Shoulder pain is often linked to the rotator cuff, a group of four delicate muscles (subscapularis, infraspinatus, supraspinatus, and teres minor) and their tendons. The rotator cuff stabilizes the upper arm in the shoulder socket and allows it range of motion.
Injuries to the rotator cuff vary in severity, ranging from rotator cuff tendinitis (a microscopic tear and inflammation of any of the rotator cuff tendons) to rotator cuff tear, a rupture of a tendon. Golfers, swimmers, tennis players, volleyball players, and baseball pitchers may all have trouble with their rotator cuffs, as may people who install high shelves, work with hand tools, or do anything with a lot of shoulder movement. Smokers and people who are obese may have an increased risk for developing rotator cuff injuries. Luckily, when caught early, a mild case of rotator cuff disease can be treated fairly easily.
Symptoms of rotator cuff injury
• Sharp or dull pain in and around the shoulder joint; often worse at night.
• Pain aggravated by rotating or lifting the arm, especially raising it to shoulder level or higher.
• Shoulder weakness.
• Loss of shoulder mobility.
What causes a rotator cuff injury?
Sports with a repetitive overhead movement (swimming, baseball, or tennis, for example) can gradually strain the rotator cuff tendons, as can manual labor such as painting, plastering, or even housework. A more acute injury can occur from lifting heavy objects or falling onto your shoulder or upper arm.
The pain that results may be caused by what’s known as an impingement syndrome. This means that because of exertion or overuse, one or more of the rotator cuff muscles and tendons are impinged upon—that is, compressed and irritated—by the shoulder bone, resulting in inflammation and possibly microscopic or even larger tears. The bursae, small fluid-filled sacs that protect the muscles and tendons from irritation by the bone, are usually inflamed as well. (Shoulder pain that occurs suddenly without an obvious acute injury or overuse activity may be bursitis.)
What if you do nothing?
Rotator cuff damage is unlikely to heal on its own and without treatment, it can lead to a gradual loss of shoulder mobility. At the very least you need to rest the shoulder and avoid activities that may be causing the problem. If you have rotator cuff pain, the important thing is to treat the injury so that it does not become chronic and interfere with everyday activities.
Home remedies for rotator cuff injuries
The first stage of this condition may be tendinitis or bursitis, which is common not only in athletes but in nonathletes—typically those 45 years and older—as well. A mild case of shoulder tendinitis or bursitis can be treated with the following self-care measures.
• Rest. If you suspect that a certain activity has caused the pain, stop it for a while.
• Take over-the-counter pain relievers. Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling; acetaminophen will help with pain but not inflammation.
• Reduce inflammation. Apply ice for 20-minute intervals during the first two days.
• Condition your shoulder. Do some gentle exercises to restore range of motion and strengthen the rotator cuff. The exercises in the inset box will help get you started, but first discuss them with your doctor, who may refer you to a physical therapist. A physical therapist will help design a targeted exercise program for you. This is especially important if you’ve reinjured your rotator cuff or have chronic pain.
Hot to prevent a rotator cuff injury
If you are a golfer or swimmer or you have other risks for rotator cuff injuries, the same exercises, when performed regularly, can help strengthen your rotator cuff muscles and tendons and make them less susceptible to injury.
Exercises to Prevent Shoulder Pain
A good way to prevent shoulder problems is to strengthen the muscle groups that you underuse and stretch all shoulder muscles involved in your activity, making sure your shoulder moves through its full range of motion.
When to call your doctor
If you often have pain when raising your arm above your head, or with any activity, it’s a good idea to get medical help. Your doctor may send you to a physical therapist or another specialist in body mechanics. Rotator cuff tendinitis usually responds well to moist heat, ultrasound, and gentle exercises, especially stretching.
What your doctor will do
After a careful physical examination, your physician will check your shoulder for pain and loss of motion. To exclude a possible fracture or bone spur, an x-ray may be taken. Other tests may be ordered for further evaluation of your injured shoulder, including ultrasoundor magnetic resonance imaging (MRI).
Your doctor may prescribe medications to control pain and exercises to help restore full range of motion and use of the shoulder. In advanced cases of rotator cuff injury, surgery is sometimes recommended. However, research has found that conservative methods that included physical therapy and exercise were as effective as surgeryand should be considered first.