Left untreated, rotator cuff tendinitis can quickly go from a minor nuisance to a major disruption. Even worse, the inflamed shoulder joint tendon may rupture, requiring surgery. That’s why understanding what rotator cuff tendinitis is and learning how to treat it — and how to prevent future bouts — is crucial.
How To Treat Rotator Cuff Tendinitis
In this article:
- What Is Rotator Cuff Tendinitis?
- What Causes Rotator Cuff Tendinitis?
- Early Treatment
- Ongoing Treatment
What Is Rotator Cuff Tendinitis?
Rotator cuff tendinitis is also known as pitcher’s shoulder, tennis shoulder, and swimmer’s shoulder. The nicknames are not surprising, given that the repetitive motion of these sports is often the culprit for stiff, aching arms and shoulders. When the shoulder joint performs the same motion over and over, the tendon becomes over-stressed.
The rotator cuff is the group of tendons and muscles in the shoulder that connect the shoulder blade to the upper arm bone. When any of the rotator cuff’s four tendons get irritated or swollen, extreme discomfort and stiffness results.
There are four tendons in the shoulder region, so the injured tendon determines which arm motions become more difficult. Most people who develop rotator cuff tendinitis have an inflamed supraspinatus muscle tendon. This tendon is in the top front section of the shoulder region. When the supraspinatus tendon becomes inflamed, it makes raising the affected arm past shoulder height almost impossible.
What Causes Rotator Cuff Tendinitis?
Sports aren’t the only cause of rotator cuff tendinitis. Certain jobs or hobbies require frequently moving the shoulder joint. These activities range from crafts such as knitting to jobs like stocking shelves. While rotator cuff tendinitis usually results from repetitive motion, it’s not always the cause. Some patients discover a habit of sleeping on one side, which can cause shoulder impingement.
If a patient can’t pinpoint an incident or habit that would strain the shoulder joint tendon, a doctor may order an X-ray to rule out other problems. But in most cases, a physical exam is enough to confirm the rotator cuff tendinitis diagnosis.
When a patient first begins to feel the effects of rotator cuff tendinitis, dealing with acute discomfort is the first priority. It’s also important to apply ice to the shoulder and upper arm regularly. Over-the-counter anti-inflammatory capsules can also help, as can a topical ointment that is analgesic and anti-inflammatory.
Make sure to rest the injured shoulder as much as possible. If necessary, use a sling to keep the shoulder immobilized. Of course, put on hold tennis, softball, and similar sports for the time being. Carry items using the unaffected arm whenever possible. If certain repetitive tasks can’t be avoided, ice the area after undertaking them.
Stretches for Rotator Cuff Tendinitis
Stretching is also important in the early, acute phase of rotator cuff tendinitis. One of the simplest moves involves crossing the arm with the injured shoulder across the chest, fingers pointing to the side. Hold the arm in place, using the opposite hand.
A doorway stretch is another method of loosening shoulder joint tendons. Stand in an open doorway with both arms out to the side, each hand gripping the door frame or wall opening. Slowly lean forward while holding the doorway, until both shoulder joints feel as if they’re lightly stretched.
Another common rotator cuff stretch starts by holding a yardstick or rolled towel behind the back. Move the stick or towel from one side to another, gently limbering up both shoulders.
Stop at the first sign of discomfort during these basic stretches. Rotator cuff tendons can be further inflamed when forced into positions they’re not ready to hold. Instead, work on expanding the arm’s range of motion gradually, over a period of days and weeks.
In addition, make sure to eat a balanced diet to aid the healing process. Add supplements where needed to support tendon tissue health. Nutrients such as B vitamins, zinc, and magnesium speed tendon and ligament recovery, as do collagen supplements. Foods and supplements containing vitamins A and C promote faster tissue growth, for optimum tendon health.
After the first week or two of icing and lightly stretching the rotator cuff area, it’s time to add strengthening exercises. These build up the muscles supporting the shoulder joint. These prevent future flare-ups. A physical therapist can demonstrate the best ways to strengthen the shoulder region to ease the discomfort and stiffness of rotator cuff tendinitis.
For tendinitis injuries, the Mayo Clinic recommends focusing on a technique known as “eccentric” resistance training. These moves concentrate on the part of the repetition in which the muscle is lengthening while contracting. In terms of shoulder joint workouts, the emphasis is on lowering the arm while holding a free weight or resistance band.
The classic “lawnmower” is one such move. Follow the steps below to do the exercise:
- Stand on one end of a resistance band while pulling up with the other end of the band. (Use the foot on the opposite side of the affected shoulder hold the band down.)
- Bend slightly at the waist, then “pull the cord” by pulling the band upward.
- Bring the end of the band to about rib-level.
- Slowly return the cord to its original position, then repeat.
- Do at least 10 reps during each set.
Some patients prefer free weights. With these, the “reverse fly” is ideal for strengthening shoulder muscles.
- Start by bending at the waist slightly.
- Extend both arms out to the sides, then slowly lower both hands until the weights are touching, at about thigh level.
- Do at least 10 repetitions per set.
External Eccentric Rotation
The “external eccentric rotation” is another classic treatment for rotator cuff tendinitis. By constantly bending the elbow and rotating the wrist while holding a weight, the muscles around the shoulder joint get flexed and strengthened.
To do this, follow the steps below:
- Sit on a chair sideways, so that the injured arm can rest atop the back of the chair.
- Hold a free weight in this hand. Slowly move the hand towards the chest, palm facing down.
- Then rotate the wrist so that the palm is facing outward.
- Bend the elbow while raising the weight to shoulder height, with the forearm at a 45-degree angle toward the shoulder.
- Straighten the forearm so that it is vertical, then lower the forearm straight down so it’s resting on the back of the chair again.
- Repeat at least 10 times per set.
What to Remember When Exercising
While moves like the external arm rotation and the reverse fly are considered basic moves, they can be hard to master for beginners. Consider a session with a physical therapist or reputable trainer in order to get the positioning right, for maximum tendon support.
When building up the shoulder muscle groups to protect the rotator cuff, consuming specific nutrients helps maintain muscle function. These include potassium, calcium, magnesium, and Vitamin D. In addition to foods rich in these vitamins and minerals, consider taking supplements containing one or more of them.
It’s never too late to make lifestyle changes that support rotator cuff health. Even minor adjustments can limit the severity of future flare-ups of rotator cuff tendinitis.
If repetitive tasks involving the shoulder can’t be avoided, try to take more breaks between sessions. At work, ask a supervisor about switching between physical tasks and desk work. In terms of fitness, try the “cross-training approach.” For example, alternate kayaking or weight lifting days with walking or biking days.
Sometimes it’s not possible to walk away from a job with physically demanding tasks. And certainly giving up a favorite activity can be heart-breaking. If possible, consider undertaking occupational therapy, or taking a class, to learn the best techniques to prevent rotator cuff strain. Equipment can also play a part in preventing bouts of rotator cuff tendinitis. Look into ergonomic chairs, computer stations, and hands-free phones. These can all be set up to accommodate a patient’s specific measurements.
Change Usual Activities
People who suspect their sleeping position might be causing shoulder impingement should try to sleep on the opposite side, or on the back. A body-length pillow helps prevent rollovers to the “bad” side during the night. Improved posture also plays a role in minimizing back and shoulder problems. Focus on straightening the back while sitting and standing.
Gotten into the habit of always carrying a purse or messenger bag on one shoulder? Switching sides helps prevent problems like rotator cuff tendinitis.
Stretching and strength training play an important role in tendinitis prevention. After doing anything physically demanding, make sure to cool down with stretching. In addition, work to strengthen chest, core, shoulder and leg muscles to minimize joint and tendon problems. It pays to focus on more than just the rotator cuff region. After all, when one area of the body gets hurt, the rest of the body can get thrown out of alignment while accommodating that injury.
Here are some exercises to prevent rotator cuff tendinitis from JourneyToLegends:
Remember — coping with rotator cuff tendinitis doesn’t have to mean going it alone. Even when surgery or prescription medication isn’t needed, a medical team is still invaluable. For example, physical therapists clarify the best ways to stretch and strengthen the area. In addition, blood tests determine if nutritional definitions contribute to muscle and tendon weakness. Whatever the suspected reason for rotator cuff tendinitis, there are a number of non-aggressive, holistic avenues to consider that will ease that aching arm and shoulder. Visit Dr. Seeds Health products effective joint repair and pain relief, among others.
Keep visiting Dr. Seeds Health for more information on rotator cuff injury treatment and prevention as well as other holistic approaches to health issues. Comment questions on rotator cuff injury exercises below!