Five years ago, Sharon Williams Duncan of New York City couldn’t lift her right arm and was diagnosed with a tear in her shoulder’s rotator cuff. Although she had not done anything specific to strain her shoulder, she chalked it up to having worked out too hard at the gym.
Shoulder injuries are becoming more prevalent, according to Dr. Nancy Yen Shipley, an orthopedic surgeon based in Portland, Ore. “People are staying active later and later, and that’s why we’re seeing more of these problems,” Yen Shipley said. “It hits people in their 30s, 40s and beyond.”
The most common shoulder injuries seen by Yen Shipley are tendonitis (an inflammation of tendons around the shoulder joint), bursitis (when the sac of fluid helping to protect the shoulder becomes inflamed) and tears in the rotator cuff tendons. Impingement — the development of bone spurs in the shoulder — and arthritis are other frequent problems that can occur in the joint.
As an injury worsens and a person becomes reluctant to move a shoulder, the soft tissue can become contracted and tight. This painful condition, called frozen shoulder, makes it impossible to reach over the head or behind the body. Although frozen shoulder mysteriously goes away on its own after a couple of years, most patients prefer to speed up the process with physical therapy, steroid injections and, in some cases, surgery.
“People with diabetes, thyroid problems, heart disease and Parkinson’s tend to be more prone to getting frozen shoulder,” Yen Shipley said. “But anytime you have a shoulder injury or some kind of condition that causes pain, that can lead to frozen shoulder.”
Most shoulder injuries are diagnosed through a physical exam as well as diagnostic imaging such as X-rays or MRIs. Minor pain can usually be treated by activity modification and anti-inflammatory medication. Some injuries require surgery, however. “Working on shoulders is a much less invasive procedure than it used to be,” Yen Shipley said. “With arthroscopic surgery, we can use a tiny incision, and that makes a big difference in the amount of pain and the speed of recovery afterward.”
One doctor has developed a simple maneuver that alleviates pain and restores range of motion in 90 percent of patients with rotator cuff tears so treated. Dr. Loren Fishman, a rehabilitation physician based in New York City, had developed frozen shoulder after he tore his rotator cuff. As an avid yoga practitioner, Fishman was doing his “one-armed” version of yoga one day when he decided to try a headstand. “Before this time I couldn’t lift my arm above 80 degrees,” Fishman recalled. “After I did the headstand, I got up and realized that I could raise my arm painlessly over my head.”
Fishman has since treated more than 800 patients with the “triangular forearm support” maneuver (which can be performed using a chair or against a wall), with nine out of 10 patients reporting immediate improvement, even though the tear was still present. A study of the technique was published this year in the journal Topics of Geriatric Rehabilitation.
“The body is really smart,” Fishman said. “You basically replace the function of the torn muscle with [that of] another muscle, and it’s activated by standing on your head.” He is working on a new study to determine if Botox injections into the injured muscle will allow it to heal. (See the sidebar for details.)
Williams Duncan consulted Dr. Fishman for treatment of her rotator cuff tear, and was surprised when he asked her to try the yoga pose. “I did the variation off the chair,” she said. “My arm went up and down, and it continues to go up and down. I now have complete rotation. It was a miracle.”
Shoulder injuries are becoming more prevalent, according to Dr. Nancy Yen Shipley, an orthopedic surgeon based in Portland, Ore. “People are staying active later and later, and that’s why we’re seeing more of these problems,” Yen Shipley said. “It hits people in their 30s, 40s and beyond.”
The most common shoulder injuries seen by Yen Shipley are tendonitis (an inflammation of tendons around the shoulder joint), bursitis (when the sac of fluid helping to protect the shoulder becomes inflamed) and tears in the rotator cuff tendons. Impingement — the development of bone spurs in the shoulder — and arthritis are other frequent problems that can occur in the joint.
As an injury worsens and a person becomes reluctant to move a shoulder, the soft tissue can become contracted and tight. This painful condition, called frozen shoulder, makes it impossible to reach over the head or behind the body. Although frozen shoulder mysteriously goes away on its own after a couple of years, most patients prefer to speed up the process with physical therapy, steroid injections and, in some cases, surgery.
“People with diabetes, thyroid problems, heart disease and Parkinson’s tend to be more prone to getting frozen shoulder,” Yen Shipley said. “But anytime you have a shoulder injury or some kind of condition that causes pain, that can lead to frozen shoulder.”
Most shoulder injuries are diagnosed through a physical exam as well as diagnostic imaging such as X-rays or MRIs. Minor pain can usually be treated by activity modification and anti-inflammatory medication. Some injuries require surgery, however. “Working on shoulders is a much less invasive procedure than it used to be,” Yen Shipley said. “With arthroscopic surgery, we can use a tiny incision, and that makes a big difference in the amount of pain and the speed of recovery afterward.”
One doctor has developed a simple maneuver that alleviates pain and restores range of motion in 90 percent of patients with rotator cuff tears so treated. Dr. Loren Fishman, a rehabilitation physician based in New York City, had developed frozen shoulder after he tore his rotator cuff. As an avid yoga practitioner, Fishman was doing his “one-armed” version of yoga one day when he decided to try a headstand. “Before this time I couldn’t lift my arm above 80 degrees,” Fishman recalled. “After I did the headstand, I got up and realized that I could raise my arm painlessly over my head.”
Fishman has since treated more than 800 patients with the “triangular forearm support” maneuver (which can be performed using a chair or against a wall), with nine out of 10 patients reporting immediate improvement, even though the tear was still present. A study of the technique was published this year in the journal Topics of Geriatric Rehabilitation.
“The body is really smart,” Fishman said. “You basically replace the function of the torn muscle with [that of] another muscle, and it’s activated by standing on your head.” He is working on a new study to determine if Botox injections into the injured muscle will allow it to heal. (See the sidebar for details.)
Williams Duncan consulted Dr. Fishman for treatment of her rotator cuff tear, and was surprised when he asked her to try the yoga pose. “I did the variation off the chair,” she said. “My arm went up and down, and it continues to go up and down. I now have complete rotation. It was a miracle.”
