Rotator-cuff tear is common shoulder injury
DEAR DR. DONOHUE: Twice a week I play doubles tennis, year-round. Last week, when serving, I got a terrific pain in my right shoulder and had to stop playing. My tennis partner thinks I tore my rotator cuff. I’ve heard of the rotator cuff, but don’t know what it is or what it does. If it is torn, how long will it keep me from playing? — T.R.
ANSWER: I have confidence in your partner’s diagnostic abilities, but you really need a doctor’s input on your shoulder problem. Rotator-cuff tears are only one cause of shoulder pain. Tendonitis, fractures, dislocations, arthritis and conditions called impingement syndromes give rise to shoulder pain and have nothing to do with the rotator cuff.
The rotator cuff is the merging of the tendons of four muscles that arise on the back of the shoulder blade. They wrap around the top of the upper arm bone, the humerus, which is a ball that fits snugly in the shoulder socket. The cuff keeps the shoulder stable through the enormous range of motion that joint has, greater than any other body joint.
Tennis players are not the only ones to have rotator-cuff troubles. Pitchers, quarterbacks and any athletes using the arm in an over-the-head motion are subject to cuff problems. So are painters, housewives reaching to stock upper shelves and those engaged in any activity that requires the arm to work above the head.
A doctor can be reasonably certain of the diagnosis from the information patients relate and from examination of the shoulder. Sometimes an MRI scan or ultrasound of the shoulder is needed. Tears show well on the images generated by those procedures.
Small tears become painless without interference in a matter of weeks. Larger tears have to be repaired. Often the repair takes place through a small incision through which a scope can be inserted into the joint. Downtime from this surgery is a couple of months.
DEAR DR. DONOHUE: I am a 69-year-old male who exercises every day. I do weight training, stretching and calisthenics. I can do 120 pushups in 60 seconds. I do 15 to 20 repetitions of leg presses with 450 pounds. I have started early-morning speed walks to become more aerobically fit. For the third day in a row, after a mile walk, I developed heartburn and need to drink water. After drinking the water, I feel fine. If I wait until after breakfast, I don’t have this problem. Will you please comment? — V.I.
ANSWER: Yours is an extremely rigorous program. The “heartburn” pain worries me. When someone your age talks about chest pain that comes with exertion, the first thought should be to consider it heart pain and not heartburn pain. I’m not convinced water can soothe heartburn pain. Perhaps it’s the rest you take while drinking the water that stops it. At any rate, speak to your doctor.
I also can’t explain why you don’t get it after eating breakfast. If your doctor says your heart is fine, then eat before exercise, advice that is contrary to the usual advice.
DEAR DR. DONOHUE: I am 60. I go to the gym three times a week, and I golf twice a week. My problem is finger arthritis, mainly my thumb. Can cortisone shots help? Are they dangerous? I take two Aleve on the days I golf, but they help very little. I would appreciate any information you can provide. — B.N.
ANSWER: Hand arthritis incapacitates lots of people. You need a regular program of supervised exercise and medicine. It might help your golf to take Aleve the day before and the day of your golf game. And before playing, soak your hands in warm water or with a towel that’s been soaked in warm water. If you can do this with little delay between the treatment and your time of play, it will be effective.
A cortisone shot might help. Three shots, spaced out over a year’s time, won’t harm you or your joints.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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