Rotator Cuff Pain

What is the Rotator Cuff ?

The rotator cuff refers to a group of four tendons and muscles that form a “cuff” to stabilize the shoulder joint. The rotator cuff works to keep the arm in the shoulder socket, while allowing it to move in different directions. The shoulder is stable because of the rotator cuff, but it is also relatively weak. Acute injuries or repetitive stress and strain on the shoulder joint can cause swelling and tears in the rotator cuff tendons. Damage to the rotator cuff tendons can be due to trauma, as from falling and injuring the shoulder; overuse in sports, particularly those that involve repetitive overhead motions; inflammation, as from tendonitis, bursitis, or arthritis of the shoulder; or degeneration, as from aging. If your rotator cuff is damaged, the protective function has been interrupted, placing your shoulder at risk. If the problem progresses, you may lose the ability to raise your arm.

 

Did You Know?

After neck and back pain, shoulder pain is the third most common musculoskeletal disorder. Up to 70% of shoulder disorders are related to rotator cuff disease. The peak age for rotator cuff disease is 45-64 years old (American Academy of Orthopaedic Surgeons, AAOS).

 

Strengthening Exercises

By strengthening the healthy portions of your injured rotator cuff there is a good chance you can regain the ability to use your arm for your daily needs. The exercises are specific and should be performed on a regular basis. Below are three different theraband exercises that can be incorporated into your daily routine. These exercises work to increase the motion and strength in your shoulder. If you do not have a theraband at home, you can use a light household item (i.e., soup can, light dumbbell).

 

3 Exercises to Improve Rotator Cuff Strength

Bilateral Shoulder External Rotation

1. Standing with an upright posture, hold the middle of a piece of theraband with both hands (thumbs facing outwards).
2. With your elbows at your side and arms bent at 90 degree angel (as demonstrated in picture above) pull your hands outward.
3. As you pull your hands outward, squeeze your shoulder blades down and together.
4. Hold for 2-3 seconds.
5. Complete 10 repetitions for two sets.

*If pain increases with this exercise discontinue at once.

 

Elastic Band Rows

1. Holding elastic bands with both hands draw back the band as you bend your elbows (as pictured).
2. Keep your elbows near the side of your body.
3. Hold for 2-3 seconds.
4. Complete 10 repetitions for two sets.

*If pain increases with this exercise discontinue at once.

 

 

 

 Elastic Band Shoulder Internal Rotation

1. Place a rolled towel under your arm (slightly below your armpit).
2. Hold the elastic band at your side with your elbow bent.
3. Start with your hand away from your stomach, and then pull the band towards your stomach (like your punching yourself in the gut).
4. Keep your elbow near your side the entire time.
5. Hold for 2-3 seconds.
6. Complete 10 repetitions for two sets in each arm.

*If pain increases with this exercise discontinue at once.

 

4 Tips to Reduce Pain

If you are experiencing shoulder pain and/or are suffering from rotator cuff disease complete the exercises below. These exercises are aimed to relieve pain, increase range of motion, and improve circulation in your injured shoulder.

 

Pendulums

Caution: If you have moderate to severe back pain consult your physician before beginning exercise.

Purpose: this exercise uses the weight and momentum of your arm to encourage movement at the shoulder joint. Items needed: open space, table.

*Note: your affected arm will remain inactive throughout the exercise. This exercise does not use the arm muscles. Rather, use your legs and your hips to create movement that makes your arm swing freely.

1. Stand beside a table with the hand of your non-injured shoulder on the table and feet slightly wider than shoulder-width apart.
2. Bend slightly at the hips and let your affected (injured) arm hang down toward the floor.
3. Shift your weight side to side. Using the momentum from your hips and legs let your arm swing freely side to side (pictured on far left).
4. Shift your weight forward and backward. Using the momentum from your hips and legs, guide the slightly swinging arm forward and backward like a pendulum (or elephant trunk) letting your arm swing freely front to back (pictured in middle).
5. Once you feel comfortable with these movements, move your body so that your arm swings in a circle, being careful not to use your shoulder muscles to create movement. Keep the circle small, less than 8 inches (pictured on far right).
6. Continue for 30 seconds. Each day, increase the time until you can do 3 to 5 minutes.
7. Repeat exercise 5 to 7 times per day.
8. As you have less pain, try bending over a little farther to do this exercise. This will increase the amount of movement at your shoulder.

Ball Squeeze

Purpose: to help maintain strength in your muscles and reduce swelling.

Items needed: rubber ball, chair, sling (if available)

1. While sitting, grip a rubber ball with your injured arm and squeeze it with your hand for a total of 5 seconds.
2. Keep your injured arm in a sling (if available).
3. Keep your elbow at your side.
4. Complete this exercise 4-5 times per day.

 

                                           Applying Ice

Apply ice for 10-15 minutes to the injured shoulder area at least 2-3 times a day. It is important not to ice the shoulder longer than 15-20 minutes at a time. Longer periods can produce skin irritation and also damage underlying tissue. Applying ice can reduce shoulder swelling and can help reduce pain-it is especially helpful to ice the shoulder before bed if sleeping is difficult and/or painful.

             Applying Heat

Applying moist heat to your shoulder can improve blood flow to the restricted and tight tissues. Moist heat penetrates deep into the joint, helping to ease that deep ache and improve the range of motion of the joint. I recommend applying moist heat for 8-10 minutes prior to working on exercises. This can help reduce any pain/stiffness in your shoulder, resulting in increased motion in your affected shoulder.

 

Thank You!

This article is aimed to provide you with some home exercises and remedies (heat & cold) to help improve your condition. If you experience an increase in pain, weakness, or numbness in the arm or hand please contact our shoulder specialists at Flex Physical Therapy and Sports Medicine. Our phone number is 1-800-930-8803 we specialize in the treatment of rotator cuff pain.