The stabbing pain and limited mobility caused by rotator cuff injury take months to heal and subside. Accelerate your recovery with these 3 unconventional, research-backed approaches to conquer inflammation, reduce impingement, and strengthen your shoulder faster than rest alone.

1.  Accelerate rotator cuff recovery with natural therapies

Dietary supplements and alternative therapies help expedite healing when used alone or in conjunction with existing treatment plans. With effective use, these therapies reduce the need for medication or invasive procedures. 

Specific natural treatments that promote tendon healing are discussed below.

Speed up tendon repair through targeted nutrition

Tendons are primarily made up of the protein collagen.1Khatri M, Naughton RJ, Clifford T, Harper LD, Corr L. The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review. Amino Acids. 2021;53(10):1493-1506. doi:10.1007/s00726-021-03072-x Not getting enough nutrients that help build collagen slows down tendon healing. 

Foods and supplements that provide the raw materials for collagen formation and help expedite tendon repair are discussed below.2Curtis L. Nutritional research may be useful in treating tendon injuries. Nutrition. 2016;32(6):617-619. doi:10.1016/j.nut.2015.12.039,3Hijlkema A, Roozenboom C, Mensink M, Zwerver J. The impact of nutrition on tendon health and tendinopathy: a systematic review. J Int Soc Sports Nutr. 2022;19(1):474-504. Published 2022 Aug 3. doi:10.1080/15502783.2022.2104130

  • Vitamin C regulates the function of enzymes that synthesize collagen and reduce oxidative stress.4DePhillipo NN, Aman ZS, Kennedy MI, Begley JP, Moatshe G, LaPrade RF. Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review. Orthop J Sports Med. 2018;6(10):2325967118804544. Published 2018 Oct 25. doi:10.1177/2325967118804544 Common dietary sources of vitamin C include tomatoes, citrus fruits, and broccoli. Vitamin C is also widely available in supplemental form as oral capsules and tablets.
  • Protein is needed to stimulate tendon growth, and protein deficiencies have the potential to impede the healing of muscles and tendons after a rotator cuff injury.5Hijlkema A, Roozenboom C, Mensink M, Zwerver J. The impact of nutrition on tendon health and tendinopathy: a systematic review. J Int Soc Sports Nutr. 2022;19(1):474-504. Published 2022 Aug 3. doi:10.1080/15502783.2022.2104130 Whey protein is a high-quality, easily digestible protein that meets the nutrition demands for tendon repair. Alternatively, increasing the intake of foods rich in protein, such as beans, lean meats, poultry, and fish, also has the potential to aid tendon repair.
  • Glucosamine and chondroitin sulfate supplements hasten tendon and ligament repair through collagen synthesis.6Lippiello L. Collagen Synthesis in tenocytes, ligament cells and chondrocytes exposed to a combination of Glucosamine HCl and chondroitin sulfate. Evid Based Complement Alternat Med. 2007;4(2):219-224. doi:10.1093/ecam/nel081,7Huri G, Familiari F, McFarland EG. Treatment options for rotator cuff tear arthropathy. Seminars in Arthroplasty 2014 Mar 1 (Vol. 25, No. 1, pp. 13-16). WB Saunders. https://doi.org/10.1053/j.sart.2014.02.002
  • Minerals, such as manganese, zinc, and copper, promote the synthesis of collagen.8Rondanelli M, Faliva MA, Peroni G, Infantino V, Gasparri C, Iannello G, Perna S, Riva A, Petrangolini G, Tartara A. Essentiality of manganese for bone health: An overview and update. Natural Product Communications. 2021 May;16(5):1934578X211016649. https://doi.org/10.1177/1934578X211016649 These minerals are found in nuts, seeds, legumes, and shellfish. A deficiency of these minerals impedes collagen synthesis, and taking multivitamins that contain these minerals ensures meeting the daily requirements. 
  • Amino acids, such as leucine, glutamine, and arginine, are the building blocks of collagen protein.9Barbosa AW, Benevides GP, Alferes LM, Salomão EM, Gomes-Marcondes MC, Gomes L. A leucine-rich diet and exercise affect the biomechanical characteristics of the digital flexor tendon in rats after nutritional recovery. Amino Acids. 2012;42(1):329-336. doi:10.1007/s00726-010-0810-1,10Williams JZ, Abumrad N, Barbul A. Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg. 2002;236(3):369-375. doi:10.1097/00000658-200209000-00013 Alongside supplements, you can find these amino acids in protein-rich foods, such as meat and milk.
  • Bromelain, an enzyme found in pineapples, facilitates the breakdown of protein to produce amino acids. These amino acids are then used to synthesize new proteins, such as collagen. Bromelain is available in pill form and has been shown to improve outcomes after rotator cuff surgery when used in combination with other supplements.11Gumina S, Passaretti D, Gurzì MD, Candela V. Arginine L-alpha-ketoglutarate, methylsulfonylmethane, hydrolyzed type I collagen and bromelain in rotator cuff tear repair: a prospective randomized study. Curr Med Res Opin. 2012;28(11):1767-1774. doi:10.1185/03007995.2012.737772

In addition to promoting the growth of new collagen, part of the tendon repair process involves reducing inflammation.

Supplements like fish oil (omega-3 fatty acids) and turmeric (curcumin) have been shown to effectively reduce inflammation and consequently alleviate pain.12Sandford FM, Sanders TA, Wilson H, Lewis JS. A randomised controlled trial of long-chain omega-3 polyunsaturated fatty acids in the management of rotator cuff related shoulder pain. BMJ Open Sport Exerc Med. 2018;4(1):e000414. Published 2018 Oct 19. doi:10.1136/bmjsem-2018-000414,13Güleç A, Türk Y, Aydin BK, Erkoçak ÖF, Safalı S, Ugurluoglu C. Effect of curcumin on tendon healing: an experimental study in a rat model of Achilles tendon injury. Int Orthop. 2018;42(8):1905-1910. doi:10.1007/s00264-018-4017-5 Furthermore, foods like red cabbage, red grapes, cherries, apples, and blueberries contain cyanidin, a pigment that aids in inflammation reduction.14Sun Y, Li L. Cyanidin-3-glucoside inhibits inflammatory activities in human fibroblast-like synoviocytes and in mice with collagen-induced arthritis. Clin Exp Pharmacol Physiol. 2018;45(10):1038-1045. doi:10.1111/1440-1681.12970

advertisement

Use heat therapy to improve blood circulation

Heat therapy provides pain relief by improving blood flow to the muscles and tendons.15Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med. 2015;127(1):57-65. doi:10.1080/00325481.2015.992719

An ideal time for heat therapy is before bedtime or upon waking in the morning. Enjoying a warm shower or applying a heating pad or wrap to your shoulder promotes relaxation and aids in the recovery process, offering convenient ways to benefit from heat therapy.

Similarly, keeping a heating pad at work is also useful in reducing bouts of pain at the workplace.

See How to Make Your Own Moist Heat Pack Infographic

Try cold therapy for instant pain relief

Cold therapy reduces inflammation, providing an instant numbing effect.8Rondanelli M, Faliva MA, Peroni G, Infantino V, Gasparri C, Iannello G, Perna S, Riva A, Petrangolini G, Tartara A. Essentiality of manganese for bone health: An overview and update. Natural Product Communications. 2021 May;16(5):1934578X211016649. https://doi.org/10.1177/1934578X211016649 Cold therapy is most effective within the first 72 hours after an injury. 

An optimal time for cold therapy is during a flare-up of rotator cuff pain or at the end of a busy day. It is advisable to limit cold therapy to 10-15 minutes per session to prevent damage to the skin and soft tissues. 

See 3 Useful Tips for Icing Your Injury

Modify daily activities to prevent strain on the rotator cuff

Reduce the risk of aggravating your rotator cuff pain and promote a smoother recovery with small but meaningful adjustments to your daily routine. 

Examples of activity modification include:

  • Refraining from lifting weights or raising objects overhead 
  • Taking frequent breaks while performing activities that involve repetitive shoulder movements, such as vacuuming and mopping 
  • Choosing clothing that does not strain the affected shoulder, such as wearing buttoned-down shirts instead of overhead shirts
  • Using an electric toothbrush instead of a regular toothbrush

The length of time for rest and activity modification is influenced by the severity of the injury.

advertisement

Reduce tendon pain and stress with aromatherapy 

Aromatherapy involves the topical application of essential oils to the affected region, such as the shoulder, and alleviates pain and stiffness in musculoskeletal disorders by16Bakó E, Fehérvári P, Garami A, et al. Efficacy of Topical Essential Oils in Musculoskeletal Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pharmaceuticals (Basel). 2023;16(2):144. Published 2023 Jan 19. doi:10.3390/ph16020144:

  • Reducing inflammation 
  • Relaxing muscles
  • Producing a cooling effect
  • Improving blood circulation to the affected region

Additionally, the fragrance of essential oils is known to have mood-boosting properties that reduce the perception of pain.17Lakhan SE, Sheafer H, Tepper D. The Effectiveness of Aromatherapy in Reducing Pain: A Systematic Review and Meta-Analysis. Pain Res Treat. 2016;2016:8158693. doi:10.1155/2016/8158693

Commonly used oils for aromatherapy include:

  • Lavender oil
  • Peppermint oil
  • Ginger oil
  • Rosemary oil

These essential oils should be diluted with a carrier oil to reduce the risk of skin irritation.

Although generally safe, some individuals experience skin irritation and allergic skin reactions when treated with essential oils. In rare cases, the inhalation of essential oils in large amounts irritates the respiratory tract and exacerbates asthma symptoms.

2. Optimize sleep for rotator cuff healing: Best positions and surfaces

If your rotator cuff pain worsens at night or disturbs your sleep, follow this routine:

  • Sleep on your back with arms at your sides to alleviate pressure on the sore shoulder.
  • Use a medium-firm mattress that conforms to your body contours, provides adequate support, and an ergonomic pillow to enhance neck support and alignment.
  • Avoid sleeping on the affected side or with your arms overhead.

The goal is to sleep in a position that does not twist or pinch the sore rotator cuff. 

advertisement

3. Perform exercises that specifically work on strengthening the rotator cuff muscles

Exercise and stretches encourage the release of endorphins, the body's natural pain-relieving hormone, and reduce muscle tension. 

3 easy exercises that target the rotator cuff tendons and muscles include:

Pendulum swing

Stand to the side of a table and place your right hand on it.

  • Lean forward without rounding your back and allow the left arm to dangle freely.
  • Lightly move this arm forward and back, side-to-side, and in circles. 

Repeat the exercise with the other arm.

Crossover arm stretch 

Stand up straight and relax your shoulders.

  • Stretch the right arm across your chest but below your chin; reach as far as tolerable.
  • Use your left hand to support the right elbow.
  • When performing this exercise, you should feel a stretch—not pain.

Repeat the exercise with the other arm.

Internal rotation 

This exercise involves a stretch band tied at the ends to make a three-foot loop.

  • Attach one end of the loop to a steady object like a doorknob.
  • Stand to the side and hold the band in your left hand.
  • Bend your elbow to a 90-degree angle and keep it close to your body. Then, bring the left forearm over the midsection of the body.

Repeat the exercise with the other arm.

Bonus tip: Relieve rotator cuff pain with complementary therapies 

Research shows that some complementary therapies have demonstrated effectiveness in decreasing rotator cuff pain when performed under the guidance of a trained medical professional. These therapies include:

  • Massage. Soft tissue massage is effective in the short term in reducing shoulder pain.18van den Dolder PA, Ferreira PH, Refshauge KM. Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis. Br J Sports Med. 2014;48(16):1216-1226. doi:10.1136/bjsports-2011-090553 The pain-relieving effects of massage are further enhanced when combined with heat therapy.19Yeun YR. Effectiveness of massage therapy for shoulder pain: a systematic review and meta-analysis. J Phys Ther Sci. 2017;29(5):936-940. doi:10.1589/jpts.29.936
  • Prolotherapy. Prolotherapy involves the injection of a solution of dextrose and lidocaine at the site of the affected tendon. Prolotherapy reduces pain and facilitates tendon repair in individuals with rotator cuff injuries, including tendinopathies and tears.20Rabago D, Reeves KD, Doherty MP, Fleck M. Prolotherapy for Musculoskeletal Pain and Disability in Low- and Middle-Income Countries. Phys Med Rehabil Clin N Am. 2019;30(4):775-786. doi:10.1016/j.pmr.2019.07.003
  • Platelet-rich plasma therapy (PRP). PRP involves the injection of the patient’s own plasma enriched in platelet cells (a type of blood cell) to aid the healing of the rotator cuff tendon.

Early studies show that PRP may be effective in the treatment of rotator cuff tears, but more research is needed to establish its long-term safety and efficacy.21Bhan K, Singh B. Efficacy of Platelet-Rich Plasma Injection in the Management of Rotator Cuff Tendinopathy: A Review of the Current Literature. Cureus. 2022;14(6):e26103. Published 2022 Jun 20. doi:10.7759/cureus.26103

See: Are PRP Injections Effective?

If your rotator cuff pain fails to improve in the initial stages, worsens with time, or develops any concerning symptoms (such as arm numbness or weakness), it is advisable to consult a physician for further evaluation and treatment.

See Rotator Cuff Repair Surgery

  • 1 Khatri M, Naughton RJ, Clifford T, Harper LD, Corr L. The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review. Amino Acids. 2021;53(10):1493-1506. doi:10.1007/s00726-021-03072-x
  • 2 Curtis L. Nutritional research may be useful in treating tendon injuries. Nutrition. 2016;32(6):617-619. doi:10.1016/j.nut.2015.12.039
  • 3 Hijlkema A, Roozenboom C, Mensink M, Zwerver J. The impact of nutrition on tendon health and tendinopathy: a systematic review. J Int Soc Sports Nutr. 2022;19(1):474-504. Published 2022 Aug 3. doi:10.1080/15502783.2022.2104130
  • 4 DePhillipo NN, Aman ZS, Kennedy MI, Begley JP, Moatshe G, LaPrade RF. Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review. Orthop J Sports Med. 2018;6(10):2325967118804544. Published 2018 Oct 25. doi:10.1177/2325967118804544
  • 5 Hijlkema A, Roozenboom C, Mensink M, Zwerver J. The impact of nutrition on tendon health and tendinopathy: a systematic review. J Int Soc Sports Nutr. 2022;19(1):474-504. Published 2022 Aug 3. doi:10.1080/15502783.2022.2104130
  • 6 Lippiello L. Collagen Synthesis in tenocytes, ligament cells and chondrocytes exposed to a combination of Glucosamine HCl and chondroitin sulfate. Evid Based Complement Alternat Med. 2007;4(2):219-224. doi:10.1093/ecam/nel081
  • 7 Huri G, Familiari F, McFarland EG. Treatment options for rotator cuff tear arthropathy. Seminars in Arthroplasty 2014 Mar 1 (Vol. 25, No. 1, pp. 13-16). WB Saunders. https://doi.org/10.1053/j.sart.2014.02.002
  • 8 Rondanelli M, Faliva MA, Peroni G, Infantino V, Gasparri C, Iannello G, Perna S, Riva A, Petrangolini G, Tartara A. Essentiality of manganese for bone health: An overview and update. Natural Product Communications. 2021 May;16(5):1934578X211016649. https://doi.org/10.1177/1934578X211016649
  • 9 Barbosa AW, Benevides GP, Alferes LM, Salomão EM, Gomes-Marcondes MC, Gomes L. A leucine-rich diet and exercise affect the biomechanical characteristics of the digital flexor tendon in rats after nutritional recovery. Amino Acids. 2012;42(1):329-336. doi:10.1007/s00726-010-0810-1
  • 10 Williams JZ, Abumrad N, Barbul A. Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg. 2002;236(3):369-375. doi:10.1097/00000658-200209000-00013
  • 11 Gumina S, Passaretti D, Gurzì MD, Candela V. Arginine L-alpha-ketoglutarate, methylsulfonylmethane, hydrolyzed type I collagen and bromelain in rotator cuff tear repair: a prospective randomized study. Curr Med Res Opin. 2012;28(11):1767-1774. doi:10.1185/03007995.2012.737772
  • 12 Sandford FM, Sanders TA, Wilson H, Lewis JS. A randomised controlled trial of long-chain omega-3 polyunsaturated fatty acids in the management of rotator cuff related shoulder pain. BMJ Open Sport Exerc Med. 2018;4(1):e000414. Published 2018 Oct 19. doi:10.1136/bmjsem-2018-000414
  • 13 Güleç A, Türk Y, Aydin BK, Erkoçak ÖF, Safalı S, Ugurluoglu C. Effect of curcumin on tendon healing: an experimental study in a rat model of Achilles tendon injury. Int Orthop. 2018;42(8):1905-1910. doi:10.1007/s00264-018-4017-5
  • 14 Sun Y, Li L. Cyanidin-3-glucoside inhibits inflammatory activities in human fibroblast-like synoviocytes and in mice with collagen-induced arthritis. Clin Exp Pharmacol Physiol. 2018;45(10):1038-1045. doi:10.1111/1440-1681.12970
  • 15 Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med. 2015;127(1):57-65. doi:10.1080/00325481.2015.992719
  • 16 Bakó E, Fehérvári P, Garami A, et al. Efficacy of Topical Essential Oils in Musculoskeletal Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pharmaceuticals (Basel). 2023;16(2):144. Published 2023 Jan 19. doi:10.3390/ph16020144
  • 17 Lakhan SE, Sheafer H, Tepper D. The Effectiveness of Aromatherapy in Reducing Pain: A Systematic Review and Meta-Analysis. Pain Res Treat. 2016;2016:8158693. doi:10.1155/2016/8158693
  • 18 van den Dolder PA, Ferreira PH, Refshauge KM. Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis. Br J Sports Med. 2014;48(16):1216-1226. doi:10.1136/bjsports-2011-090553
  • 19 Yeun YR. Effectiveness of massage therapy for shoulder pain: a systematic review and meta-analysis. J Phys Ther Sci. 2017;29(5):936-940. doi:10.1589/jpts.29.936
  • 20 Rabago D, Reeves KD, Doherty MP, Fleck M. Prolotherapy for Musculoskeletal Pain and Disability in Low- and Middle-Income Countries. Phys Med Rehabil Clin N Am. 2019;30(4):775-786. doi:10.1016/j.pmr.2019.07.003
  • 21 Bhan K, Singh B. Efficacy of Platelet-Rich Plasma Injection in the Management of Rotator Cuff Tendinopathy: A Review of the Current Literature. Cureus. 2022;14(6):e26103. Published 2022 Jun 20. doi:10.7759/cureus.26103

Dr. Yash Mehta is a board-certified, fellowship-trained physiatrist at VSI, VA.

advertisement
advertisement