Rotator Cuff Problems: Care Instructions

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Rotator cuff around top of arm bone at shoulder, with close-up of rotator cuff tendons and muscles

Overview

The rotator cuff is a group of tendons and muscles around the shoulder that keeps the shoulder joint stable. It is what allows you to raise and rotate your arm. Over time, daily wear and exercise can cause the tendons to rub on the bones of your shoulder. This is called impingement. This condition may cause the tendons to bruise, degenerate, or tear.

In many people, these problems do not cause pain. When they do cause pain, you can do things to reduce the pain and swelling. These include rest, physical therapy, ice and heat, and anti-inflammatory medicine. If you still have pain after trying these treatments, you and your doctor can discuss having a steroid injection or surgery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Put ice or a cold pack on your shoulder for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake). Put a thin cloth between the ice pack and your skin.
  • After 2 or 3 days, if you don't have swelling, apply heat. Put a warm water bottle, a heating pad set on low, or a warm cloth on your shoulder. Do not go to sleep with a heating pad on your skin. Put a thin cloth between the heating pad and your skin. While holding a warm cloth on your shoulder, lean forward so your arm hangs freely, and gently swing your arm back and forth like a pendulum. You also can do this standing under a warm shower.
  • Follow your doctor's advice for physical therapy. When your doctor says it is okay, try these stretching exercises. Do them slowly to avoid injury. Put a warm, wet towel on your shoulder before exercising. Stop any exercise that increases pain.
    • Range-of-motion exercises. If it is not too painful, stretch your arm in four directions: across the body, up the back, to the side, and overhead.
    • Pendulum exercise. Lean forward and hold onto a table or the back of a chair with your good arm. Bend at the waist, letting the arm with the sore shoulder hang straight down. Swing your arm back and forth like a pendulum, then in circles that start small and slowly grow larger. This exercise does not use the arm muscles. Instead, use your legs and your hips to create movement that makes your arm swing freely. Try this for about 5 minutes, several times a day.
    • Wall climbing (to the side). Stand with your side to a wall so that your fingers can just touch it. Then turn so your body is turned slightly toward the wall. Walk the fingers of your injured arm up the wall as high as pain permits. Try not to shrug your shoulder up toward your ear as you move your arm up. Hold that position for a count of 15 to 30 seconds. Walk your fingers down to the starting position. Repeat 2 to 4 times, trying to reach higher each time.
    • Wall climbing (to the front). Face a wall, standing so your fingers can just touch it. Walk the fingers of your affected arm up the wall as high as pain permits. Try not to shrug your shoulder up toward your ear as you move your arm up. Hold that position for a count of 15 to 30 seconds. Slowly walk your fingers to the starting position. Repeat 2 to 4 times, trying to reach higher each time.
  • Rest your shoulder when you are not doing stretches and other exercises. Your doctor may tell you to wait for the pain to go away before doing exercises. Do not lift heavy bags of groceries, play sports, or do anything else that makes you twist or stress your shoulder. Avoid activities where you move your affected arm above your head.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have severe pain.
  • You cannot move your shoulder or arm.
  • You have tingling or numbness in your arm or hand.
  • Your arm or hand is cool or pale.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your pain gets worse.
  • You have new or worse swelling in your arm or hand.
  • You do not get better as expected.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

Enter E207 in the search box to learn more about "Rotator Cuff Problems: Care Instructions".

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.