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 the rotator cuff) 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. 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
- Crackling sensation when moving the shoulder to different positions
- Feeling of instability
What Causes 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 pain is unlikely to heal on its own; 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 Injury
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 during the first day or two; then try heat.
- Condition your shoulder. Do some gentle exercises, to restore range of motion and strengthen the rotator cuff. These exercises will help get you started, but first discuss them with your doctor. Do not continue any exercise that causes pain. For chronic rotator cuff pain, you’ll need professional advice from a doctor or physical therapist in designing an exercise program.
- Cortisone injections. In severe cases, cortisone injections can help promote healing.
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 for Preventing 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.
Shoulder strengthener 1. Lie on your side with your sore shoulder up and your head supported. Holding a light weight, bend your arm at a 90-degree angle and position your forearm parallel to the floor. Keeping your elbow against your side, lift the weight toward the ceiling, then slowly lower the weight forward. Repeat 10 times.
Shoulder strengthener 2. Lie on a table or bed, with the arm of your sore shoulder hanging down. Hold a light weight, and with your hand rotated outward, swing the arm straight back. Hold for 2 seconds, then lower slowly, and repeat 10 times. Variation: Rotate your hand inward and lift the weight forward, almost parallel to the floor; hold, lower, and repeat.
Towel stretch. Grasp a towel behind your back with one arm behind you and the other arm raised over your shoulder. Pull the towel upward, but not to the point of discomfort. Hold for 10 seconds, then switch arms.
Shoulder stretch. Stretch the back of the painful shoulder by reaching with that arm under your chin and across the opposite shoulder. Gently push the arm back with the other hand. Hold for 15 seconds. Repeat 5 times.
Beyond Home Remedies: 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 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, a controlled study of 125 people with severe rotator cuff injuries (ages 19 to 66) found that a supervised exercise program produced the same improvements as surgery. Conducted at University Hospital in Oslo, Norway, and published in the British Medical Journal, the study showed that even in patients whose condition resists treatment, an exercise program is worth trying before any surgery is considered.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media