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Rotator cuff - self-care

The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move in a coordinated and pain-free way and remain stable. The tendons can be torn from overuse, injury, or wearing away over time.

Pain relief measures, using the shoulder properly, and shoulder exercises may help ease your symptoms.

Rotator Cuff Problems

Common rotator cuff problems include:

  • Tendinitis, which is inflammation of the tendons and swelling 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 health care provider so that your general health can be monitored.

Moist heat, such as a hot bath, shower, or a heat pack, can help loosen up your shoulder 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 cut down the swelling when you are in pain. Wrap the ice pack in a clean towel or cloth. Do not place it directly on the shoulder. Doing so may cause frostbite.

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 footstool.
  • Practice good posture in general to keep your shoulder blade and joint in their ideal 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 a long time. 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 every day 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 provider 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. Or, you can use your good arm to move the injured arm. The exercises may help get the full movement back in your shoulder.
  • After that, you will do exercises the therapist teaches you to strengthen your shoulder muscles.
  • Most of the exercises may focus on your shoulder blade and improvements with shoulder movement.

Returning to Sports

It is best to avoid playing sports until you have no pain during rest or activity. Also, when examined by your provider or physical therapist, before returning to sports, 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 activities 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.

Open References

References

Finnoff JT, Johnson W. Upper limb pain and dysfunction. In: Cifu DX, ed. Braddom's Physical Medicine and Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 35.

Mosich GM, Yamaguchi KT, Petrigliano FA. Rotator cuff and impingement lesions. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 47.

  • Rotator cuff problems

    Animation

    •  

    Rotator cuff problems - Animation

    Feeling pain in your shoulder when you lift your arm over your head may mean you have a have a problem with your rotator cuff. So, what causes rotator cuff problems? The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keeps it stable. Pain in your rotator cuff area usually means you have rotator cuff tendinitis, or inflammation of these tendons and inflammation of the bursa, smooth slippery sacs the tendons glide across; or a rotator cuff tear, when one the tendons is torn from overuse or injury. Rotator cuff tendinitis may be due to keeping your arm in the same position for long periods of time, such as doing computer work or hairstyling. Sleeping on the same arm each night can also cause this problem. You can also get tendinitis playing sports that require you to move your arm over your head repeatedly, such as in tennis, baseball especially pitching, swimming, and weight-lifting. Rotator cuff tears may happen if you fall on your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. Chronic tears occur slowly over time, particularly in people who have chronic tendinitis. At some point, the tendon wears down and starts to tear. If you have tendinitis, you'll have pain when you lift your arm over your head, such as when you brush your hair and reach for objects on shelves. The pain may be mild at first, but over time you may have pain at rest or at night, especially when you lie on your shoulder. The pain of a sudden rotator cuff tear can be intense. Your shoulder may be weak, and you may hear a snapping sound when you move your shoulder. Chronic symptoms include a gradual worsening of pain, weakness, stiffness or loss of motion. Most people with rotator cuff tears have worse pain at night and when they wake up. To treat your rotator cuff problem, your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. X-rays may show a bone spur, a bony projection. If your doctor thinks you have a tear, you may have an ultrasound or MRI. Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like ibuprofen may help reduce swelling and inflammation. Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff, which may help relieve the pressure on your tendons. Someone with a partial rotator cuff tear can try rest and exercise, if they don't normally put a lot of demand on their shoulder. But if there's a complete tear, or if the symptoms don't improve with therapy, you may need surgery to repair the tendon. But with rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.

  • Rotator cuff muscles

    Rotator cuff muscles - illustration

    There are four muscle tendons that connect to the shoulder that make up the rotator cuff. Together these four tendons stabilize the upper arm bone to the shoulder socket and allow the wide range of motion in the shoulder.

    Rotator cuff muscles

    illustration

  • Rotator cuff problems

    Animation

    •  

    Rotator cuff problems - Animation

    Feeling pain in your shoulder when you lift your arm over your head may mean you have a have a problem with your rotator cuff. So, what causes rotator cuff problems? The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keeps it stable. Pain in your rotator cuff area usually means you have rotator cuff tendinitis, or inflammation of these tendons and inflammation of the bursa, smooth slippery sacs the tendons glide across; or a rotator cuff tear, when one the tendons is torn from overuse or injury. Rotator cuff tendinitis may be due to keeping your arm in the same position for long periods of time, such as doing computer work or hairstyling. Sleeping on the same arm each night can also cause this problem. You can also get tendinitis playing sports that require you to move your arm over your head repeatedly, such as in tennis, baseball especially pitching, swimming, and weight-lifting. Rotator cuff tears may happen if you fall on your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. Chronic tears occur slowly over time, particularly in people who have chronic tendinitis. At some point, the tendon wears down and starts to tear. If you have tendinitis, you'll have pain when you lift your arm over your head, such as when you brush your hair and reach for objects on shelves. The pain may be mild at first, but over time you may have pain at rest or at night, especially when you lie on your shoulder. The pain of a sudden rotator cuff tear can be intense. Your shoulder may be weak, and you may hear a snapping sound when you move your shoulder. Chronic symptoms include a gradual worsening of pain, weakness, stiffness or loss of motion. Most people with rotator cuff tears have worse pain at night and when they wake up. To treat your rotator cuff problem, your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. X-rays may show a bone spur, a bony projection. If your doctor thinks you have a tear, you may have an ultrasound or MRI. Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like ibuprofen may help reduce swelling and inflammation. Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff, which may help relieve the pressure on your tendons. Someone with a partial rotator cuff tear can try rest and exercise, if they don't normally put a lot of demand on their shoulder. But if there's a complete tear, or if the symptoms don't improve with therapy, you may need surgery to repair the tendon. But with rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.

  • Rotator cuff muscles

    Rotator cuff muscles - illustration

    There are four muscle tendons that connect to the shoulder that make up the rotator cuff. Together these four tendons stabilize the upper arm bone to the shoulder socket and allow the wide range of motion in the shoulder.

    Rotator cuff muscles

    illustration

Self Care

 
 

Review Date: 4/24/2023

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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