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When patients present with shoulder pain, it can be numerous things and that’s why it’s helpful to go and see an orthopedic doctor. Your doctor can assess for the various shoulder problems that you may have. The other things that it could be that would be that at the top of your doctor’s differential diagnosis list would be: a labral tear. The labrum is a structure that goes around the socket. It’s like a bumper that goes around your glenoid and that provides structural support for the humeral head. That’s something to consider and that also can present with pain and weakness and difficulty lifting your arm up over your head, so that’s something else to consider would be a labral tear. With a rotator cuff tear – you can also have issues with your biceps tendon. The long head of your biceps (the biceps are what allows us to not only flex our elbow, but also (more importantly) allows us to do what’s called supinate, which is this motion *demonstrates*. One of the two heads of the biceps tendon actually originates in the shoulder joint and it runs down the humeral head down into the arm. That tendon oftentimes can get degenerated and it can be associated with a rotator cuff tear. So that’s something else to consider and that’s another possible cause of pain. Arthritis is another very common finding. Oftentimes, patients have all of the above. A 65 year old man who has been active, enjoys playing golf, for instance, can come in with shoulder pain, weakness, limited mobility. I’ll get x-rays which will look okay, and then I’ll get an MRI, will show a full thickness rotator cuff tear, degeneration of the long head of the biceps, a labral tear, and sometimes some arthritis as well.
