Rotator cuff - self-care

  • Rotator Cuff Problems
    • The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and remain stable.

      Common rotator cuff problems include:

      • Tendinitis, which is irritation of the tendons and inflammation of the bursa (a normally smooth layer) lining these tendons
      • A tear, which occurs when one of the tendons is torn from overuse or injury
  • Relieving the Pain
    • Medicines, such as ibuprofen or naproxen, may help reduce swelling and pain. If you take these medicines every day, tell your doctor so that your general health can be monitored.

      Moist heat, such as a hot bath, shower, or a heat pack, can help when you feel pain in your shoulder. An ice pack applied to the shoulder 20 minutes at a time, 3 to 4 times a day, may also help when you are in pain.

  • Using Your Shoulder
    • Learn how to care for your shoulder to avoid placing extra stress on it. This can help you heal from an injury and avoid re-injury.

      Your positions and posture during the day and night can also help relieve some of your shoulder pain:

      • When you sleep, lie either on the side that is not in pain or on your back. Resting your painful shoulder on a couple of pillows may help.
      • When sitting, use good posture. Keep your head over your shoulder and place a towel or pillow behind your lower back. Keep your feet either flat on the floor or up on a foot stool.
      • Practice good posture to keep your rotator cuff tendons and muscles in their right positions.

      Other tips for taking care of your shoulder include:

      • DO NOT carry a backpack or purse over just one shoulder.
      • DO NOT work with your arms above shoulder level for very long. If needed, use a foot stool or ladder.
      • Lift and carry objects close to your body. Try not to lift heavy loads away from your body or overhead.
      • Take regular breaks from any activity you do over and over again.
      • When reaching for something with your arm, your thumb should be pointing up.
      • Store items you use everyday in places you can reach easily.
      • Keep things that you use a lot, such as your phone, with you or close by to avoid reaching and re-injuring your shoulder.
  • Physical Therapy and Exercises
    • Your doctor will likely refer you to a physical therapist to learn exercises for your shoulder.

      • You may start with passive exercises. These are exercises the therapist will do with your arm. They help get the full movement back in your shoulder.
      • After that, you will do exercises the therapist teaches you to strengthen your shoulder muscles.
  • Returning to Sports
    • It is best to avoid playing sports until you have no pain during rest or activity. Also, when examined by your doctor or physical therapist, you should have:

      • Full strength in the muscles around your shoulder joint
      • Good range of motion of your shoulder blade and upper spine
      • No pain during certain physical exam tests that are meant to provoke pain in someone who has rotator cuff problems
      • No abnormal movement of your shoulder joint and shoulder blade

      Returning to sports and other activity should be gradual. Ask your physical therapist about the proper technique you should use when doing your sports or other activities that involve a lot of shoulder movement.

  • References
    • Miller RH III, Azar FM, Throckmorton TW. Shoulder and elbow injuries. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 46.

      Rudolph GH, Moen T, Garofalo R, Krishnan SG. Rotator cuff and impingement. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 52.

      Whittle S, Buchbinder R. In the clinic. Rotator cuff disease. Ann Intern Med. 2015;162:ITC1-15. PMID: 25560729