Patient education: Rotator cuff injury (The Basics)

What is a rotator cuff injury? — A rotator cuff injury is a condition that can cause shoulder pain. The rotator cuff is made up of 4 shoulder muscles and their tendons. Tendons are strong bands of tissue that connect muscles to bones.

People can get different types of rotator cuff injuries. One common injury is "tendinopathy," which is a problem with 1 or more of the tendons. When a person has tendinopathy, the tendons are not inflamed or swollen. If they do get inflamed or swollen, doctors call it "tendinitis." Tendinopathy and tendinitis can happen if you:

●Do a job or activity that involves repeated use of your shoulder muscles (like window washing, painting, or construction)

●Do sports that involve throwing a lot (like pitching a baseball) or raising your arm over your head (like swimming)

●Do any exercises or activities that make some of your shoulder muscles stronger than others

Another type of rotator cuff injury is a tear in a tendon or muscle. Tears can happen if you fall on your shoulder or move your shoulder too fast and with too much force. Tears can also happen as a tendon wears out over time.

What are the symptoms of a rotator cuff injury? — Most people with tendinopathy or tendinitis have pain where the shoulder meets the top of the arm and down the outer part of the upper arm. The pain is usually worse when they try to move their arm over their head or lie on their shoulder.

Will I need tests? — You might. Your doctor or nurse will talk with you and do an exam. If they suspect you have a tear, you might need an imaging test of the shoulder, such as an MRI scan or ultrasound. Imaging tests create pictures of the inside of the body.

How is a rotator cuff injury treated? — Many rotator cuff injuries get better on their own, but they can take months to heal completely. To help your shoulder get better, you can:

●Rest your shoulder – Avoid doing activities that cause pain or strain your shoulder, such as raising your arm over your head or reaching behind you. In general, try to keep your arm down, close to, and in front of your body. But you can move your shoulder gently if you need to.

●Ice your shoulder – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time, as needed. Put a thin towel between the ice (or other cold object) and your skin. Ice can be especially helpful after you've been using your shoulder a lot for work, sports, or chores.

●Take medicine to reduce the pain and swelling – Your doctor or nurse might recommend that you take ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample brand names: Aleve, Naprosyn).

Some tears, especially large tears, might need to be treated with surgery.

Is there anything I can do on my own to feel better? — Maybe. Depending on your injury, you might be able to do specific exercises to help your shoulder feel better. Ask your doctor or nurse which exercises you should do, when to start them, and how often to do them. They might suggest working with a physical therapist (exercise expert).

Some exercises help keep your shoulder from getting too stiff. One of these is called the pendulum stretch. To do this exercise, let your arm relax and hang down. Move your arm back and forth, then side to side, and then around in small circles in both directions (figure 1).

Other exercises can help strengthen your shoulder muscles. Your doctor, nurse, or physical therapist can show you how to do these types of exercises.

When you do shoulder exercises, it's important to:

●Warm up your shoulder first. You can do this by taking a hot shower or bath, putting a warm towel on your shoulder, massaging the area, or doing gentle movements.

●Start slowly and make the exercises harder over time. Follow all instructions for how often to do your exercises and how many times to repeat each motion.

●Know that some soreness is normal. If you have sharp or tearing pain, stop what you're doing and let your doctor or nurse know.

What if my symptoms don't get better? — If your symptoms don't get better, talk with your doctor or nurse about other possible treatments, such as:

●Getting a shot of medicine into your shoulder

●Surgery

More on this topic

Patient education: Frozen shoulder (The Basics)
Patient education: Biceps tendinopathy (The Basics)
Patient education: Shoulder impingement (The Basics)

Patient education: Rotator cuff tendinitis and tear (Beyond the Basics)
Patient education: Frozen shoulder (Beyond the Basics)
Patient education: Shoulder impingement syndrome (Beyond the Basics)
Patient education: Biceps tendinitis or tendinopathy (Beyond the Basics)