New York Orthopedist Dr. Evan Karas advises on Shoulder Pain

Posted on: June 25, 2012

Save Your Shoulder – Don’t Push Through the Pain

by Dr. Evan Karas

Dr. Evan Karas orthopedic surgeon new yorkYour shoulder is a remarkably intricate joint. The centerpiece is the rotator cuff—a cradle of muscles and tendons that enables you to rotate your arm in a full arc. The rotator cuff is instrumental to swinging a tennis racquet or golf club, throwing a softball or football, or even reaching overhead to get the china from the top shelf in your kitchen.

While most people think injuries to this vital structure are a concern for professional pitchers and other fulltime athletes, anyone can suffer rotator cuff problems.  As Chief of Orthopedic Surgery at Northern Westchester Hospital, specializing in shoulder treatment, I can tell you the injuries typically occur in people older than 35.

A fall can create a tear in the cuff, as can heavy lifting from tasks such as gardening. A tear can also result from a lifetime of wear and tear.  The tendons tend to lose elasticity as we age, and they can give way.

What brings most people to see me is they can’t sleep at night.  Lying on the shoulder causes pain as do certain motions:  Putting on a coat, reaching into the backseat of the car—this is when the pain occurs.

Ignoring or trying to live with the pain is a bad idea because tears can worsen with time. The ball in the joint can start to push through the cuff, preventing a full recovery and a dramatic loss of range of motion. Tears may also get larger over time.

An orthopedist can diagnose or rule out a tear through a physical examination followed by imaging with MRI and X-ray.  If there is a tear, physical therapy can strengthen the muscles that support the shoulder and a cortisone shot can alleviate the pain—allowing rehabilitation to move much more quickly.  But often a tear requires surgery.  Happily, arthroscopic procedures make this surgery much less bothersome than it once was.  We can repair a rotator cuff in outpatient surgery, and you can be home within a few hours.

Help prevent rotator cuff troubles by stretching your shoulders before you exercise, and keeping the surrounding muscles in the shoulder strong.  If you have shoulder pain, don’t put off a visit to the doctor.  The sooner you get a diagnosis, the less risk to your rotator cuff.

Editor’s Note:  Evan Karas, MD, FAAOS, is Co-Chief of Orthopedic Surgery at the Orthopedic and Spine Institute at NWH.  Learn more about the leading-edge technology at the Orthopedic & Spine Institute at

View animated video on shoulder surgery at Northern Westchester Hospital’s Orthopedic and Spine Institute.