Diagnosis Explanation:

A rotator cuff injury involves strain, tear, or inflammation of the four muscles and tendons that stabilize the shoulder joint. These injuries are often caused by repetitive overhead movements, trauma, or age-related wear.

Types of Rotator Cuff Injuries:

• Tendonitis – Inflammation from overuse or repetitive motions.
• Partial Tear – Some fibers of the tendon are torn but not completely detached.
• Full-Thickness Tear – The tendon is completely torn from the bone, leading to weakness and dysfunction.

Symptoms:

• Shoulder pain and weakness, especially with overhead motions.
• Clicking, popping, or grinding in the shoulder.
• Pain at night or when lying on the affected shoulder.
• Limited range of motion, particularly lifting the arm.

Specific Work Modifications:

• If your job requires standing or walking: Avoid reaching overhead, take breaks to rest the arm, and use a shoulder brace if needed.
• If your job involves lifting: Avoid heavy lifting, overhead reaching, and repetitive shoulder motions. Use both hands when possible.
• If your job is desk-based: Keep shoulders relaxed, adjust the monitor to eye level, and take breaks every 30 minutes to move the arm.
• Avoid: Overhead work, repetitive shoulder use, and carrying heavy loads.

Specific Activity Modifications:

• If you play sports: Avoid throwing, swimming strokes, and repetitive overhead movements until cleared for return.
• If you do weightlifting: Avoid bench presses, pull-ups, dips, and overhead presses; instead, focus on controlled, pain-free movements.
• If you do yoga or Pilates: Modify poses to avoid excessive shoulder stretching, deep rotation, or weight-bearing on the arms.
• Avoid: Contact sports, repetitive overhead motions, and exercises that cause shoulder discomfort.

Recommended Supplements:

• Collagen Peptides – 10g daily for tendon and joint repair.
• Vitamin C – 500mg daily to support collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support tendon repair.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain tendon flexibility.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support tendon recovery.

Home Exercise Prescription (Rehabilitation for Rotator Cuff Injuries)

Early Phase (0-2 Weeks, Reducing Pain & Protecting the Joint):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Scapular Retractions – Squeeze shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Mobility):

• External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
• Wall Slides (Forward & Lateral) – Stand facing a wall, slide affected arm up and down, 10 reps, 2x/day.
• Bicep Curls (Light Resistance) – Controlled motion, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Restoring Strength & Preventing Recurrence):

• Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.