Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Pain control usually is the goal of treatment. This can be accomplished with rest and acetaminophen
(Tylenol) or ibuprofen.
Physical therapy and range-of-motion exercises may be helpful in maintaining shoulder function and strength.
Steroid injections into the shoulder joint may be helpful.
Patients who continue to have pain and loss of shoulder function may benefit from a referral to an orthopedic surgeon to discuss surgical repair of the rotator cuff injury.
Apply ice to decrease swelling.
Anti-inflammatory medications like ibuprofen and naproxen may help reduce pain and swelling.
A sling may help support the arm rest the rotator cuff muscles. Long-term use of a sling is not advised, since it may cause significant stiffening of the shoulder joint.
Usually, acute rotator cuff injuries require more than one visit to the care provider and may also require referral to an orthopedic specialist for advice and care. Surgery may be considered within a few weeks, especially in younger, active patients, to return the shoulder to full function.
Indications for surgical treatment include the following:
Usually for patients younger than 60 years of age
Complete rotator cuff tears
Failure of conservative therapy (physical therapy, rest and anti-inflammatory medications) after
six to eight weeks
Employment or sporting activity that requires constant shoulder use.
Rest the shoulder in a sling for a short period of time. Prolonged use of the sling can cause stiffness, weakness, and loss of motion of the shoulder joint.
Take anti-inflammatory medicines such as ibuprofen or
More severe cases
Use the techniques described for beginning care.
Steroid injections into the shoulder joint may be considered.
After a few days, ice may be alternated with heat and massage therapy and range-of-motion exercises initiated.
Perform Codman exercises. These are passive range-of-motion exercises (often initially done with a physical therapist). These exercises are done to increase slowly the amount of motion of the shoulder while putting a low amount of stress on the rotator cuff itself. The exercises are performed as the person leans toward the injured side with the arm hanging freely and slowly moving the arm in a circle. Initially, the circles are small. With improvement and decrease in pain, the circles enlarge (also called pendulum exercises).
Holding a broom with both hands and moving it in a large arc while relaxing the affected shoulder can passively stretch the soft tissues.