DEAR READER: The rotator cuff helps stabilize the shoulder. Consequently, it can be easily strained, irritated or torn in people who are physically active. Therefore, in answer to your question, swimming and other forms of exercise can aggravate your shoulder and may be the cause of the rotator cuff problem, if that is what is causing your discomfort. If you gain pleasure from remaining fit, and it appears you certainly do, I highly endorse the exercise. If, however, you feel you are damaging your shoulder every day, you might consider taking a few days or a couple of weeks off to determine if the pain subsides. Settle for a brisk walk to get your daily exercise. If you remain pain free, gradually introduce a modified hiking schedule that shouldn’t require much shoulder involvement. You can ultimately add a modified swim program once or twice a week, stepping the program up to your current daily regimen if you remain pain free.

Treatment depends on the amount of damage. A strained cuff usually responds to rest and heat. An irritated cuff usually improves with rest, over-the-counter anti-inflammatory drugs such as Advil, Aleve and others, coupled with physical therapy. A torn cuff can be a real problem that may require surgery.

You may need further testing, such as a CT scan or MRI, to determine the extent of damage. Ask your primary care physician for his recommendation of a referral because more than anything, you need a consultation with an orthopedic surgeon who is familiar with sports injuries. He may determine your pain isn’t related to your rotator cuff at all. The CT or MRI can provide vital information on this annoying problem.