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Oh, My Aching Shoulder!

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. Although these maneuvers are quite common in drumming, they can predispose a drummer to shoulder injury.

The shoulder is made up of two bones that form four articulations — the glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic joints. The shoulder is the most mobile of all joints, permitting almost complete range of motion. Four muscles, the rotator cuff, and a number of ligaments and muscle tendons support the shoulder.

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 commonly affected structures in the shoulder are the rotator cuff muscles and tendons, the biceps tendon, the labrum, and the 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 while sleeping on the shoulder or to be awoken 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 two to three 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.

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