How to Treat Rotator Cuff Pain and Injuries
What Is the Rotator Cuff?
If you are feeling pain in and around your shoulder when you try to lift your arm or rotate it in a certain direction, it is possibly because you strained or injured your rotator cuff. The pain can feel like a sore or bruised muscle, or it can be more excruciating and feel like you are being stabbed with a knife (assuming you know what it must feel like to be stabbed with a knife).
The rotator cuff is a group of four muscles that support the shoulder. They are: the supraspinatus muscle, the infraspinatus muscle, the teres minor muscle, and the subscapularis muscle. Along with those muscles are the tendons that actually attach the muscles to the bone, not to be confused with ligaments, which connect bone to bone. Any one of those muscles and their tendons can be the reason you are feeling pain in your shoulder.
If you know the exact location of the pain, you can pinpoint the affected muscle or tendon. Correctly diagnosing the cause of the pain will guide your treatment plan.
Rotator Cuff Injuries
There are several possible reasons you are feeling the pain. Some are more serious than others, so it’s not really a good idea to try and diagnose yourself; if you are wrong it could lead to more serious complications. But in general, the pain is a result of one of the following:
- Subacromial bursitis, which is the inflammation of the bursa, a small sac of fluid, that acts as a cushion for the tendons and the nearby bone.
- Adhesive capsulitis, also known as "frozen shoulder," which is where the humerus bone adheres to the shoulder blade and causes stiffness and pain.
- Rotator cuff impingement, which is where the tendons of the rotator cuff are squeezed between the humerus and another bone.
- Rotator cuff tendinitis, which is an inflammation of the tendons caused by overhead use, repetitive motion, or physical strain from lifting something too heavy.
- Rotator cuff tear, which is the most severe of injuries, occurs when the tendon is weakened by age or the existing pain has been neglected for too long, and the things that caused the tendinitis have now caused the tendon to tear.
Quick Check of Rotator Cuff Symptoms
- Severe or intermittent pain in the shoulder
- Loss of range of motion in the shoulder
- Inability to abduct, or lift the arm away from the body
- Pain when reaching overhead
- Pain when reaching behind your back
- Pain when sleeping on the affected side
- An inclination to protect your shoulder or keep your shoulder from moving
Rotator Cuff Injury Symptoms
No matter how minor the pain is, the location of the pain should compel you to seek out the advice of your family doctor. As I stated before, a wrong self-diagnosis can lead to more serious complications. Not addressing the pain, if it persists for more than a couple of days, can actually cause more severe damage to the rotator cuff. Tendons are tough but can only take so much strain. Weakened tendons that are already exhibiting the symptoms of tendinitis can tear and cause immobility of the arm and shoulder.
Most rotator cuff injuries are the result of chronic issues which develop over a period of time through neglecting or ignoring the pain. Acute issues are those that are sudden and usually caused by some sort of trauma.
The most noticeable symptom of an acute rotator cuff injury is the pain. The pain radiates through the entire arm. Also, you will have a limited range of motion especially when abducting the arm (lifting the arm away from the body).
The symptoms of chronic rotator cuff injuries are more subtle, which is why many people neglect or ignore them until the pain is too severe. Some symptoms include intermittent pain, atrophy or weakness of the shoulder muscle, crackling when moving the shoulder or at rest, and severe pain in the shoulder when trying to sleep.
Have You Suffered from Rotator Cuff Pain? If So, What Was Your Approach?
You may never find the true cause of the rotator cuff injury, but through medical tests and examinations such as an MRI, ultrasound, or nerve Induction test, the doctor can pinpoint the exact location of the injury, the exact affected muscle or tendon, and then prescribe a method of treatment.
Treatments for rotator cuff pain and injuries include the following:
- Pain medicines such as acetaminophen and ibuprofen, which have anti-inflammatory properties.
- Corticosteroid injections, which most typically involve a shot of cortisone or another anti-inflammatory steroid.
- Physical therapy, which includes stretching and strengthening the rotator cuff muscles through resistance exercising using latex resistance bands.
- Cold compression therapy, which uses a shoulder wrap to immobilize the shoulder and also apply a cold or heat source.
- Occupational therapy, which is similar to physical therapy but focuses on the repetitive nature of your daily work tasks.
- Arthroscopic surgery, which is surgery through a small incision using a tool that has a camera on its end.
- Open surgery, which requires a larger incision and more invasive procedures to cut through tissue and muscle to reach the affected torn rotator cuff muscle.
Abducts the arm
(RICE) Rest, Ice, Compression, Elevation
Externally rotates the arm
(RICE) Rest, Ice, Compression, Elevation
Externally rotates the arm
Cortisone injections and Stretching Exercise
Internally rotates the humerus
Surgery and Resistance Exercise
Resistance Band Exercises
Rotator Cuff Exercises
There are two types of rotator cuff exercises. The first type is intended to is strengthen the joint and prevent rotator cuff injuries. The second type is for those who have already had an injury and now need to rehabilitate the rotator cuff muscles. We’re going to focus on the second.
The first thing you need to understand is that you need to take things slow and consider the limits on your range of motion. You will want to avoid lifting anything heavy, or even reaching into the backseat of your car to give your kid a smack. Just kidding about smacking the kid, but reaching for things that are still out of your range of motion can reinjure your rotator cuff.
Resistance types of exercises are best. If you watch the videos to the right you will get a good idea of how to use latex resistance bands to minimize your shoulder pain and also the proper movements for each exercise.
If you don’t have time to watch the videos, here is a pdf you an can print out showing you the exact way to exercise and strengthen your rotator cuff. OrthoInfo.org is a website of the American Academy of Orthopaedic Surgeons with hundreds of articles about fractures, sports injuries, and joint replacement, all written by medical experts.
Address Your Rotator Cuff Pain
Just to recap:
- if you are having pain in the front of your shoulder then it is possibly related to the subscapularis muscle.
- If the pain is in the back of and on top of the shoulder, it is possibly related to the supraspinatus muscle.
- If the pain is in the back and just under the shoulder blade it is possibly related to the infraspinatus muscle.
- And if the pain is in the back and closest to the armpit, then it is possibly related to the teres minor muscle.
If you have pain that persists for more than a couple of days, then go see your doctor and do not try to self diagnose. If you are wrong it can lead to more serious complications. However, if you are certain that the pain is minimal and you have not lost most of your range of motion, then exercising and strengthening your rotator cuff muscles should be a priority.
Consult Your Doctor
I am not an MD. Always consult your doctor before starting any therapeutic regimen.