For active people with rotator cuff injuries, the most commonly asked question is whether or not the injury will heal without need for surgery. In 2012 the American Academy of Orthopaedic Surgeons revealed studies reporting that surgical repair fails in about 57% of rotator cuff cases. Non-surgical treatment of rotator cuff injury succeeds in about 50% of cases. It seems, then, that opting first for a non-invasive method has just as much potential for success as surgery.
Anatomy Of An Injury
Rotator cuff injury is common because the four major muscles involved in rotating the arm in the shoulder socket are used frequently every day. Each time a person moves their arm they are using their rotator cuff. The “cuff” is created by muscles surrounding the shoulder blade, working together to form a cuff of tendons that cover the top portion of the arm bone as it enters into the shoulder socket. The cuff serves to keep the ball of the arm bone properly positioned within the socket.
Lifting is the most common action that will become painful with a rotator cuff injury. You may feel pain as muscle tissue of the rotator cuff is pinched between the bones of the ball and socket joint. This condition may sometimes be commonly called bursitis. Rotator cuff pain becomes more likely in active adults as they age due to the normal effects of wear and tear or repetitive movement. Just as a rope will fray if constantly rubbing against a sharp edge, the tendons of the cuff will also eventually wear and possibly tear. Symptoms are usually noticeable as:
- Sharp pain down the side of the arm when reaching upward or behind.
- Throbbing pain at night during sleep.
- Pattern of pain across the shoulder and down the arm.
Physical therapy may be the first recommendation by a physician. In addition to a method of treatment, there are also many things an individual can do outside of a physical therapy environment to aid in recovery.
Rest: Rest the rotator cuff by limiting range of motion, especially overhead reaching.
Support: Compression wear is available with devices designed to specifically support the shoulder and rotator cuff. Often called a sling or sleeve, many have designs that integrate heat and ice therapies that further help to reduce inflammation and pain as well as accelerate healing.
OTC Medication: Non-prescription drugs like ibuprofen or naproxen can help reduce swelling and manage pain.
Exercise: It is important to continue to strengthen the affected shoulder and maintain flexibility. However, exercises and stretches should be adapted so as not to further exacerbate an injured rotator cuff that is in recovery.
Crossover Reach Stretch
- Standing or sitting, raise affected arm chest high and reach across the chest.
- Using the opposite hand, apply gentle pressure just below the elbow and hold for about 30 seconds.
- Switch arms and repeat.
Back Hand Clasp Stretch
- Clasp both hands behind you with arms lowered.
- Slowly raise clasped hands as long is it does not cause pain. Hold for 30 seconds.
- Release hands and relax for 10 seconds then repeat stretch.
When using weights in exercises to improve strength, select a weight that will not cause pain during use.
- Using a table for support, lean over with one forearm resting on the table top, back parallel to the floor, and dumbbell in the other hand hanging straight down.
- Gently swing dumbbell back and forth for 30 seconds.
- Switch arms and repeat.
Treatment approaches for rotator cuff injuries should have in mind multiple goals:
- Healing the injury.
- Managing pain.
- Maintaining range of motion.
Moderate immobilization with compression wear and limiting movement will help accelerate healing of the affected muscles. Proper use of ice, heat and over-the-counter medications can give a person pain management options within their control. Commitment to a regular stretching and exercise program will help to prevent atrophy of the affected muscle while waiting for the injury to heal.
A person does not have to be a professional athlete to experience a painful rotator cuff injury. Such an injury can occur just through the normal effects of aging and the everyday activities a person engages in. Pain from rotator cuff injuries can stay with a person for years. It is also very common to have a repeat performance of injury after a prior injury has healed. That is why once the problem arises it is important for any sufferer of rotator cuff injury to modify their lifestyle to include habits and methods that are pro-active in maintaining rotator cuff health. Don’t perform the recommended flexibility and strengthening exercises only after an injury occurs, make them a regular part of your daily health regimen.
Also keep in mind that healing properly from a rotator cuff injury can take a very long time. Be patient and stay committed to your physical therapist’s advice on how to care for your injury. For more information regarding rotator cuff health and injury recovery, consult medical experts who are committed to non-surgical approaches first.