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Oh My Aching Shoulder

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Over the past few years, I have had the opportunity to care for a number of legendary drummers with shoulder pain. The causes of shoulder pain in drummers can vary. The most common causes however are due to repetitive overhead activity such as reaching for a high crash cymbal or reaching behind the shoulder to hit a drum or cymbal. These maneuvers, although quit common in drumming can predispose a drummer to shoulder injury.

The shoulder is made up of 2 bones that form four articulations the glenohumeral joint, acromioclavicular, sternoclavicular and scapulothoracic joints. The shoulder in the most mobile of all joints permitting almost complete range of motion. The shoulder is supported by four muscles-the rotator cuff and a number of ligaments and muscle tendons.

With repetitive overhead reaching the soft tissues supporting the shoulder (muscle tendons) can get compressed or impinged between the bones leading to inflammation, partial or complete tearing and associated pain. The most common structures in the shoulder affected are the rotator cuff muscles and tendons, the biceps tendon, labrum and acromioclavicular joint.

Pain is experienced with elevation of the arm and shoulder. Pain may also be experienced down the arm to the elbow and hand. It is also very common to experience pain sleeping on the shoulder or being awaken at night by shoulder pain. If pain persists for longer that a week medical advice by an orthopaedic physician is recommended.

If shoulder pain develops the first line of treatment should include relative rest by limiting overhead activity of the affected arm (lowering your cymbals). After activity with the arm the entire shoulder should be iced for 15 to 20 minutes every 2-3 hours. Anti-inflammatory medications can also be effective in reducing the inflammation and pain. If pain persists, a corticosteroid injection can be extremely effective in reducing the pain and inflammation. A shoulder exercise program emphasizing scapular stabilizer muscle and rotator muscle strengthening should be initiated once the majority of the pain has subsided. This is very helpful to prevent further occurrences of pain from developing.

Properly warming up and stretching prior to playing and cooling down after practice and performances can prevent shoulder injuries. Maintaining shoulder flexibility and strengthening is also important in preventing injuries from developing.

Dr. Podesta practices orthopaedic sports medicine in Thousand Oaks, California specializing in the non-surgical treatment of the upper extremity, knee and spine. He is a sports medicine consultant and Team Physician for the Los Angeles Dodgers, serves as Head Team Physician for the Los Angeles Avengers of the Arena Football League and is an avid drummer. Dr. Podesta can be reached at [email protected].

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