Complaints & connections · borters.ch
The shoulder pinches when lifting — targeted exercises help most people without surgery.
Also known as: shoulder pain · impingement · supraspinatus tendon · rotator cuff tear · calcific shoulder
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The rotator cuff is four muscles and their tendons that centre the humeral head and rotate the shoulder. Common is impingement: tendons pinched under the shoulder roof — pain lifting the arm, typically in the mid-range (“painful arc”, ~60–120°), and night pain lying on it. Add cuff tears (from wear or a fall) and calcific shoulder. Diagnosis is clinical plus ultrasound/MRI. Treatment is mostly conservative: targeted physiotherapy (posture, centring, strengthening), pain relief; injections and surgery only in selected cases. Much of it improves with consistent training.
With wear-related tears an exercise programme over three months is equal to the operation; many manage without any procedure. It is different with a fresh injury tear in a younger person — that is operated on early.
Weeks of resting lead to a frozen shoulder, and that is more troublesome than the original problem. Move within the low-pain range, several times a day, even if it pulls.
Pain when lying on the side is typical and steals sleep. A cushion under the upper arm or behind the back takes tension off the tendon — the simplest effective measure of all.
One injection can open a window in which exercising finally becomes possible. Repeated injections weaken the tendon — the injection does not replace the programme, it makes it possible.
Working above shoulder height and sitting for long with the shoulders pushed forward narrow the space under the shoulder roof. Screen height, breaks and changing posture work more strongly here than any ointment.
In impingement, exercise programmes give the same results after twelve weeks as an operation — several comparisons have found this. A cortisone injection takes the pain away for six to twelve weeks; more than three a year weaken the tendon. Tears in the tendon are seen on ultrasound in about one in four people over sixty with no complaints at all — a finding on its own says little here.
Anti-inflammatories and a cortisone injection take the pain away for six to twelve weeks — they heal no tendon. In impingement without a tear, comparisons show the same results at twelve weeks for an exercise programme and for surgery. With a large, fresh tear in a younger person it is different. Calcium deposits dissolve by themselves in many over months to years; shockwave treatment speeds that up in some.
Raising the arm sideways hurts between about sixty and a hundred and twenty degrees, less above and below. This window is the classic sign of a narrowing under the shoulder roof.
The pain at night when lying on the affected shoulder is one of the most reliable signs — and often the reason someone finally comes.
Doing up a bra, reaching the back pocket, combing hair, getting something from the top shelf: these everyday movements show the limitation more clearly than any number of degrees.
If the outstretched arm gives way against light pressure or can no longer be lifted actively while it stays passively movable, that speaks for a tear and not just for irritation.
A raised sugar clearly delays healing at the shoulder and is one of the reasons a frozen shoulder develops.
With calcium deposits in the tendon the blood value is almost always normal — and that is exactly the information: the deposit does not come from the diet.
Belongs alongside when the shoulder stiffens up, because an underactive thyroid occurs together with it.
Without vitamin D only a fraction of the calcium from food is taken up. It is the value that is most often too low with bone and joint complaints.
The building material itself. Better from food than from a tin: hard cheese, yoghurt, calcium-rich mineral water, almonds, broccoli and fortified plant drinks.
Activates the proteins that build calcium into bone. Green leafy vegetables and fermented foods cover it — under coumarin blood thinning the amount stays steady rather than swinging.
Bone is a third protein scaffold, and the muscles that hold it need protein too. In older people too little protein is more common than too little calcium.
Needed for building calcium in and for vitamin D to work. A lack slows both — even when calcium and vitamin D are supplied in sufficient amounts.
The honest ranking in this field: a targeted strengthening programme over three months achieves in most people the same as an operation — that is how several comparisons came out. No preparation comes near that.
The tendon needs vitamin C in order to cross-link collagen — that is undisputed. Whether additional collagen brings anything is open; the pointers come from small studies with 15 g about an hour before the exercise. Without the exercise nothing happens in any case: it is the pull on the tendon that sets off the rebuilding.
The shoulder pain on lifting is mostly an irritation, not an inflammation in the classical sense — and there the effect of omega-3 is correspondingly small. What measurably counts is something else: smoking distinctly worsens the healing of the tendon, and so does sugar in excess.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
With diabetes shoulder tendons tear more often and heal less well — the same sugar attaching to collagen that stiffens the hand. That explains why the shoulder with diabetes is often the first place that hurts.
Tendon complaints increase markedly in women around menopause — tendon tissue has receptors for this hormone. That is described and explains why the shoulder becomes such a topic in those years.
Ligament tissue needs 6–12 weeks and collagen as building material; vitamin C is needed to cross-link it. 1.2 g protein per kg a day covers the need — in a good nutritional state supplements add nothing beyond that.
Shoulder tendon problems are markedly more common in diabetes and heal more slowly. That often explains stubborn courses better than loading alone.
In impingement and partial tears exercise therapy matches surgery in studies. Studied are 3 months of consistent training before an operation is decided on.
Warmth before the exercises makes the shoulder more mobile, cold afterwards dampens the irritation. Both relieve for hours, the exercises work over months.