Rotator cuff injuries need immediate treatment

Q. I am a 40-year-old right-handed secretary who has had bad pain in my shoulder for a month when I try to sleep. Every time I roll onto it it wakes me up. I never hurt it although I do work out occasionally with weights. I have taken some Advil, which helps a little bit but wonder why it has not gone away. What should I do?

A: Pain in the right shoulder when trying to sleep is usually indicative of an injury to the rotator cuff tendon. There are four muscles from the front, top, and back of the shoulder that come together to form a tendon that allow you to rotate the shoulder.

Rotator cuff tears are uncommon in someone as young as you but the classic symptoms for a tear are weakness and pain at night in the affected shoulder. When you are a 20-year-old pitcher or quarterback it usually takes a significant trauma to injure the rotator cuff tendon.

As we get older, many times the rotator cuff tendon can tear without trauma on a gradual basis. Not all rotator cuff tears require surgery to fix them but I do recommend you see an orthopedic surgeon for evaluation of your shoulder.

In addition to the physical exam, X-rays will likely be taken to make certain there is no calcification of the rotator cuff tendon or bursa, arthritic narrowing, or bony spurs. An MRI scan may also be necessary to assess the condition of the tendon. It is also important that you maintain your range of motion so you do not get a secondary frozen shoulder with scar tissue that can form.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to

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