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 keeping it stable.

• Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons.
• A rotator cuff tear occurs when one of the tendons is torn from overuse or injury.

Relieving the Pain

Drugs like ibuprofen and naproxen will help reduce swelling and pain. If you are taking these medicines every day, make sure that you tell your health care provider so that they can monitor your general health.

Ice packs applied to the shoulder 20 minutes at a time, 3 - 4 times a day, can help when your shoulder is painful.

Using Your Shoulder

Learning how to take care of your shoulders to avoid placing extra stress on them can help you heal from an injury and avoid re-injury.

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

• When sleeping, lay either on your back or side that is not painful. Resting your painful shoulder on a couple of pillows may help.
• When sitting, use good posture. This means keeping your head over your shoulder and your shoulders back, a towel or pillow behind your lower back, your feet either flat on the floor or up on a foot stool.

A few other tips for taking care of your shoulder include:

• Avoid carrying a backpack or purse over just one shoulder.
• Avoid working 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.
• Take regular breaks for any activity you are doing over and over again.
• When reaching for something with your arm, your thumb should be pointing up.

Consider making some changes around your home so it is easier for you to take care of yourself. Store everyday items you use in places you can reach easily. Keep things with you that you use a lot, like your phone.

Physical Therapy and Exercises

Your surgeon will refer you to a physical therapist to learn exercises for your shoulder.

• You'll probably 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. These will help increase the strength in your shoulder and the muscles around your shoulder.

Returning to Sports

Over all, it is best to avoid sports activity until you have no pain during rest or any 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 still has rotator cuff problems
• No abnormal movement of your shoulder joint and shoulder blade

While you may feel impatient and want to push the time frame of your recovery, you should think about a few points. If you return to sports too soon, the way you use your shoulder and your elbow, spine, and hip will be different. Your risk of injury to any of these areas increases.

Returning to any demanding sport should be gradual and not at full force in the beginning. Ask your physical therapist about the proper technique you should use when doing your sports activity.

References

III FA, Fehringer EV, Lippitt SB, Wirth MA, Rockwood Jr. CA. Rotator cuff. In: Rockwood CA Jr, Matsen FA III, Wirth MA, Lippitt SB, eds. The Shoulder. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 17.

Greiwe RM, Ahmad CS. Management of the throwing shoulder: cuff, labrum and internal impingement. Orthop Clin North Am. 2010 Jul;41(3):309-23.