Rotator Cuff Information

What is the Rotator Cuff?

It Can be Tricky, But You Can Heal It!

You might be frustrated by the process of healing, but you can heal. The good news is that your body is trying to heal your Rotator Cuff right now. The challenge is that you are using it constantly and that constant use comes with frequent re-injury. Understanding how to avoid re-injury will be key to healing your Rotator Cuff once and for all.

What is the Rotator Cuff?

If you search online, the internet will tell you the Rotator Cuff is made up of 4 muscles: The Supraspinatus, the Infraspinatus, the Teres Minor, and the Subscapularis. You do not need to remember those muscle names. Typically, if one of those first four muscles is injured or torn your doctor will diagnose it by the name of the muscle - whatever it is in your case. It is unlikely that with injury to the first four muscles often cited online, that the doctor will just call it a 'Rotator Cuff Injury', he/she will call it a specific muscle injury.

If your doctor's diagnosis is a 'Torn Rotator Cuff', then usually they are talking about another set of muscles in the Rotator Cuff. The rotator cuff also includes the Deltoid Muscles. The deltoid group are complex, and when they are injured, it often impacts more than one, so the doctor just calls it a 'Rotator Cuff Tear' rather than referring to the muscle names. Generally, all the muscles of the rotator cuff hold the shoulder together and move the shoulder and arm through multiple planes and ranges of motion.

If you were told that you have a Rotator Cuff injury, that means that either they could not precisely identify which muscle is injured or there might be multiple tissues injured. Usually, the injury is in the deltoid muscles which surround the top of the arm and extend down the arm. Any movement you make with your arm is partly controlled by these muscles. Your injury is unique, it is not necessarily the same as another person with a rotator cuff injury. You might have pain in the front, side or back of the shoulder. The pain can also radiate from the shoulder into the chest or back. You know where the main injury is though, it's that spot that suddenly hurts so sharply when you move the wrong way. That's the spot exactly. The rest of the pain is called 'referred pain' and, even if it extends outside that key spot, that spot is the root cause of all the pain. Protect that spot, treat that spot, and your rotator cuff will heal.

Symptoms of Rotator Cuff Injury

The Rotator Cuff is a complex structure. You can experience pain with Rotator Cuff tear in a variety of ways. Most pain will be felt in the arm portion of the shoulder area in the front, back or side. Some people also feel the referred pain in the bicep and top of the shoulder. Others feel referred pain in the bicep in the side of the shoulder. Others will feel a dull ache inside the shoulder that gets worse in the evening. Pretty much everyone with a Rotator Cuff Tear will have a shooting twinge of pain at the key point of injury that happens when they move the wrong way. Do not feel alone if your symptoms don't seem to match what you hear. You are having your own experience of injury and healing. The important part is cutting through the noise and focusing on the right steps to healing.

Of all the symptoms, the shooting pain or twinge of pain that you get when you move certain ways is the most important one to pay attention to and avoid. Those moments of sudden and extreme pain are a sign that you are reinjuring yourself. It is also the number one thing slowing your healing down.

It can be difficult to find a comfortable position to rest the arm that does not hurt the shoulder. Lying down at night can be quite challenging and you may need to experiment with different positions and using pillows to prop your arm. It may take some time to find a good sleeping position. But it is worth taking the time. Some people must stack pillows and prop themselves up or only lay on one side. Keep trying until you find the right position for you. Once you find it you may have to change it up a little over time as your healing progresses.

You will notice that you have a serious shooting pain or twinge when you move the wrong way. Pay attention to what causes this sensation. You are going to want to avoid this motion as much as possible. Ideally, once you figure out what movement causes that shooting pain, you will hopefully be able to avoid that movement altogether during the healing process. For sure though, that pain is a warning from your body that you are causing reinjury. It's very important to listen to your body and avoid this.

Lifting something heavy, swinging your arm, throwing something, or moving your arm behind your back... The motion that hurts you is entirely unique to your injury. What hurts you may be very different from what hurts someone else with a torn rotator cuff because every injury is unique. It should go without saying that whichever movement causes you pain, that is a big no-no with your Rotator Cuff Injury. It can even be the smaller movements or specific directions of movement that cause shooting pain. It does not have to be you moving a heavy load or straining your arm, it's can be as simple just moving the wrong way that does it.

What Causes Rotator Cuff Injury

It usually happens from a specific event where the small muscles of the shoulder contract suddenly and forcefully. This is very often from a fall or a sudden and strenuous movement. Perhaps you slipped and reached out to stop your fall with your arm. Maybe your dog on a leash took a big jump and caught you off guard. Maybe it was when you were doing a sport. Typically, most people remember the moment they did the damage when it comes to rotator cuff tears. It could be tendon. It could be muscle. It could be a ligament. But usually, it is an overstretch or tear of the muscle or tendon in the deltoid.

There are many things that lead up to Rotator Cuff Injuries. In rare cases it can happen from overuse injuries. Overuse injuries usually occur from people doing repetitive overhead tasks. Painters, for example, could experience this. But it does not really matter. Healing from where you are is all that matters. This is your healing journey. Ultimately what matters is the steps you take to protect yourself from reinjury, manage pain the right way, and stimulate healing.

The Most Important Factor in Healing Your Rotator Cuff

Your body is actively working to heal your Rotator Cuff as you read this. Without going into all the biology, your cells are diligently gathering building blocks to make new muscle, tendon and ligaments, assembling new tissues, and so on. It is quickly going about this at the cellular level with no time to waste. You do not have to think about it or do anything special. Your body has a job to do and it is doing it.

But... What if you get up to get a glass of water? Maybe you reach too high for that glass and you get that shooting twinge of pain. You know it instantly. It might be a different motion like reaching to the side or something. But you know instantly when you have moved in a way you should not move. Here is the thing: It's not just a moment of pain. When you feel those sudden twinges, you literally just wrecked all that work your cells were doing. You have reinjured your damaged tissue. You have undone some of the work your body just did for you while you were being good all day. So, the more you can avoid these motions, the more you work with your body and not against it. The more you work with your body the faster you heal. This is the number one factor in healing from this injury. Avoid those motions.

Since that twinging Rotator Cuff pain is you undoing all the work you have done, it is important to figure out how you can avoid those types of situations where you cause that pain. How many times a day do you do the same things that cause that shooting twinge of pain in your shoulder and arm that let you know you hurt your shoulder again? Let's say your do this 6 times a day. Even if you are only successful in avoiding 3 of those you have cut your setbacks by half!

It helps to plan to avoid those situations where you might hurt yourself again. Think back about all the things you have done that cause you to create that shooting reinjury pain. What can you do to keep that from happening? Grab the seatbelt and pull it out with your other arm? Move your coffee cup down to a lower shelf? Get help from others with certain tasks?

Even putting on a shirt can be the thing that sets off the shooting pain. If you think about it a bit ahead of time, you can remember "problem actions" and anticipate them in the future. One thing that helps a lot is putting your arm in a sling. Not because it's broken, but because it makes you think before using it. You will be more likely to use your other arm.

Thinking about your workplace is important too. Do you need to adjust your desk or change where you reach for certain items. The more you adjust in your life to reduce reinjury the faster you can heal and get back to normal.

Sleep is Another Big Area to Consider.

There are two things to consider about your sleep. One is just getting the right position where your shoulder does not hurt so you can get to sleep. The other thing making is sure you are not causing reinjury during the night while sleeping. Some people rest their head on their arm while sleeping. This may not be a good idea for your injury. If you are a side sleeper, then for most people, you should sleep on the side that is not injured. But some people report the opposite works best for them. You will want to experiment with sleep positions to find one that is comfortable and prevents you from moving in a way that causes reinjury.

Some people have to prop themselves up on pillows or in a recliner to sleep for a while. Others use some pillows behind their back to keep from rolling over during the night. Some people will sleep on their side and rest their arm on a pillow at just the right height. With a little experimentation you can quickly find what works best for you. Remember, as you heal you might find that you must make some adjustments to what has been working for you. Do not be afraid to change it up as you progress.

Exercise for Rotator Cuff Injuries

You need to be limiting the range of motion of your shoulder and arm and not put those muscles under load. Avoiding that shooting, sharp, shooting pain that signals you are reinjuring your Rotator Cuff. You should not be putting your damaged tissues under any intense stretch or load. This means no gym. No heavy lifting. No swinging your arm. Yes, you can search the internet for "exercises for torn Rotator Cuff" and find some hits, but that does not mean those fit your situation. That is for after healing to help prevent a future Rotator Cuff Syndrome. Many people or websites will recommend all kinds of things including exercises. Only do exercise after the injury is stable enough to do it without ever having pain.

Stretching for Rotator Cuff Injuries

Doing stretches for torn Rotator Cuff is another great way to make your shoulder worse. You are taking muscle fibers which are torn and putting them under direct stretch. You could have injury of the ligaments or tendons that are actively healing, and stretching them will interrupt that healing process. Right now, you need to be limiting the range of motion of your shoulder and arm.

Again, avoiding that pain that signals you are reinjuring your Rotator Cuff is the most important thing you can do. Doing exercise or stretches for torn Rotator Cuff is the opposite of taking steps to protect yourself. You should not be putting your damaged tissues under any intense stretch or load. No bendy poses. No upper body yoga. We are trying to heal. To do that you need to give those torn and damaged fibers time. You will hear people online recommending stretching. Only do stretches after the injury is stable enough to do it without ever having pain.

How Long Does a Rotator Cuff Injury Last?

What Not to do When You Have a Rotator Cuff Injury

The internet is full of bad advice about treating your shoulder. Here's a short list though:

• Light repetitive activity is neither a cause nor a cure.
• Stretching can surely cause reinjury.
• Pain killers probably make it worse.
• Driving through the pain will just make it worse.

Common Mistakes and What to Avoid

Your shoulder needs your help to heal. But it does not need you to just start randomly doing stretches and exercises you find on the web. This is a great way to keep your injury going. Reinjuring the muscle is the number one thing prolonging your healing time. The shoulder muscles are engaged every time we use our arms. So, it does not get to rest, unless, you focus and make a point of resting and using a control like wearing a sling.

Another complicating factor is that many people find that sleeping aggravates the rotator cuff injury. You may need to either find a way to change your sleeping position, so you alleviate pressure on the impacted shoulder. But obviously, if both sleeping and daily activities cause irritation, it will take some planning to arrange the time to rest your rotator cuff.

At first, you want to focus on three things. Reduce pain with cold compression not medication. Avoid reinjuring the area (consider a sling). Increase blood flow to the muscle to stimulate rapid healing.

Here are some definite things to avoid that people wrongly think may help:

Pain Medication

Pain reduction is important. When the rotator hurts, you need to reduce pain so you can go about your day and do the things you need to do. But masking pain with pain medication is not recommended because it can lead to you being unaware of the damage you are doing to a muscle. This is a very common way people get caught in an injury and reinjury cycle. Don't get caught in this loop. ^{33x 50x}

Get some initial rest for the muscle and give it time to heal. Find ways to protect the muscle from too much use during the early healing phase. Use cold for pain during the day. If you do use pain medications, use them at night for sleep. Don't use them during the day since they greatly increase your chances of adding more damage to the muscle strain. ^{25x 50x}

Some pain medications can help - if you use the right one at the right time. Call us and speak to one of our trained treatment advisors about which pain relievers work best. We are here to help.

Tens

TENS is an acronym that means Transcutaneous Electrical Nerve Stimulation. The TENS machine is designed to overstimulate the nerves to relieve pain. It deadens the nerves and that's it. Yes, you want to reduce pain. The pain with a Rotator Cuff tear can be debilitating for sure. But TENS machine use over an injury is a very bad idea. ^54x

TENS causes your muscles to spasm during treatment. That's bad. Having your shoulder injury pulse and flex uncontrolled will cause further tissue damage and slow down healing.^55x Avoid this treatment as it can make things significantly worse for this condition.

What You Should do When You Have a Rotator Cuff Injury?

For a little while - not forever - it is really helpful to give your shoulder a rest. In many cases, resting your shoulder for a few weeks will give it time to heal to a point that your body feels it is ahead of the healing / reinjury cycle. It's important to realize that once the pain and swelling go away, your underlying condition may not be completely gone, so take it easy and go back to regular life gradually. There are things you can do to speed up your recovery. If you want to be more proactive about healing the problem, you can use proactive treatments that accelerate healing and prevent reinjury. For proactive treatments, click here to visit the Recommended Treatments page.

Rest & Use Conservative Treatments

If you want your Rotator Cuff Injury to go away as quickly as possible, you need to rest the affected shoulder. It is a battle of steps forward and backward in the healing and reinjury cycle. You want to make the steps forward as often and big as possible while making the steps backward as small and infrequent as possible. The more effectively you achieve this, the faster your shoulder will heal.

Avoid any physical activities that could cause further injury to your shoulder. Do your best to avoid the activity that caused the original injury. Also avoid any activity that causes that shooting pain in your shoulder or arm. Consider using a sling to keep the strain off your injured shoulder and avoid re-injury. A sling doesn't mean don't move though, that's just to prevent you from doing strenuous activity or perhaps change a bad habit.

You can do regular ColdCure^® treatments to control the pain and swelling. The compression during each treatment helps soothe the aggravated tissue in the joint and stabilize the tissue following reinjury.^{26x 27x}

Focus on accelerating the healing of the tissue with regular BFST^® treatments. Your body wants to heal, so BFST^® will significantly help it do that to the best of its ability. BFST^® makes the healing steps forward as big as they can possibly be.^{1x 2x 7x}

Medical grade tape is an excellent way to prevent reinjury and reduce the amount of damage you do when you move the wrong way. Tape in the morning and wear it all day, every day, so that you are always protected when you move the wrong way.^52x Proper medical taping can really reduce the amount and size of the backward steps during the healing process.

This combination will work to heal your torn Rotator Cuff as quickly as possible.

Don't do any stretching or strengthening exercises until you no longer feel pain at any time. It is very easy to cause reinjury with stretching or strength exercises. There will come a time for exercise, but that's after the pain is gone. Remember, healing Rotator Cuff Injury is a slow process, it may take a few months to get past it completely, but that's much better than ignoring it and suffering for a few years. Continue doing BFST^® treatments long after the pain disappears to maintain the healing you've done. Do a ColdCure^® treatment if you experience any flare-ups of pain and swelling and after any significant activity.

Surgery Should Be a Last Resort

In most cases, you don't have to undergo surgery in order to get rid of your issue. Often, you can get rid of your Rotator Cuff Injury with conservative treatments. Only in rare cases of significant damage such as a complete tear would a person require surgery.

If it's not a complete tear, it is often possible to avoid surgery. But if it is a complete tear, then surgery needs to happen quickly. Before any surgery, always get a second opinion. Surgeons are always quite confident, because surgery is what they do. That doesn't mean that's the right choice for you. You want to do everything you can to let your shoulder heal on its own.

If surgery is your only option, make sure your post-surgery recovery goes as smoothly as possible by using BFST^® and ColdCure^®. Use a ColdCure^® Wrap to reduce the inflammation and relieve the pain for the first few days following surgery. ^{26x 27x 51x} Once the inflammation has gone down, promote blood flow to the injured area using a BFST^® Wrap. ^{2x 7x 20x} This will improve your circulation and help you heal faster.

Dealing With Rotator Cuff Pain

Painkillers are BAD, Not Good

Painkillers mask the pain, causing you to continue to stress and injure your shoulder. This will only make your condition worse. It is understandable that people need relief from the pain, so if you have to take painkillers, restrict them to times when you are at rest. You can use painkillers to help you sleep. Using them when you are active is a recipe for permanent damage.^{25x 50x}Your choice of pain killers is important. You can give us a call to discuss which ones are best.

When it comes to Rotator Cuff pain relief The ColdCure^® Top Shoulder Wrap is designed to relieve the pain. This safe and effective pain reliever is also great at bringing down swelling and inflammation.^{26x 27x 51x} The ColdCure^® Wrap is incredibly soothing and provides support and protection for your shoulder. The painkilling element is incredibly powerful and it works instantly - there's no 20 minute wait like with pills.

A Torn Rotator Cuff can be extremely painful and debilitating. Painkillers such as ASA or acetaminophen are often used to treat the pain but these drugs do nothing to treat the actual condition.^25xIn fact, painkillers are known blood thinners and make the bleeding worse for fresh tissue injuries. Cortisone injections are used in extreme cases but these too are intended to only address the pain. They do not promote healing of the injury itself and they put you at a very high risk of further injury.^{34x 35x 36x 37x}

Blood Flow is Essential for Healing

There's no doubt about it, for healing most tissue injuries in the body, blood flow is the most critical element in rapid recovery. The blood flow brings the building blocks for new cell growth. It carries away the waste and damaged tissue. It brings antibodies to protect against infection. Your blood flow supplies the cells in your body with everything it needs and removes much of what needs to be taken away.

While your heart ensures a sufficient supply to your body as a whole, in the individual parts of your body there are a lot of factors that determine how much that area receives. Motion in local tissue can play a significant role in blood supply, but when you are injured, that motion is reduced, and so is the trigger to bring blood to the area.^43x People often don't understand that motion alone is enough, and that does not mean putting a heavy load on your joint. When you swing your arm gently and with limited range, that's enough. Adding weight, or doing stressful exercise doesn't improve the motion, and the added loads can end up resulting in reinjury.^33x Find light, gentle motions that you can do with no pain at all and do those several times each day. Even leaning over and swinging your dangling arm through the day is enough; you don't need to add more load.

Diathermy is a medical process to promote blood flow in tissue that is at rest.^7x Diathermy is a process by which energy is sent deep into the body to stimulate blood flow in tissue far below the skin.^{1x 2x} An example of diathermy is ultrasound treatment, commonly used in physiotherapy.^13x The challenge with ultrasound is that all diathermic treatments are effective for only up to 4 hours, whereas most people go to the clinic once every couple of days. Also, ultrasound is an older, more risky process that can damage subdermal tissue, so it needs to be performed by a trained technician. That means you can't do it at home.

The good news is that you have an option other than ultrasound. BFST^® devices from King Brand are diathermic devices that people can safely use at home to promote healing.^{1x 2x} With a home diathermic device, you can apply treatment multiple times each day, which significantly improves blood flow and accelerates the healing process.^7x And they are more powerful too, providing deeper stimulation than traditional clinic-based treatments.^13x

An ultrasound device is highly focused, and the effective treatment area may be less than 1 square inch beneath the surface. That is why it must be constantly moved around during treatment, both to cover the entire injury and to avoid overheating or burning tissue.

BFST^® devices offer a major improvement. They treat up to 70 square inches of tissue at once, without requiring any movement. This means your rotator cuff injury can be treated more completely, with better safety and far less effort.^{1x 2x}

They are typically up to 10 times more powerful than ultrasound and completely safe for home use.^13x

BFST^® brings extra oxygen and nutrient-rich blood to the injured area - a requirement for the body to heal itself.^1x Unfortunately, an injured shoulder at rest often has restricted blood flow, which extends your healing time.^33x With a King Brand^® BFST^® Side Shoulder Wrap, blood flow can be stimulated in the area of injury while you are at rest. With improved blood flow and reduced strenuous activity, you reduce the risk of re-injury and you can recover from your rotator cuff injury at a surprisingly rapid rate. For proactive treatment advice click here for our Recommended Treatments page.

For more in-depth information about how an injury heals click here for our Healing Page.

How We Can Help You with Rotator Cuff Pain:

To be more proactive about healing your underlying problem, you can click here to visit the Recommended Treatments page.