1. Support the affected arm during activities of daily living. This includes driving, typing at the computer, sitting in a chair and relaxing in your lazy boy at home. Gravity pulls the arm down when it is unsupported, and this increases strain on the rotator cuff. It is best to use a soft pillow or cushion when available.

2. Use ice along the top of the shoulder daily. I always suggest a frozen bag of veggies or soft wrap that conforms to the shape of the shoulder. Be sure to support the arm as mentioned previously while icing. Keep the ice on for 15-20 minutes and then off for an hour. You may ice more than once per day if desired based on pain. I usually suggest icing before bed to improve sleep.

3. Avoid raising the arm overhead in painful ranges of motion unless absolutely necessary. The rotator cuff gets compressed when the arm is elevated above 90 degrees and this often further aggravates the symptoms. This is problematic with getting dressed, fastening the seat belt or placing carry-on baggage in a plane. Overhead athletes will simply need to rest for a given period of time to let the inflammation subside.

4. Do not perform single arm or overhead heavy lifting during periods of inflammation. This position coupled with external loads will prolong your pain and slow the recovery process.

5. Perform arm pendulums (clockwise and counterclockwise circles) with arm hanging

6. Use a pillow under the arm at night to better support the injured arm. I also recommend trying to sleep on the other side if possible, as lying on the sore side compresses the bursa and will typically increase pain and wake you. Another no-no is sleeping with your arms overhead or on your stomach with arm tucked above your head. This is sure to create a shoulder ache.

7. Perform a routine rotator cuff strengthening program within a pain free range of motion. Lower intensity and higher repetition exercises designed to work the rotator cuff muscles are essential to promote healing, reduce inflammation and return you to pre-injury activity levels again. You will not be able to break free of the pain cycle without this type of exercise. More importantly, effective rehab exercises will prevent future injuries and more damage to your shoulder.

Brian Schiff, PT, CSCS, is a respected author, physical therapist and fitness expert. For additional information and a proven exercise program for solving rotator cuff pain and related shoulder injuries, visit http://www.rotatorcufftraining.com

Copyright © 2005 Brian Schiff

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