Have you ever thrown a ball as hard as you possibly could and heard a crunchy or popping sound in your shoulder? Did your shoulder hurt immediately afterwards? Did the pain travel down into your elbow?

During my sophomore college softball season at the University of Tennessee, I lost my throwing ability. What used to feel like a natural throwing motion was no more. My release point was gone, and at times I could not make a strong throw from the outfield to the infield. My confidence was so low that I did not know where the ball was going to end up.

One afternoon during practice, I was fielding a ground ball hit directly to me. Once caught, my throw to first should have been an easy out. Instead of my throw going to the first baseman, the ball sailed into the dugout hitting one of the athletic trainers in the head! I was mad, embarrassed, and in total disbelief. I immediately ran into the dugout to check on the trainer who brushed off the misthrow with a smile. Unfortunately, as practice progressed, the pain in my
right shoulder increased, and my throwing motion became worse. I was now side-arming all my throws!

Later that night and the following nights, my right arm ached and throbbed while I tried to sleep. I could only sleep on my back with my arm resting on a pillow to achieve any type of relief. For over a week, I had to eat with my left hand because the pain in my right arm prevented me from using my right hand. After telling my coaches and athletic trainers what had happened, I was immediately sent to physical therapy to rehab my right shoulder. After weeks of physical therapy and ice and heat treatments to my arm every day, my rotator cuff tendonitis healed. I began to
relearn how to throw again.

What had caused my debilitating injury?

Rotator cuff tendonitis is an inflammation of the four tendons that make up the rotator cuff.

Causes

• Inflammation of tendons during increased shoulder movement.
• Various types of repetitive motions can cause this injury.

o Throwing
o Painting
o Lifting weights
o Sleeping on your arm for extended periods of time
o Swimming
o Tennis serves

• Other injuries (e.g., trying to prevent yourself from falling)
• Chronic rotator cuff tears

Symptoms

● Difficulty elevating the arms above the head
● Pain in the front shoulder, the clavicle area, and the scapula

Treatment

• If you are experiencing any of these symptoms, please contact your primary care physician for a shoulder X-ray to assess the bone structure and an MRI/CT to assess soft tissue, tendons, fluid buildup (bursitis), and tears.
• The best treatment plan for rotator cuff tendinitis is to reduce the pain and restore the affected shoulder function.
• Rotator cuff tendonitis is treatable with rest, ice packs and heating pads for 20 minutes four times per day interchangeably, and physical therapy.
• NSAIDS (Advil, Aleve, Naproxen, ibuprofen, etc.) are effective for managing the pain and swelling.
• Steroid shoulder injections may be effective.
• Depending on the results and the level of your pain, a referral to an orthopedic surgeon may be necessary.

Figure 1: (Anterior Right Shoulder) Shoulder bursa, bursitis
Figure 2: Anterior and Posterior Shoulder Muscles

References

Alila Medical Media. (2019). Shoulder bursa, bursitis. [Illustration]. https://www.shutterstock.com/image-illustration/shoulder-bursa-bursitis-122298685?src=LgujqAxYpFEk2V8pW5kcBw-1-8

Alila Medical Media. (2020). Rotator Cuff Anatomy, Labeled. [Illustration]. https://www.shutterstock.com/image-illustration/rotator-cuff-anatomy-labeled-147943874

American Academy of Orthopedic Surgeons. (2019). Shoulder Pain and Common Shoulder
Problems. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-pain-and-common-shoulder-problems
/NIH
. (2019). Rotator Cuff Problems. Retrieved from https://medlineplus.gov/ency/article/000438.htm

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