The Mystery of Emotions and Illness

A few years ago, a friend, Greg, and I were talking at a park where we were having a picnic. He complained that his right shoulder had been painful for over a year. Nothing helped. He took medications and went to physical therapy. He even went to an orthopedic surgeon, who told him he had a rotator cuff tear. However, there was no injury. The shoulder just started hurting. It gets better, then worse, and doesn’t ever go away. He was driving for Uber and had a hard time turning left because he couldn’t lift his right shoulder. That movement induced more pain. He mostly wanted to avoid surgery at all costs. But he wondered why he had so much pain and what he could do about it, besides an operation.

The shoulder is a common issue with many people. They live with chronic pain until they can’t function in some way.

• “I can’t carry my grandchild.”
• “It’s painful to clean the house.”
• “I can’t do my work.”
• Or “Even getting dressed hurts!”

They then go to an orthopedic surgeon who orders an MRI scan which shows one or more tendons with tears.

A shoulder joint is not a “ball and socket” like a hip. The body side has a “fossa” which is a little one-inch diameter cupped bone. The arm side is a ball, allowing this amazing joint to move more than 360 degrees! The shoulder joint is one of the most mobile in the body, at the expense of stability.

There are ligaments surrounding it to generally hold it in place. But a group of five tendons called the “rotator cuff” attach to muscles on the arm and body to pull the arm into the body with each type of movement. Without those tendons and ligaments, the shoulder would literally just fall out of its socket. A “rotator cuff tear” is when one or more of those tendons tears. Usually it is a partial tear, but sometimes the tendon can be completely ruptured, requiring surgical repair.

The big question is, how does this happen? The shoulder can handle a great deal of stress. Gram for gram tendons are stronger than steel cables.[1] People can lift over a thousand pounds without any noticeable damage to the rotator cuff. You might work out at a gym and repeatedly lift hundreds of pounds and never create a tear. How can a person who does no significant physical activity, just driving a car, have tears in the rotator cuff? This is a mystery to solve!

Part of the answer is