Get Well Soon: How to Heal a Strained Rotator Cuff

Dinged your shoulder climbing or swimming? Here are the steps to recovery.

The shoulder consists of three bones: the shoulder blade (scapula), the upper arm bone (humerus), and the collarbone (clavicle). Surrounding these bones are a series of tendons and muscles that keep the shoulder’s ball-and-socket structure tight and strong. This elegant system is known as the rotator cuff; and furnishes the joint with the greatest range of motion in the body.

The same flexibility that allows the shoulder to handle strenuous and diverse movement, however, is also its greatest weakness. According to the American Academy of Orthopedic Surgeons, nearly 2 million Americans visited their doctors for rotator cuff problems in 2008 alone.

There are many causes for injury, chief among them overhead movements. Sports such as swimming, volleyball, tennis and baseball are all major culprits, and climbers sometimes strain their rotator cuffs. Also, the wear and tear of age, direct impact trauma and arduous household labor exposes the joint to weakness.

If you hurt your rotator cuff, immediately take the following precautions:

Rest Your Shoulder
Stop doing whatever activity caused the pain. Avoid heavy lifting, and try not to limit overhead movements until the pain subsides.

Apply Ice and Heat
Ice your shoulder for 15 to 20 minutes at a time to reduce inflammation (a bag of frozen peas or ice pack work well). Ice every few hours for the first couple of days. After that, if the pain has significantly, try applying a heating pad or hot packs to relax your tight, sore muscles.

Take Pain Relievers
Over-the-counter anti-inflammatories, like aspirin and ibuprofen can help you cope with the pain. Stop taking them when the pain improves.

Stay Limber
Avoid stiff joints by doing gentle range-of-motion exercises within a reduced, pain-free range.

Sometimes, though, these home measures aren't enough, and it's time to see a doctor. Don’t fret just yet, though: The prognosis is overwhelmingly positive.

“The majority of rotator cuff injuries are treated successfully without surgery through rest, activity modification and physical therapy—which includes a lot of stretching followed by strengthening exercises,” said Andrew S. Rokito, M.D., an orthopedic surgeon and shoulder specialist at New York University’s Langone Medical Center.

Non-surgical treatments are typically used for partial tears of ligaments, including oral anti-inflammatory medicines and steroidal injections such as cortisone. Full-thickness tears—a complete tear of the ligament—often requires surgical repair, which, according to Dr. Rokito, can take between six months and a year for recovery.

Dr. Rokito also noted that prognosis for chronic cases—those who’ve ‘played through the pain,’ or suffered ongoing issues without treatment—is often notably worse. So be sure to get checked out immediately if any pain occurs, and work toward healing and prevention with sport-specific training and home remedies