Here it is – Part 3 of 3, Rotator Cuff – Injury treatment for all you pickleball players.
The most common injuries to the rotator cuff muscles are inflammation/tendonitis and tears. If shoulder pain and weakness are restricting functional ability, it is important to have an examination performed by a medical doctor to determine the extent of your injury. There are several treatment options available depending on the pathology, to help reduce pain and improve functional use of the shoulder.
Treating acute or chronic shoulder tendonitis requires resting the shoulder from the activities that are causing the pain and inflammation. Taking a break for a period of time from overhead activities can be especially helpful. Typically, the amount of time required to heal is directly proportionate to the length of time symptoms have persisted. So, if you have had symptoms for several months or more while playing frequent ongoing pickleball, don’t expect them to disappear by taking just one day off. Unfortunately, you may need to take a week or two off.
Taking oral anti-inflammatory medication and applying ice to the shoulder after play and before bedtime can help reduce the inflammation. This treatment is especially helpful with acute strains of the rotator cuff muscles. Oral anti-inflammatory medications are available both over the counter and by prescription. You may need to consult your primary medical doctor to help determine which one to take based on your past medical history.
If conservative treatment does not help reduce rotator cuff pain, more invasive treatment may be necessary. Cortisone injections can help reduce inflammation and pain. This treatment is often followed by physical therapy treatment.
Physical therapy will incorporate therapeutic exercises (including those listed in part 2) and mechanical modalities. The use of ultrasound, electrical stimulation, short wave diathermy, and low level laser treatments have been proven to speed up the healing process. Physical therapy is typically ordered for 2-3 times per week for 4-6 weeks. If pain and weakness persist following physical therapy treatment, there is a possibility that a tear of the rotator cuff is present.
Rotator cuff tears are most often diagnosed following image testing, such as an MRI. Rotator cuff tears do not heal well with time and tend to enlarge. Partial thickness tears can stabilize and not require surgery. Unfortunately, any sport (especially pickleball) requiring a swinging motion of the arm will tend to enlarge existing rotator cuff tears. Because of this fact, surgical intervention is recommended early if you intend to continue playing pickleball. A full thickness tear is much more difficult to repair, has a longer recovery time, and a poorer prognosis.
Recovery time from rotator cuff surgical repair will vary depending on the extent of the injury. Typically, expect a return to full activities (including pickleball) in minimum of about 6 months. It could take up to a year if complications arise during rehabilitation. Physical therapy is typically ordered during a large portion of the recovery period. If all goes well, expect to return to the pickleball courts with pain-free full shoulder motion.
I hope this series on the rotator cuff has been helpful. It is important to not overuse/abuse your joints with repetitive strenuous activities. Pickleball is a very addictive sport. It is important to listen to your body when it is fatigued and in pain. I personally find it is important to not combine three “too’s” into your playing routine. You shouldn’t play too hard, too long, too often. Combining all three will eventually lead to injury, no matter what your age or physical well being is. Either back off the intensity of your pickleball play, how long you are on the courts each day, and/or how many days you play in a week. By doing so, you will be able to prevent injuries and enjoy ongoing pain-free pickleball.
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