There are several different treatment options available for a rotator cuff injury, including surgical and non-surgical therapy. The type of rotator cuff therapy recommended is influenced by a number of factors, including level of activity, type of injury, age, and additional health risks. In cases of minor injury, rest and anti-inflammatory medications followed by rehabilitation exercises are often the only rotator cuff therapy needed.
There are three sets of ligaments, four muscles, and four tendons which surround the shoulder joint and provide stability. The four muscles, collectively known as the rotator cuff, are the infraspinatus, the subscapularis, the supraspinatus, and the teres minor. An injury to the rotator cuff most commonly refers to an injury to one of these muscles. The most frequently injured rotator cuff muscle is the supraspinatus.
If there is a large or complex tear in one or more muscles of the rotator cuff, surgery may be required to repair the damage. Arthroplasty is a complex and extensive surgical option used when damage to the rotator cuff is particularly extensive or severe, or when other treatment options have been unsuccessful. This method is also used to as rotator cuff therapy when a long-term rotator cuff tear has contributed to a condition called rotator cuff arthropathy, which is a condition that often causes severe pain and restriction of movement in the shoulder. In these cases, two different procedures may be offered as rotator cuff therapy: hemiarthroplasty, which is a partial shoulder replacement, or prosthetic arthroplasty, which is a complete shoulder replacement.
Minor injuries can often be treated with less dramatic forms of rotator cuff therapy. Resting the injured shoulder and refraining from performing movements which cause or increase pain can allow the muscles and tendons time to recover from minor injury or inflammation. Heavy lifting and raising the arms over the head should also be avoided until the pain has receded. Anti-inflammatory medication such as ibuprofen may help relieve pain and inflammation. Cortisone injections and a course of physical therapy may be recommended if the injury does not require surgery but the pain and restriction of movement is significant.
Ice packs also help to reduce pain and swelling and should be applied to the injury for 15 to 20 minutes every two to three hours for the first 48 hours after the injury occurs. After this period, heat packs can be used to warm and relax sore, tightened muscles. It is also important to keep the muscles and joint loose and flexible; otherwise the muscles and joint stiffen. If the joint has stiffed, any attempt at resuming activity may risk of further injury as well as additional pain and discomfort. The patient should attempt to perform small movements to help rehabilitate the joint, providing the exercises do not cause additional pain or discomfort.
Tennis, squash and badminton players frequently injure the rotator cuff due to the nature of the movements required, as do baseball and cricket pitchers. Older people may suffer degenerative tendinitis of the rotator cuff, which is a result of the weakening of the muscles and tendons, primarily due to age and wear. Pain in the shoulder area may be misdiagnosed as a rotator cuff injury, as the pain and restriction of movement is very similar in other injuries, such as biceps tendinitis.