Managing Rotator
Cuff-Related Pain or Injury

Pain Control

Heat and cold can be used for short term pain relief. Try both to see which works best for you.

Pain medication such as acetaminophen, aspirin or ibuprofen can help reduce the initial pain and inflammation so you can get active and start exercising. Check with your doctor first to ensure that the pain medication is right for you if you have other medical conditions. Take the recommended dose at the recommended intervals to manage your pain. If your pain is not improving with over-the-counter medication see your doctor and they may prescribe a medication that can help you.

Some patients have reported doing pendular exercise throughout the day and night helps reduce pain. Try to see if it works for you.

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Bend at the waist so your arm is dangling down. You may want to hold onto a table or chair for support. Gently rock your body weight in a circular motion to move your arm in a circular pattern about the size of a dinner plate. Do this 10 times in both a clockwise and counter clockwise direction.

Positioning

Regardless of whether you are sitting or lying down, ensure your arm is supported in a position where your elbow/hand does not fall or rest behind the midline of your body.

In sitting, use an arm rest or place a pillow under your elbow to support your arm. Make sure you are not reaching down to the arm rest or propping it too high, such that you shoulder is pushed up toward your ear. You may also feel more comfortable with support under your elbow while driving.

When lying on your back, place a pillow or folded towel under your elbow and upper arm to keep it level or above the midline of your body. You may also find having the pillow placed under and between your arm and chest more comfortable.

Many people find it very uncomfortable or painful to lie on the injured or painful side.

When lying on your good side, you may want to place a large pillow in front of you to “hug” and support your arm from dropping across the front of your body or place a pillow between your elbow and side.

In extreme cases of night pain some patients have found it helpful to sleep in a more upright position such as a recliner or propped up on pillows in a slightly reclined sitting position. Make sure to support behind your elbow so your elbow doesn’t fall back behind the midline of your body.

Movement

Movement is important and it can help us heal. There are, however, certain do’s and don’ts when recovering from rotator cuff related pain or injury.

  • Keep all arm and hand movement in front of your body. Do not reach behind you with your hand such as reaching into the back seat of your vehicle. Support your arm so your elbow and hand are always in line with or in front of your shoulder.
  • Minimize prolonged repetitive positions or activities at or above shoulder height.
  • Avoid heavy lifting, pushing or pulling with the affected arm at home or at the gym.
  • Avoid long lever lifting. Keep anything of weight or load close to your body. Follow the “front burners of the stove” rule – do not reach out beyond this distance.
  • Keep good posture! Posture affects our shoulder blade position where the rotator cuff muscles are attached. Good posture prevents impingement, giving space for the rotator cuff to move through when you lift your arms. It also recruits the muscles that attach your shoulder blades to your spine (scapular muscles). When you use these muscles your rotator cuff has support when you lift your arms or anything of weight. Without these muscles, your rotator cuff has to strain more to lift your arm which can cause pain.
  • When moving your arm/shoulder, ensure you do not shrug your shoulder toward your ear. Keep your shoulder down when lifting your arm up. This will minimize neck related issues and stress on the rotator cuff (impingement).
  • It is okay to work into soreness or stiffness when doing exercises but sharp pain, pinching pain or catching is not. You should be stretching to, but not far beyond the edge of discomfort. Pushing to the proper limit will slowly tell the body where to heal and lengthen to improve mobility.
  • The general rule is IF IT HURTS DON’T DO IT.

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