Shoulder injuries can be extremely painful and debilitating. Two common conditions are frozen shoulder and rotator cuff tears. It is important to understand the specifics of each and how you can work with orthopedic specialists to treat them.
Frozen Shoulder: Symptoms, Risk Factors and Treatment Options
Frozen shoulder is also known as adhesive capsulitis. When the lining of the shoulder joint becomes inflamed, the tissue can thicken. This process causes significant pain and loss of motion—thus earning the name “frozen” shoulder.
There are stages to frozen shoulder. It starts with an inflammatory phase marked by severe pain, which can last from weeks to months. Then, individuals progress into the frozen stage, defined by a loss of motion. Although the range of motion will often return on its own, full recovery can take a year or more.
Risk factors for frozen shoulder include:
- Reduced use of the shoulder due to surgery
- Prior treatment for breast cancer
- Thyroid disorders
- Diabetes
- Often the condition occurs for no known reason
Regardless of the cause, addressing frozen shoulder starts with physical therapy. This involves slow, static, progressive stretching. Patients may also receive a steroid injection to calm down any inflammation. If individuals fail to progress with conservative management, surgical options may be recommended. One option is a “capsular release” to restore range of motion. However, it may still take up to a year or more to return to “normal.”
Rotator Cuff vs. Frozen Shoulder
The rotator cuff is a group of four important muscles that help keep your shoulder stable and moving smoothly. These muscles are attached to the shoulder bones by strong bands called tendons. The tendons help hold the shoulder joint in place while allowing your arm to rotate and lift. When the rotator cuff works well, it lets you move your shoulder in many ways, which is important for everyday activities.
Rotator cuff injuries are different from frozen shoulder. With frozen shoulder, a person loses both active and passive movement. Active movement means using your own muscles to move your shoulder, like raising your arm. Passive movement happens when someone else moves your arm for you.
On the other hand, rotator cuff injuries may make it difficult to move your arm on your own because a tendon is torn. Often, passive motion is maintained and someone else can still move your arm for you without much trouble.
Traumatic or Degenerative Rotator Cuff Injury?
Rotator cuff injuries usually fall into two main types: traumatic and degenerative. While they can sometimes overlap, knowing the difference helps explain how they happen and what to do next.
Traumatic tears occur suddenly, often due to an accident, such as falling, dislocating your shoulder, or lifting something too heavy. These injuries occur when the shoulder endures a force or strain that exceeds its capacity.
Degenerative tears happen slowly over time. As people age, the rotator cuff receives less blood flow, making the tendons weaker and more likely to tear. Age is the biggest risk factor, but other things can also contribute, like heavy physical work, diabetes or circulation problems, or even smoking, which can weaken the blood vessels and rotator cuff.
Knowing what caused the injury is important for choosing the right treatment. Traumatic and degenerative tears may require different care, but both can lead to severe pain and difficulty using the shoulder if not treated properly.
How Are Rotator Cuff Injuries Treated?
Physical therapy can be effective for many patients with degenerative rotator cuff tears. In cases where the tendon has worn down over time and you’re experiencing shoulder pain, therapy is often the first line of treatment. The goal of physical therapy is to strengthen the surrounding muscles, improve the range of motion, and reduce discomfort. In addition to therapy, an injection may help alleviate pain and decrease inflammation in the shoulder joint. If, after about six weeks of therapy, there’s no significant improvement, it’s time to consider surgical intervention.
Traumatic rotator cuff tears, on the other hand, often require immediate attention to restore function. These injuries typically respond better when treated with surgical repair. Most rotator cuff repairs today are fixed with arthroscopic surgery. During this procedure, an orthopedic surgeon puts a camera in one small cut to see inside the shoulder and uses other small cuts to fix the tear with tiny tools. They sew the torn tendon back to the bone and secure it in place.
Whether the tear is degenerative or traumatic, the recovery process after surgical repair requires patience as the tendon reattaches to the bone. With proper care, many patients achieve a successful outcome.
Lifestyle Habits Matter
As with many injuries, individuals can speed healing by practicing healthy lifestyle habits. Eating a healthy diet, staying active (without compromising the injury), getting proper rest, and not smoking all aid in recovery.
Of course, any kind of shoulder injury needs the expertise of an orthopedic specialist. If you’re experiencing shoulder pain, contact your primary care provider or orthopedic team to discuss your path to relief.
Listen to a Podcast
In a recent podcast interview, Dr. Michael Livesey, an orthopedic surgeon at UM Upper Chesapeake Health Orthopaedics and a member of the UM Joint Network, provided an in-depth discussion of frozen shoulder and rotator cuff tears. Listen to the episode below, on our website or on your favorite podcast platform.
More to Read
- Are Corticosteroid Injections the Right Treatment for Your Joint Pain?
- Supplements for Joint Pain: Helpful or Harmful?
- Healing Shoulder Pain
- Managing Pain with Physical Therapy
Medically reviewed by Michael Livesey, MD.
