The treatment of rotator cuff injuries depends on the severity of the of the damage. Injuries can range from a strain and sprain to a tear in one or more of the tendons. Full recovery can take up to six months. Here are some of the most common and effective treatments for rotator cuff injuries.
Rest and Ice
Minor rotator cuff injuries can initially be managed at home. Rest and ice are the primary treatment options. The affected shoulder should be iced three times a day for 15 to 20 minutes. A sling can be helpful to isolate the arm and provide support and rest. However, it’s important not to immobilize the shoulder for extended periods of time as this can cause the joint to stiffen up, which can later lead to a reduction in function.
Pain Control
The first line of medication for a rotator cuff injury is an anti-inflammatory pain medicine. This type of medication not only provides pain control but also reduces swelling and inflammation in the affected arm. Examples of anti-inflammatory medications include ibuprofen (Motrin) and naproxen (Aleve).
If an anti-inflammatory is not providing enough pain control, a doctor may perform cortisone injections. Cortisone shots are injected into the shoulder joint and consist of a corticosteroid (a powerful anti-inflammatory) and a local anesthetic. One treatment can provide pain relief for several weeks to months. The doctor would determine the number of injections allowed during a year.
Physical Therapy and Exercise
The goal of physical therapy is to strengthen the four major tendons around the shoulder, reduce and eliminate pain, and improve the functionality of the joint.
The first activities introduced in physical therapy are passive and active range of motion (ROM) exercises. Passive ROM exercises are completed by a physical therapist with no assistance from the patient. Active ROM exercises are performed by the patient with the assistance of the physical therapist and are later also completed at home. The initial goal of ROM exercises focuses on stretching and regaining the function of the joint. Depending on the extent of the injury, the focus may also include areas of the neck and upper back.
As the treatments continue, the exercises regime will be expanded to include strengthening exercises to build the rotator cuff ligaments and the muscles around the shoulder, including the neck, shoulder blade, and upper back. These activities will usually incorporate the use of stretching band, exercise machines, or free weights. Strengthening exercises help to prevent future injuries.
Ultrasound Therapy
Physical therapists also use ultrasound technology to stimulate the tendons around the rotator cuff. The ultrasound will send sound waves into the shoulder. The sound waves can cause vibrations in the soft tissue areas which will create heat in the tendons. This heat will reduce pain and encourage healing. In addition, the waves can stimulate collagen formation and an increase in blood flow, which can accelerate healing. Ultrasound treatments are able to be adjusted depending on the depth of the injury. Lower sound waves will penetrate deeper into the joint, whereas higher frequency waves are used for injuries located closer to the skin.