Ever had pain turning the steering wheel or tucking in your shirt?
January 18, 2010 by dlorenz
Filed under Frozen Shoulder, Rotator Cuff, Shoulder Education
PAIN TURNING THE STEERING WHEEL AND PAIN TUCKING IN MY SHIRT…TWO RECENT COMPLAINTS
I recently got asked these two questions over the phone by people. These are always tricky questions to answer because there are several things that it could be. First of all with the steering, more than likely the rotator cuff is jamming into the roof of the shoulder and is irritating the bursa, which is the fluid filled sac between the rotator cuff and the bony roof that makes up the clavicle (collar bone) and the acromion. You may have a rotator cuff tear that’s causing the humerus to “ride high”, but if you are able to raise your arm without a lot of difficulty, then you likely don’t have a tear. You may also have pain if you rest your body weight on your elbows. It is also possible that you have bone spurs poking down into the cuff from the undersurface of the roof. If that is the case, there is less room for the cuff and bursae to move without getting irritated. If that is the case, an X-ray will usually let you know. Surgery is only necessary if pain is limiting your function or if even after therapy and activity modification, you are still miserable. Bottom line is that you don’t need surgery or injections just yet – contact a physical therapist to try and fix it. A good PT can take care of this in 6-10 visits or so (less if you are self-motivated and don’t need a lot of supervision).
Now as far as the tucking in of the shirt…well, you may see from my other posts that frozen shoulder is a possibility. If that’s the case, your shoulder motion is globally restricted. You may also have tightness from a previous surgery that hasn’t been addressed. Finally, you may have some arthritis in your shoulder (yes, your shoulder can get it too!). If that is the case, the analogy I like to use is from the sport of hockey. Have you ever seen the ice after the Zamboni cleans it? It’s nice and smooth like glass and the puck will glide forever. Now think of how the ice will be after playing a full game with no cleanings between periods. The puck won’t move and the ice will be really chopped up. That’s kind of what it’s like in an arthritic joint (if you have no idea about hockey, think about it as a lubed up wheel versus a rusty wheel). Motion gets really restricted and painful because the shoulder can’t roll, slide, and glide like it should and instead ends up grinding like a mortar and pestle. Again, if you are having trouble with these things, a physical therapist can help you out. They should be able to take care of this in no more than 6-10 visits.




