How Can You Make Your Rotator Cuff Heal Faster?

Article by John Miller

How Can You Make Your Rotator Cuff Heal Faster?

Rotator cuff injuries are common. Around 732,000 people seek medical advice for rotator cuff injuries in Australia (Naunton et al., 2020). The majority of these will not need surgery. Does time heal all wounds? Or, is some motion your lotion?

The answer is predictably measured and will involve a little of both. Here are the dot points on how to get your recovery right;

Finding Your Appropriate Load Level

Most rotator cuff injuries are from repetitive overuse. Continuing to load these muscles at the same rate will delay healing. But, complete rest isn’t going to work. The damage that has been done requires an appropriate load to stimulate tissue remodelling.

The same can be said of acute rotator cuff injuries, with caveats. A short period of complete rest is usually appropriate before gentle exercise is required to prevent scar tissue buildup.

Providing an appropriate load level at the proper time for your type of cuff injury is tricky. Identifying causative factors and respecting pain are good places to start, but seeking the guidance of a health professional, such as your shoulder physiotherapist, is recommended to ensure you’re ticking all the boxes.

Avoid Sleeping On Your Affected Side

Thankfully this one shouldn’t require an appointment to get right. Just don’t sleep on it.

The reason is that tendons hate compression. And the rotator cuff is very susceptible to compression due to its anatomy.

The cuff muscles originate on the shoulder blade and work to hold the head of the arm bone in place. This naturally leads to them adopting an L shape. When the arm is by the side, the long part of the L is stretched (in the case of the top muscle pictured) and compresses the tendon (the corner of the L) against the arm bone.

Sleeping on the affected side adds another compression element, and now your tendon is being squished from both sides.

Using this new knowledge, you can reason that it is preferable to avoid sleeping on the affected side and with your arm away from your side a slight amount.

It is also best to avoid any rotation, which tensions the other cuff muscles. The most common mistake is sleeping on the unaffected side but letting your hand fall onto your belly.

Changing your sleep position is sometimes difficult. It can be helpful to start thinking about this before you’re staring at the ceiling by taking pain relief or icing before it’s time for bed.

Ice

Usually, ice is used to reduce inflammation, but in tendon overuse conditions, its function involves preventing the abnormal formation of new blood vessels in the tendon (Khan et al., 2000). Studies have shown that shoulder tendons with neovessels present are 6.5 times more likely to experience shoulder pain than those without (Skazalski et al., 2021). It’s a complicated reason for a simple intervention; 20 minutes, multiple times a day, with at least 45 minutes between exposures.

Rotator cuff injuries are common, and most don’t need surgery. Minimising compression to the area by adjusting your sleep positioning, icing regularly and loading the right amount at the right time will ensure your rotator cuff heals as fast as possible.

For more specific advice, please seek the guidance of your trusted shoulder physiotherapist or doctor.

More info: Shoulder Injuries

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References

Naunton J, Harrison C, Britt H, Haines T, Malliaras P (2020) General practice management of rotator cuff related shoulder pain: A reliance on ultrasound and injection guided care. PLOS ONE 15(1): e0227688. https://doi.org/10.1371/journal.pone.0227688

Skazalski, C, Bahr, R, Whiteley, R. Shoulder complaints more likely in volleyball players with a thickened bursa or supraspinatus tendon neovessels. Scand. J. Med. Sci. Sports. 2021; 31: 480– 488. https://doi.org/10.1111/sms.13831

Khan, K. M., Cook, J. L., Taunton, J. E., & Bonar, F. Overuse Tendinosis, Not Tendinitis. The Physician and Sportsmedicine, 28(5), 38–48. doi:10.3810/psm.2000.05.890

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