What’s the Best Treatment For Your Painful Rotator Cuff?

What is the Rotator Cuff?

  • 4 muscles from the shoulder blade (scapula) merge into one tendon that attaches to the top of the arm bone (humerus).
  • It stabilizes the ball in the socket.
  • A bursa is a slippery layer of tissue on top of the rotator cuff; it lubricates these moving parts, but can get inflamed and painful if irritated.
  • Part of an intricate system that moves the shoulder.

What Causes the Pain?

  • Tendonitis = Bursitis = Impingement all mean the same thing: inflammation and tendon damage in this area.
  • Friction between the tendon and the bone (acromion) can eventually wear a hole in the tendon.
  • The tendon can tear from a sudden injury.
  • Arthritis at the “AC” joint where the collarbone (clavicle) meets the acromion.

How Can You Relieve the Pain?

  • Heat or Ice: use whichever feels good.
    • Heat before activity warms up the joints by opening up the blood vessels, improving the flow of oxygen.
    • Ice after activity cools inflammation from friction and strain; there’s less swelling, therefore less pain.
    • Use your ice/heat pack as often as you’d like; start with 20 minutes, three times a day.
  • Sleep in a reclining chair or with a large wedge-shaped pillow in bed to relieve pressure from your shoulder.
  • Don’s slouch! Maintain a strong core. Use good posture and body mechanics. Sit up straight!
  • Avoid heavy lifting away from the body or overhead.
  • Do simple exercises to keep your shoulder moving so it doesn’t “freeze” up: up to 5 minutes, 3-5 times a day.
  • A Physical Therapist can teach you rehab exercises that rebalance muscle strength, flexibility and endurance. You’ll learn to correct your body mechanics so your problem is less likely to keep coming back.

Cortisone Shots for Shoulder Pain:

  • Delivers a powerful anti-inflammatory to the painful area.
  • Pain relief could last for months or years.
  • There’s no hard-fast rule about how often you can have a shot.
  • If the shot does not last more than 6-12 months, it might be time for surgery (see below).
  • For patients who can’t have surgery, periodic steroid injections could be their best was to control pain.

Ready For Surgery?

Why?

  • Pain and/or weakness interfere with quality of life despite conservative treatment: time, rehab exercises, medication, cortisone shot…
  • A sharp bone spur or calcium deposit rubs on the tendon.
  • Cortisone shots don’t “last” more than 6-12 months.
  • Acute tear after an injury.
  • Your other health issues are stable and won’t interfere with safe surgery or recovery.

What is done?

  • Outpatient surgery, general anesthesia.
  • Arthroscopic surgery if rotator cuff is not torn (per MRI) to smooth the bone spur, clean out bursa.
  • “Open” surgery to repair a torn Rotator Cuff Tendon.

How long will healing take?

  • Healing is a process that takes time. Expect 75% recovery within 6-8 weeks; full recovery depends on your shoulder and commitment to the rehab exercises.
  • You’ll wear a sling for the first few weeks. You can use your hand for light activities like holding a toothbrush or a pencil.
  • You’ll work on a series of exercises to regain range of motion, and then build strength and endurance as you heal. Most patients start physical therapy after 2-6 weeks postop.
  • It’s OK to drive after a few weeks IF you can safely control your car. Use common sense.
  • Full healing could take up to 1 year.

Info from AAOS

Shoulder Impingement
Rotator Cuff Tears