I tried so hard to go the conservative way to heal my shoulder, but it is time to have shoulder surgery. As I have mentioned so many times before, I was very hard on my body in my top sport days of judo. Through the years, having the shoulder out of socket, rotator cuff tears and tendonitis have finally caught up with me. In January, I started my journey with Dr. Ginn. He did surgery on my broken hand before and I know many people who have had successful shoulder surgery done by him. After an X-ray and MRI, I have a bone spur on my clavicle bone, a ganglion cyst over my AC joint (where the clavicle bone and shoulder blade meet), calcifications around my rotator cuff and some smaller tears and arthritis. The procedure will be arthroscopic surgery to remove the bone spur from the clavicle, remove the cyst and clean out the calcification of the rotator cuff. The MRI doesn’t always show everything, so my hope is that in my case it did.

First, let’s look at the anatomy of the rotator cuff. Some people don’t realize that the rotator muscles are actually four muscles: subscapularis, supraspinatus, infraspinatus and the teres minor.

Many people suffer rotator cuff tears. Some have no symptoms. Some may have weakness and/or atrophy.

The first steps of rotator cuff treatment (which I did):

• Physical therapy. It’s the most important step in the treatment of a rotator cuff injury.

•Anti-inflammatory medications. Medications are very helpful controlling the symptoms of a tear.

• Cortisone injections. They can be extremely helpful at limiting the acute inflammation so you can start your therapy and exercises

My go-to exercises were internal and external rotation and stretches.

Internal rotation: With your knees bent, lie on a firm surface. Bend that arm to a right angle (90 degrees). Rest your elbow on the floor. Keeping the elbow next to your side, lower the forearm toward the floor, away from the body (keep the 90-degree angle). Slowly return your forearm to your side. Do 3 sets of 10 reps using a light weight. Do both sides even if the other side does not have any problems.

Isometric internal rotation: Stand in doorway with elbow at 90 degrees and press in holding 5 seconds. Also 3 sets of 10 reps.

External rotation: Depending on the severity of your injury, you might only be able to do this exercise on your injured side due to the fact that you are lying on your side. Lie on your uninjured side with a pillow supporting your head. Place a small rolled up towel under the elbow which is on top. Bend that arm to a right angle (again 90 degrees) resting the forearm on your stomach. Keeping the elbow against the towel, slowly lift a small weight until your forearm is slightly higher than your elbow. Return to starting position.

Isometric external rotation: Same as internal but now you are pressing out towards the door frame.

Take time to keep your range of motion and stretch your shoulder muscles gently, whether it’s walking your hand up the wall, to reaching up. If you suspect rotator cuff and/or shoulder issues, I highly recommend a diagnosis by an doctor such as Dr. Ginn, and physical therapy to hopefully heal your shoulder before surgery is needed. Since I have done all the steps, I am confident in my surgery and, most of all, my surgeon Dr. Ginn.

Ester H. Marsh is associate executive director and director of healthy living at the J.F. Hurley YMCA.