I'd like to talk to you about shoulder pain. In this case, we're going to be talking about the rotator cuff. What is the rotator cuff, people ask. The rotator cuff consists of four tendons and muscles that attach right to the humerus, which is the arm bone. There's two on the back side, there's one that comes and travels underneath this bone, and there's a fourth that comes along the front side.

All of them attach to the top of the humerus and are responsible for the small movements in the arm, the little movements. If they get injured, the shoulder does not work quite right, and you end up using larger muscles like the trapezius to help move your arm. That's a coordination pattern that we don't really want and can further injure the rotator cuff.

The rotator cuff, when it gets injured, the most common muscle that is injured in muscle tendon complex is the supraspinatus, and that's because it comes under this bone. So as you move your arm up into space, what happens is if your arm movement isn't correct, this happens. This is called impingement, and if you get impingement and motion, you get this grinding sensation that happens onto the muscle, and it tears.
Now the question is, what do you do if it tears? Many of us have small tears, and do they heal? The answer is yes. They do heal. The question then becomes, well when do you pursue treatment, and is surgery necessary? The answer is says is depends. I suspect that when you have an injury, my thought is that you should be a little bit more aggressive about treating it. Go ahead and at least see a physical therapist who can help correct some of the movement problems that can occur when you have an injury and prevent further injury from happening.

There's a role for massage. There's a role for acupuncture, and there's some chiropractors who can help with that muscle tension. I'm an osteopath. I use OMT, or osteopathic manipulation to treat these areas and try to get them to calm down. However, if the discomfort or the pain persists, and the pain usually happens right where the tendon attaches, and it can radiate down the arm. Sometimes it's found right here, and it occurs with small movements. You know, lifting that arm, or reaching, lifting your arm that way, and in which case, some regenerative treatments may be beneficial, and by that I mean prolotherapy or PRP.

So if you have a rotator cuff injury, I suggest that you get it evaluated, at least by a physical therapist, and if not by a physician, on the earlier side so that you know what you're dealing with.

I'd like to talk to you about labral tears today.

Labral tears are cartilage. They occur on the most inside portion of the shoulder. This is the humerus, or the arm bone, and this is called the glenoid.

The glenoid is the bone that's right inside, and it has a layer of cartilage that helps make the joint a little bit wider so that the humerus, which is a ball on a plate, which is called the glenoid, has a little bit of a curvature to help guide the motion inside it.
The labrum, at least the upper portion, is where part of the capsule in the biceps tendon attaches to.The injury there can be kind of debilitating and can give you a sense of weakness in the arm with lifting things.

What I can tell you is that this is not necessarily a surgical treatment.

We can use prolotherapy. Sometimes we can use PRP to help strengthen the capsule.And you can recover much quicker, and without a scar, or any surgical complications.

Contact me at, or at and I'd be happy to give you more information about this.

You know those people that are double jointed. They can take their thumb and bring it down to their forearm or when they straighten their arm it goes past 180 degrees. Or they used to be able to do party tricks where they could bring their leg behind their neck. Those people are hyper mobile. They are great gymnast. It sets them up for being quite a good dancer, ice skater. But they are also more prone to ligamentous injuries. And one of the ligamentous injuries that can happen is at the shoulder. It can become loose.

And what can occur after that is they can get rotator cuff injuries or they can get bicep injuries. They can get other injuries in the shoulder. But the underlying background behind the injury is a loose capsule. And the capsule is something that attaches around the whole shoulder. It's loose on the underside, back down here. So that allows you to bring that shoulder all the way above your head.

There's a redundancy down below, and on occasion that area gets stretched out. This also happens in throwing athletes, for example, tennis players and volleyball players and anybody who uses their arm above their head.

What I can tell you is that even if you have a rotator cuff injury, something right here, and it gets treated with surgery, you haven't treated the underlying cause. And this can be treated before surgery, after surgery and maybe depending on the other injury, instead of surgery. Prolotherapy or PRP can both be used to treat ligamentous laxity or capsular laxity in hyper mobile people.

My name is Dr. Jennifer Stebbing, and I'd love to be able to have a conversation with you and talk to you more about your injury. I can be reached at, you can contact me through my website at I'm here to help you. Thank you. 


– Arthritis
– Rotator Cuff Tears
– Labral Tears
– Bicep Tendinitis or Tendinopathy
>– SLAP Tears
– Acromial Clavicular Joint Arthritis (AC Joint)
– Glenohumeral Instability
– Frozen Shoulder
– Axillary Nerve Pain/Injury (pain or weakness in the upper arm)
– Suprascapular Nerve Pain/Injury (scapula or wing bone pain or weakness)
– Hypermobile or Unstable Joints (shoulder clicks or pops)
– Sternal-clavicular instability or pain
– Tightness
– Scar pain
– Posture related injury (shoulder forward)
– Muscle imbalance (common with weight lifters who concentrate on pecs and forget about lats)
– Rib – Shoulder Blade pain or tightness
– Shoulder Dislocations after shoulder has been put back into place.
– Continued pain after surgery

Dr. Jennifer Stebbing DO Musculoskeletal & Sports Medicine
602 NE 3rd Ave
Camas, WA 98607
Phone: 360-258-1746
Fax: 603-373-8094
Office Hours

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