometimes occurs in conjunction with bursitis, or inflammation of the bursa sac of the shoulder. Rotator cuff tears can occur as a result of a traumatic injury to the shoulder and can also happen over time without a specific injury to the shoulder. Adhesive capsulitis, also known as frozen shoulder, is another common cause of shoulder pain in this age group. This occurs most often from prolonged shoulder inactivity and is more prevalent in those with a history of diabetes and hypothyroidism.

Q. How do you treat shoulder pain?

A. The best treatment for shoulder injuries is prevention. For teens and young adults, most experts recommend at least three months off from overhead sports each year. Alternating between sports can be helpful to maintain coordination and cardiovascular fitness. In addition, proper posture and attention to maintaining lower body, core and shoulder strength and flexibility is of paramount importance. For existing shoulder injuries, the treatment depends on the underlying cause. Most cases can be diagnosed by a thorough physical exam and can be treated conservatively. Conservative treatment can consist of physical therapy, rest, oral medications and injections. Occasionally, surgery may be required and should not be delayed if indicated.

Q. When are injections indicated?

A. Injections can be helpful to reduce pain and inflammation. They are most commonly used in the setting of rotator cuff tendinitis, bursitis and arthritis. Occasionally, these injections are guided by ultrasound to ensure adequate placement.

Q. When is surgery indicated?

A. Surgery can be indicated if conservative treatment fails. Rotator cuff injuries, shoulder arthritis, and frozen shoulder can each require surgical treatment. The decision to proceed to surgery depends upon multiple factors, including pain level, extent of injury, desired activity level and surgical candidacy.