Colorado is a skier's paradise, and last week I had the fun of skiing with my husband for two days in their great mountains. As part of his business every year, we have the opportunity to demo the new line of skis, boots and accessories coming out for the next season. As you can imagine, at these events you get to meet a lot of avid, die-hard skiers and snowboarders from all across the country, and you get to hear a multitude of crazy stories.

I am always mesmerized by this group of people because no matter what, they will ski or ride - with no exceptions. I mean, it could be 10 below and snowing like wild and they will still ski. Or it could be fogged in, and they just find a way to ride with a new lens in their goggles so they can "see" better. Or the lift line will be an hour long and they will stand in it to ride down one hill on two skis for five minutes. I mean, go figure; how can anyone love something so much?

Well, these two men I met last week were no exception to the rule. They both loved to ski, and who would have known that I would sit and listen to their stories about their shoulders that just did not want to work today. In retrospect, they had no clue that I was not part of their industry. They figured I would sympathize with them, give them Advil, and tell them to buck up and get back out on the hill.

Little did they know that a physical therapist like me loves the shoulder and all its integral parts. They had no idea that the shoulder muscles have to fire in a beautiful symphony in order to lift your arm overhead or push you up out of the snow. See, you wouldn't know these things until, for some reason, you can't ski because your shoulder is so stiff you can't get it up to hold onto your pole, or you can't get your jacket on to actually go outside to ski after lunch. Then suddenly your shoulder is a problem, and all you want is a quick fix so you can ride.

Well, physical therapy should be at the top of your list, if you have a shoulder that's giving you a problem like this. The shoulder is a ball and socket-type of joint. The ball needs to spin, slide, and glide in the socket, all while allowing 180 degrees of motion. No other joint in the body has so much mobility in such an unstable setting.

The rotator cuff is a key part of why this joint works so well. It is made up of a group of muscles that centralize the head in the socket so that the joint can move smoothly while the other surrounding muscles exert their force patterns to accomplish their work. When the rotator cuff is strained, weak, or torn, the mechanics of the shoulder are disrupted and the shoulder loses its ability to function normally.

The pattern of the muscles firing is important, and restoration is needed because there is not a lot of room for error. The space is small, and any amount of inflammation causes compression and irritation to the rotator cuff tendons and the bursa. The bursa is a thin fluid-filled sac that acts to absorb pressure. When it is irritated, it becomes thick and full and takes up too much room in the joint area.

Shoulder rotator cuff pain is often not even felt in the joint itself, but in the outside part of the arm. It will ache over the cap of the shoulder and feel like constant pressure. You will be unable to sleep on your shoulder at night, and it will often wake you up in the nighttime with pain.

These two men had rotator cuff shoulder pain. They wanted to ride, but didn't know what to do to take care of their shoulders so they could. They just kept riding and beating up their shoulders, and couldn't understand why they were getting worse and worse. Of course, I couldn't keep quiet, knowing the situation with their shoulders, so I told them about how their shoulders move and work, and how they could be well - with a little bit of physical therapy helping them along the way.

Sheree DiBiase, PT, is the owner of Lake City Physical Therapy. She and her staff can be reached for your shoulder injury in Coeur d'Alene at (208) 667-1988 and in the Spokane Valley at (509) 891-2623. Don't wait; your health matters to us!