The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and remain stable.
Common rotator cuff problems include:
Tendinitis, which is irritation of the tendons and inflammation of the bursa (a normally smooth layer) lining these tendons
A tear, which occurs when one of the tendons is torn from overuse or injury
Relieving the pain
Medicines, such as ibuprofen or naproxen, may help reduce swelling and pain. If you take these medicines every day, tell your doctor so that your general health can be monitored.
Moist heat, such as a hot bath, shower, or a heat pack, can help when you feel pain in your shoulder. An ice pack applied to the shoulder 20 minutes at a time, 3 to 4 times a day, may also help when you're in pain.
Using your shoulder
Learn how to care for your shoulder to avoid placing extra stress on it. This can help you heal from an injury and avoid re-injury.
Your positions and posture during the day and night can also help relieve some of your shoulder pain:
When you sleep, lie either on the side that is not in pain or on your back. Resting your painful shoulder on a couple of pillows may help.
When sitting, use good posture. Keep your head over your shoulder and place a towel or pillow behind your lower back. Keep your feet either flat on the floor or up on a foot stool.
Other tips for taking care of your shoulder include:
Do not carry a backpack or purse over just one shoulder.
Do not work with your arms above shoulder level for very long. If needed, use a foot stool or ladder.
Lift and carry objects close to your body. Try not to lift heavy loads away from your body or overhead.
Take regular breaks from any activity you do over and over again.
When reaching for something with your arm, your thumb should be pointing up.
Store items you use everyday in places you can reach easily.
Keep things that you use a lot, such as your phone, with you or close by to avoid reaching and re-injuring your shoulder.
Physical therapy and exercises
Your doctor will likely refer you to a physical therapist to learn exercises for your shoulder.
You may start with passive exercises. These are exercises the therapist will do with your arm. They help get the full movement back in your shoulder.
After that, you will do exercises the therapist teaches you to strengthen your shoulder muscles.
Returning to sports
It is best to avoid playing sports until you have no pain during rest or activity. Also, when examined by your doctor or physical therapist, you should have:
Full strength in the muscles around your shoulder joint
Good range of motion of your shoulder blade and upper spine
No pain during certain physical exam tests that are meant to provoke pain in someone who has rotator cuff problems
No abnormal movement of your shoulder joint and shoulder blade
Returning to sports and other activity should be gradual. Ask your physical therapist about the proper technique you should use when doing your sports or other activities that involve a lot of shoulder movement.
Matsen FA III, Fehringer EV, Lippitt SB, Wirth MA, Rockwood CA. Rotator cuff. In: Rockwood CA, Matsen FA III, Wirth MA, et al., eds. The Shoulder. 4th ed. Philadelphia, PA: Elsevier Saunders; 2009:chap 17.
O’Brien MJ, Leggin BG, Williams GR. Rotator cuff tendinopathies and tears: surgery and therapy. In: Skirven TM, Osterman AL, Fedorczyk JM, Amadio PC, eds. Rehabilitation of the Hand and Upper Extremity. 6th ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 88.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.