11 Natural Treatments for Rotator Cuff Pain + Best Rotator Cuff Exercises

March 30, 2017
Rotator cuff pain - Dr. Axe

It’s likely that most of us are unaware of just how important the shoulder is. Well, that is until you injure it. A shoulder that is in pain of any sort, including rotator cuff pain, can cause daily activities such as brushing your teeth, taking a shower, getting dressed, combing your hair and even sleeping very difficult and frustrating. And if fitness is important to you, having a rotator cuff tear — like suffering from frozen shoulder syndrome — can make even the smallest amount of exercise more challenging and possibly painful.

The human shoulder is made up of a somewhat complicated system of bones, joints, connective tissues and muscles that provide the support needed for the arm to function properly. It’s believed that the upper extremities can acquire more than 1,600 positions within a three-dimensional space at the shoulder joint. As long as the shoulder is working properly, complicated activities like throwing a ball, shoveling snow, raking the leaves, climbing, lifting weights, and swimming not are possible but fun. A well functioning shoulder is vital to our activities!

In fact, chronic shoulder pain, which lasts more than a few weeks to a few months, is the most commonly reported upper extremity problem in athletes, both recreational and professional. (1)


What Is the Rotator Cuff Exactly?

The rotator cuff is a group of tendons and muscles that are located in the shoulder and upper back area, connecting the upper arm to the shoulder blade. The tendons of the rotator cuff provide stability to the shoulder area and the muscles allow the shoulder to rotate.

Your shoulder is made up of three bones: your upper arm bone that is called the humerus, your shoulder blade known as the scapula, and your collarbone that is named the clavicle. The shoulder is a ball-and-socket type joint where the ball, or head, of your upper arm bone fits perfectly into a shallow socket in your shoulder blade area.

The rotator cuff tendons and rotator cuff muscles play a pretty important role since they are what keeps the arm in the shoulder socket. There is a network of four muscles that come together as tendons to form a covering around the head of the humerus and that is what we call the rotator cuff. The rotation and ability to lift the arm comes from the rotator cuff, so as you can imagine, when it is causing pain, it can be rather debilitating and very frustrating.

The muscles in the rotator cuff include the teres minor, the infraspinatus, supraspinatus and the subscapularis. There is also what is known as a lubricating sac, or bursa, which is located between the rotator cuff and the bone on top of your shoulder called the acromion. The bursa is what allows the rotator cuff tendons to freely move and glide as you engage your arm in any motion or activity. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful. (2) (3)


Common Rotator Cuff Injuries & Causes

There are many common causes of rotator cuff pain and/or injury, which is typically a torn rotator cuff, such as falling or being hit in the shoulder, such as in football or rugby but also unexpectedly falling during an activity. Overuse from repeated actions, such as lifting, painting, cleaning windows, swimming, swinging a tennis rack or golf club, or throwing a baseball, are common causes as well. Unfortunately, issues can also show up from natural wear and tear that comes from aging.

A rotator cuff tear is one of the most common injuries suffered from the shoulder area and is specifically an injury or tear to the rotator cuff tendon. Symptoms may include weakness and/or pain in the arm and is a common cause of pain and disability among adults. It has been reported that in 2008, close to 2 million people sought medical advice and/or treatment from a doctor for a rotator cuff problem in the U.S. alone. (4)

Besides a rotator cuff tear, rotator cuff pain can also be causes be these problems:

  • Rotator cuff tendonitis is the repetitive overhead use of the arms during activities such as gardening, raking, carpentry, house cleaning, shoveling, tennis, golf and throwing. (5)
  • Rotator cuff impingement is when the tendons of the rotator cuff are squeezed between the humerus and a nearby bone called the acromion. (6)
  • Frozen shoulder occurs when the humerus adheres to the shoulder blade, causing shoulder pain and stiffness. (7)
  • Subacromial bursitis happens when there is inflammation of the small sac of fluid, called the bursa, that cushions the rotator cuff tendons from a nearby bone called the acromion. (8)

Rotator cuff pain - Dr. Axe


Symptoms of Rotator Cuff Problems

An injury to the rotator cuff area can make it very painful and annoying to lift your arm out to the side. Tears that happen suddenly usually cause intense pain right away, indicating that there is a problem. There may even be a snapping sensation and immediate weakness in your upper arm area. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears typically occur in the supraspinatus muscle and tendon; however, other parts of the rotator cuff may be involved in an injury.

Tears that develop slowly over time due to overuse also cause pain and arm weakness. You may feel pain in the shoulder area when you lift your arm to the side, or you may feel pain that moves down the arm. The pain may be mild and only noticeable when performing common activities that require you to lift your arm over your head. Eventually, the pain may become more noticeable, even when the arm is at rest. Some of the most common symptoms of a rotator cuff tear include:

  • Pain at rest and at night, particularly if lying on the affected shoulder
  • Pain when lifting and lowering your arm or with specific activities
  • Weakness when lifting or rotating your arm in different directions
  • Crepitus, which is a grating sound or sensation produced by friction between the bone and cartilage or a crackling sensation when moving your shoulder in certain positions

Rotator Cuff Tests, Analysis & Conventional Treatment

There are a few different ways to assess issues that may be occurring with the rotator cuff such as magnetic resonance imaging commonly known as a MRI, a CT scan, traditional X-rays, a physical exam, ultrasound, arthrogram or a simple painful arc test. (9)

There are many treatments available such as anti-inflammatory pain medications, sports and fitness tape, cortisone injections, and surgery. But while an injection of a local anesthetic and cortisone may be helpful and provide some profound immediate relief, it ‘s temporary and probably masks the problem more than anything.

Cortisone is an effective anti-inflammatory medicine, but it comes with possible side effects: effects to the color of the skin where you get the shot, infection, bleeding from broken blood vessels that may occur within the skin or muscle, soreness, aggravation of the inflammation in the injured area because of reactions to the medication (post-injection flare), and weakened or even ruptured tendons. (10) (11)


11 Natural Treatments for Rotator Cuff Pain and/or Injuries

A study of serious injury of the rotator cuff of young athletes through contact sports shows that through the proper treatment, most can get back to a normal routine to include sports. However, early identification and efficient management are critical to achieve the best results, according to the medical journal Sports Health. “These injuries may initially be dismissed as brachial plexus neuropraxias or cuff contusions, particularly in the football population. If overlooked, the rotator cuff tear is likely to progress and may become irreparable by the time of diagnosis.” (12

But rather than opt for steroid injections or even surgery, I strongly encourage you to take advantage of the following 11 natural treatments. In fact, it’s been reported that approximately 50 percent of patients are relieved of pain and experience improved function in the shoulder through non-surgical methods of treatment. (13) Especially keep in mind that strength building through physical therapy and special exercises (see next section) may be required to regain normal shoulder function.

1. Ice

If you know that you’ve injured yourself, make sure you apply an ice pack to the area immediately afterwards. This will reduce inflammation and swelling (and hopefully your rotator cuff pain). If the ice pack or bag is extremely cold, cover the shoulder with a thin towel or clean cotton T-shirt. Apply for 15 minutes every other hour for the first few hours, and then three times a day until you’re free of pain — this including after any physical therapy or exercising.

2. Rest & spend less time doing normal activities

Often, the initial step to any injury, or even potential injury, is rest. Rest could include more sleep as well as limiting overhead activities. Your doctor may also prescribe a sling to help protect the shoulder area by keeping it still. This can also help you avoid trying to use it during this rest period.

Overall, for healing to occur, the inflammation needs to be reduced. One of the ways to do that is to avoid activities that cause shoulder pain. If you have rotator cuff pain or an injury and continue using the shoulder, even if there isn’t increasing pain, you can cause even more damage. For example, a rotator cuff tear can get bigger and more inflamed over time.

3. Ultrasound 

To speed blood flow to the damaged tissue, reduce inflammation and increase healing, an ultrasound can heat up deep tissue and address rotator cuff pain. (14)

4. Heating pad

Related to the above fact that heat can improve healing, a physical therapist may also use a moist heating pad for 15 to 20 minutes before exercise, and it can be useful to do this at home, too. (15)

5. Physical therapy

Overall, physical therapy and occupational therapy may be the best treatments long-term and could get you back to a normal routine and restoration much faster than steroid injections and/or surgery. Evidence through clinical trials suggest that physical therapy with prescribed exercises can help provide healing of conditions such as shoulder impingement, rotator cuff tendinopathy, rotator cuff tears, glenohumeral instability, adhesive capsulitis and stiff shoulders when applied to rehabilitating patients. (16)

Physical therapy involves various exercises that can improve flexibility and strength of the other muscles in the rotator cuff, ultimately providing support to help it heal. Occupational therapy is somewhat similar to physical therapy in terms of the end results, but occupational therapy for rotator cuff injuries focuses on day-to-day activities that require basic shoulder movements. Over time, this strengthens and supports the rotator cuff area and can provide natural healing. (17)

6. Anti-inflammatory foods & natural painkillers

While drugs like ibuprofen can reduce pain and swelling, they’re also dangerous. So when possible opt for non-synthetic methods such as avoiding highly inflammatory foods. Consider anti-inflammatory foods that will help you heal much faster while providing other useful benefits to your health. There are some great natural painkillers for shoulder pain and tendonitis in the rotator cuff that can be very useful as well.

7. Essential oils

One such natural painkiller is peppermint essential oil. By applying a peppermint essential oil rub twice daily, you can provide the rotator cuff with natural healing alternatives. Peppermint oil is a very effective natural painkiller and helps relax the muscles. Simply blend it with coconut or almond oil and rub onto the affected area.

Other effective anti-inflammatory oils include arnica, evening primrose and lavender oils.

 8. Strengthening

As noted above, specific exercises can help restore movement and strengthen your shoulder and the muscles and tendons that support it. I have provided a great exercise program below that includes strengthening exercises for the shoulder area. The goal is to strengthen the muscles that support your shoulder so that you get much needed pain relief while preventing additional injury to the area.

9. Stretching

The other side of the rehab coin to strength moves is stretching exercise. This can help improve flexibility and range of motion but keep in mind that it takes time and your commitment to performing these exercises 1–2 times per day/3–4 times per week. Also, while you are likely to feel discomfort, if you feel any pain when performing these exercises, please stop immediately and consult your doctor.

10. Acupuncture

A 2012 study done by Memorial Sloan-Kettering Department of Epidemiology and Biostatistics aimed to determine the effect of acupuncture for four chronic pain conditions: back and neck pain, arthritis, chronic headache and shoulder pain.

The researchers reviewed clinical trials involving over 17,000 patients, and the results showed that patients receiving acupuncture had less pain than patients in the placebo control group. (18) The conclusion was that acupuncture is effective for the treatment of chronic pain and is “more than just a placebo effect, therefore it’s a reasonable referral option for doctors.”

11. Transcutaneous electrical nerve stimulation

Transcutaneous electrical nerve stimulation (TENS or TNS) is the use of an electric current that’s produced by a device in order to stimulate the nerves for therapeutic purposes, such as to address rotator cuff pain. One meta-analysis revealed in the medical journal Current Rheumatology Reports showed the positive treatment effects of electrical stimulation for relief of chronic musculoskeletal pain, and randomized controlled trials consistently showed the effectiveness of TENS for acute, emergent as well as postoperative pain conditions. (19)


Rotator Cuff Exercises and Stretches

As I noted earlier, a proper conditioning program of physical therapy will require some dedicated time, but you should see some great results. Also, if you have concerns, ongoing pain or sudden pain, please see your doctor or a physical therapist. Try to do this program for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist.

Once you have recovered, you may want to continue with these exercises as part of a great maintenance program. Performing these exercises 2–4 days a week can help maintain strength and range of motion in your shoulders.

Warm Up

It’s best to warm up the muscles before doing these, or any, exercises.

Choose a low-impact activity for 10 minutes such as walking, riding a stationary bike, elliptical or even arm circles, forwards and backwards, while marching.

Remember: You should not feel pain during an exercise. Talk to your doctor or physical therapist if you have any pain while exercising. If you are not sure how to do an exercise, or how often to do it, contact your doctor or physical therapist.

3 Rotator Cuff Stretching Exercises

1. Crossover Arm Stretch

Stand with feet hip-distance apart. Relax your shoulders and gently pull one arm across your chest as far as possible, holding at your upper arm area, not the elbow (avoid putting pressure on the elbow area). Hold the stretch for 30 seconds and then relax for 10–15 seconds and repeat 5 times on each side.

2. Back Rotation

Hold a stick or small hand towel rolled lengthwise behind your back grabbing one end with one hand, and lightly grasp the other end with your other hand. Pull the stick or towel horizontally so that your shoulder is stretched to the point of feeling a stretch without pain. Hold for 20–30 seconds and then relax for 10–15 seconds. Repeat 4 times on the each side. Maintain good posture, standing with feet hip-distance apart, knees slightly bent and keep your core tight.

3. Pendulum

Lean forward with knees slightly bent and place one hand on a counter or table top for support. Allow the other arm to hang freely at your side. Gently swing your arm forward and back 3–4 times, then repeat the exercise moving your arm side-to-side 3–4 times. Next, move the arm in a circular motion 3–4 times. Repeat the entire sequence with the other arm. Careful not to round your back or lock your knees. Do 2 sets of 10 on each side.

 

Rotator cuff exercises - Dr. Axe

 

4 Rotator Cuff Strengthening Exercises

1. Standing Row

Using an elastic stretch band or a resistance band of comfortable tension, make a loop with the elastic band and put it around a doorknob or sturdy post. You can tie the ends together or, if using the common resistance bands, grab the handles with one hand. Stand in the start position holding the band with your elbow bent and at your side. Keeping your arm close to your side, slowly pull your elbow straight back. Then slowly return to the start position and repeat. Do 3 sets of 10 squeezing your shoulder blades together as you pull.

2. Upward Rotation

Similar to the exercise above, make a 3-foot-long loop with the elastic band and attach the loop to a doorknob or other stable location. Stand holding the band with your elbow bent at 90° with knuckles/fist facing forward at shoulder height. Maintain the positioning with your upper arm and shoulder, making sure your elbow stays in line with your shoulder; then slowly raise your hand until the forearm is vertical. Return to the start position and repeat. Perform 3 sets of 10.

3. Inward Rotation

Using the same band, stand holding the band with your elbow bent and at your side, fist vertical and facing forward. While keeping your elbow close to your side, bring your arm across your body then return to starting position and repeat. Perform 3 sets of 10.

4. Outward Rotation

This time, instead of rotating inward, simply rotate the arm away from the body. Stand with feet hip-distance apart, knees slightly bent and abs tight. Using the same band, arm down at your side then bend the arm at the elbow. Keeping your elbow close to your side, slowly rotate your forearm outward and away from the body, then return to the starting position. Squeeze your shoulder blades together as your rotate away from the body. (20)


Risk Factors

It’s important to note that since most rotator cuff tears are caused by normal use that comes with aging, most people over 40 are at greater risk. People who do repetitive lifting or activities that require lifting or reaching overhead, such as painters and carpenters, are also at risk for rotator cuff tears and injuries.

Of course, athletes, especially in contact sports and any sport that requires repetitive use, such as tennis, baseball and swimming, are very vulnerable to overuse tears and should exercise caution and awareness to any onset pain.

While those under 40 can experience issues with the rotator cuff, most of their shoulder injuries are caused by a traumatic injury, like a fall. (21)

Read Next: Bulging Disc & Back Pain — 7 Natural Treatments that Work


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37 Comments

  1. Sheryl on

    Chiropractic will help with shoulder pain. I’ve known a friend that seek chiropractic and help so he cancelled his surgery appointment. Chiropractic is amazing!

    Reply
  2. Mary Sulzer on

    Another cause for the pain is walking Siberian huskies (Oh, look! A leaf!). They’re very strong and also very strong-willed and will take off in a different direction at will, almost pulling your arm out of its socket!

    Reply
    • Norma on

      Had a hound dog. He actually separated tissue connected to the spine. Chiropractic got things to stay mainly in place but the therapeutic massage with pure essential oils has immensely helped.

      Reply
    • Kathy on

      You can buy something called “the Gentle Lead” at the pet store. It moves the leash to just under their head and they can’t pull. I went from chronic back problems to enjoyable walks with my dog.

      Reply
  3. Deborah on

    I have rotator cuff tear and Labral tear from a car accident. The information you wrote is very informative. I’ve done most of the treatments. I will also try the oils. But because I have 2 different tears I was given an ultimatum of surgery. I’m in the medical field and need my right arm!! Is there anything else I could do to not have the surgery?

    Reply
    • Linda on

      I have been having acupuncture for the last 6 weeks & have found it extremely helpful i have much more movement than when I first started & far less pain.

      Reply
    • sue kennedy on

      I have tears in three out of the four muscles in my rotator cuff, and I will not have surgery! I am having aggressive physiotherapy and my pain levels have dropped from 8 out of 10 to a 1 out of 10. I take turmeric as an anti inflammatory, and I do stretches. I have lots of golfing friends who have had the surgery, and many have had a lot of issues with frozen shoulder etc afterwards. :)

      Reply
  4. Cheri on

    A few years ago my first visit to a new chiropractor resulted in a shoulder injury. It was so serious that my shoulder would just slip out of place and I would have to do windmills to get it back in place. I dealt with it and a range of treatments, including accupuncture, physical therapy and shoulder braces for over two years before I discovered Christopher’s Bone & Tissue oil on Amazon. I put the oil on my shoulder two times a day and within the first week it was 70% better and after a few more weeks, it was 100%. I can’t recommend it highly enough to anyone who has any sort of a muscle, tendon, or ligament type injury to their shoulder or any other part of their body.

    Reply
  5. Jeanie on

    I have found a homemade linament to be very supportive to my 2 previously repaired rotator cuffs;
    I use coconut oil, Wintergreen Essential Oil, Basil Essential Oil, and Lemongrass Essential Oil. I only use Young Living Essential Oils because I know them to be pure and unadulterated. Wish I had known about them before having surgery

    Reply
    • kelly on

      could you give me the # of EO drops each and fco amount in your linament? Also I have read about sulfazyme (young living) being taken for rotator cuff tear, do you know what the doterra equivalent is to that or is there one? Any info really appreciated.

      Reply
  6. Helene Hattingh on

    A sonar of my right shoulder shows extensive severe chronic biceps tendinosis changes.
    There is a massive 1,2 cm calcific focus in the region of the supraspinatus tendon possibly representing a severe degree of calcific supraspinatus tendinitis.
    An operation is recommended.
    Do you have another suggestion?

    Reply
    • Lynn on

      I can tell you I have a rotator cuff Tear. Not large enough for surgery, I did have arthroscopy to look inside at my joint. I had a bone spur that was digging into my rotator cuff. I got total relief of pain. I will sometimes get pain, because I move to suddenly or do to much. I keep my my arm in proper alignment and I have no problems. It’s been 3 happy years.

      Reply
  7. Sue on

    Thank you for the info. It would be soooo great if your wonderful articles (and graphics) would also be presented in a format so it could easily be printed. I wanted to print out the exercises so I could take it to the LR to do (and not have to run back/forth to the computer.)

    Thanks for your consideration to of this!

    Reply
    • Nyana on

      Hi Sue, If you go up to address bar, there are 3 dots beside it. You click on them & click on print. You can also save it as a PDF into your documents. Hope this helps!

      Reply
  8. Claudia on

    Jeanie,
    Young living essential oils are not the best on the market , if you are looking for pure and unadulterated oils.
    Contact doTerra Essencial Oils and you will be amazed with them. They truly are the very best. They have just been approved in Canada, and Canada has much stricter laws than the US. Just have an open mind and read about them.

    Reply
  9. Joann Nolte on

    I experienced a frozen shoulder for over 4 years it went from achy to full-blown frozen shoulder where I can only lift my arm 6 inches from the side of my body. I had tried what I believed was everything in the relm of natural medicine: supplements, Chiropractic, acupuncture, physical therapy, massage, oils, etc
    Nothing completely healed it. At times it would be better but the range of motion progressively became less.

    It was not until I found Bowen therapy that I was completely healed and still am today 2 years later.

    What i did learn with bowen is that my pain was also attached to emotions as well.

    A great book is Unlocking Frozen Shoulder: A New Paradigm of Treatment

    If you have frozen shoulder and you’ve tried everything else or not consider Bowen it’s pretty amazing in my opinion.

    Reply
  10. Jennifer Sheets on

    As a massage therapist, I treat clients diagnosed with frozen shoulder and those who show signs of it. Myofascial Release and other medical massage techniques are very effective in restoring range of motion and reducing pain. Remember, only a doctor can diagnose you.
    On the essential oil conversation, who is best? They are both good companies with good product. It was the wellness consultant behavior that sold me. I chose a particular source because the local group wasn’t pushy and weren’t posturing in the “we are best” game. Professionalism goes a long way.

    Reply
  11. Ann on

    I had severe shoulder pain and burning due to a calcium deposit in my shoulder tendon. I dealt with it for 2 1/2 years. I tried all of the natural remedies before subjecting myself to surgery. I finally went with the surgery and the relief was amazing. I have no more pain and my shoulder is back in business. I realize this isn’t the case for every person, and I think there are other options out there and should be considered before going with the knife/drug option, but sometimes surgery is necessary. I didn’t handle the pain meds very well after the surgery was over, so I used natural pain management, and lots of magnesium oil rubs on my legs and arms to help the healing along. Good luck to all of you out there in your quest for shoulder healing!

    Reply
  12. Sharon Snell on

    I have a knotted area on the side of both arms halfway between my shoulder and elbow. What could be causing that?

    Reply
    • Ann A on

      Sharon Snell, I have this too! My shoulders are most painful in cold weather, but get better as spring arrives. The knots are there year round, but don’t hurt. I’m hoping someone answers to clear up our mystery!

      Reply
  13. Jennifer on

    I did physical therapy, chiropractor rehab, and even saw an atlas chiropractor that greatly helped to relieve the shoulder pain from a possible labrial tear or rotator cuff injury. The warmer weather has helped too! But I was told by the one chiropractor to consider surgery to repair the shoulder. I want to try the advice to use essential oil and magnesium oil to aid in healing before I opt to go for surgery. Also I have had to limit and avoid certain use of my shoulder.

    Reply
  14. Joyce on

    I use DoTerra Essential Oils. The oils are therapeutic-grade and have helped me a lot with back, neck and my emotional state of mind.

    Reply
  15. Kathleen McKee Brenner on

    I’ve been very pleased with doterra oils…lavender for relaxation. Peppermint for sinuses. frankincense with olive oil to treat dog. With cancerous growth…
    And topically for me for aches.

    Reply
  16. Danny P on

    I’ve got two completely torn (as shown from MRI) from the bone rotator cuff muscles and impinged supra nerve. I’m scheduled for Ortho surgery July 7. I assume for completely torn muscles surgery is my only option.

    Reply
  17. NancyT on

    I use a violet light, like the chiropractor uses Mine has different glass shaped attachments. I put them in this wand plug in wall and turn up the intensity. It causes the muscle to contract , so that it can relax.

    Reply
  18. Lynne on

    I have had a rotator cuff tear for approx. 10 years now. I saw 2 orthopedists and they told me Surgery was my only option. Not wanting Surgery because 1- I don’t tolerate anesthesia( I had a near death experience) and 2- I have heard this type of surgery is not always successful. Plus these doctors had told me they couldn’t do arthroscopic surgery, but needed to open my back! That’s all I had to hear! I ran out of their offices. So now 10 years later, I just started having severe pain and it’s so debilitating! I live alone, am a senior and don’t know what to do. P.S. I tried a cortisone shot and had a bad reaction to it and it did nothing to alleviate the pain. Help!!!

    Reply
  19. Dianne on

    I have partial thickness tear 10-12mm medial lateral on my supraspinatus tendon on distal fibers over 90% of tendon and subcortical cyst in humeral head where the large tear is, most likely from repetitive stress, according to the MRI. And I have a 5 x 5 mm partial thickness tear on the anterior-posterior infraspinatus tendon. I know, easy for me to say.
    My chiropractor told me not to raise my arm above my shoulder because the tendon with the large tear could burst.
    I have been resting it since the middle to the end of March. I don’t believe I have inflammation anymore. What therapy or stretching/strengthening exercises can I do without tearing the tendon further?
    and are there any oils or treatment to help that sub cortical cyst break up?

    Reply

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