Prevention

The long-term changes that occur in and around the shoulder joint because of everyday wear and tear cannot be totally prevented. But you may be able to prevent some rotator cuff problems if you:

• Keep the muscles in your shoulders flexible and strong. Daily exercises to maintain strength and flexibility may be the best defense against rotator cuff disorders.
• Have good posture at all times. Stand straight and relaxed, without slumping.
• Don't lift objects that are too heavy for you—especially over your head.
• Don't catch falling objects.
• Avoid sports or other activities where forceful contact or falls are likely or common.
• Don't keep your arms out to the side or raised over your head for long periods of time, such as when painting a ceiling. If you must do these activities:
  • Take frequent breaks, and ice your shoulder several times a day and at night.
  • Take a nonsteroidal anti-inflammatory drug to relieve any swelling and pain in the tissues that are being pinched.
  • Ask your doctor if it would be helpful to take an anti-inflammatory medicine before activities that may stress your shoulder.

Home Treatment

Home treatment is often the first treatment for a rotator cuff problem. Treatment can help relieve the discomfort and keep the problem from getting worse.

• Rest your injured shoulder, although gentle movement of the shoulder is recommended. Limit repetitive movement, and avoid strenuous activity and activities where your arms move above your head. Be sure to follow your doctor's advice on how long to limit movement. Most people don't rest long enough. The rest period for a rotator cuff disorder may be a couple of days to several weeks. During rest:
  • Avoid putting your arm in a sling. It is important that you don't keep your shoulder completely still (immobilized), because it can cause the joint to stiffen or can even lead to frozen shoulder.
  • Move your arm carefully through its full range of motion several times a day. Progress slowly to avoid injury.
• Avoid activities or positions that cause discomfort, such as playing golf or tennis or carrying heavy bags of groceries. Stop any activity that hurts your shoulder.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to relieve pain.

Using ice and heat

People respond to heat and ice differently. Use whichever one makes you feel better. In some cases, heat feels good for a while but may make pain and stiffness worse after 1 to 2 hours. For a sudden injury, don't use heat for the first 48 hours.

At first, ice helps relieve pain and reduce swelling. Try applying ice to your shoulder for the first 48 hours after discomfort begins:

• To avoid harming your skin, place a thin towel between the ice pack and your body, or put a pillowcase over the ice pack.
• Apply ice 2 or 3 times a day, up to 20 minutes at a time.
• Apply an ice pack after exercising your shoulder, to help prevent swelling.

After 2 to 3 days, start moving your shoulder with the aid of moist heat:

• Soak a towel in hot water, and wring it out. Fold the towel to about 8 in. (20 cm) square.
• While holding the towel on your shoulder, relax 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 exercise standing under a warm shower. Heat relaxes your muscles and tendons by increasing blood flow to them. When combined with gentle motion, heat can ease inflammation.
• Repeat these steps 2 or 3 times a day to reduce the risk of permanent stiffness in the joint.

Exercises

Eventually, your doctor may want you to do more to stretch and strengthen your shoulder. For exercises you can do at home (with your doctor's approval), see:

Rotator Cuff Problems: Exercises You Can Do at Home.