What rehabilitation strategies are effective in promoting recovery from a rotator cuff injury in primary care settings?

Effective rehabilitation strategies for rotator cuff injury recovery in primary care include:

• Initial rest in the acute phase followed by a gradual increase in activity within pain limits to avoid disability and improve function.
• Activity modification to reduce precipitating movements, especially overhead activities that cause pain between 60 and 120 degrees of shoulder elevation.
• Analgesia starting with paracetamol, progressing to oral NSAIDs if necessary for short-term pain relief, considering contraindications and side effects.
• Referral to physiotherapy for a usual course of about 6 weeks, which may include postural correction, motor control retraining, stretching, strengthening of rotator cuff and scapular muscles, and manual therapy.
• Low intensity, high-frequency exercises within the person’s pain threshold are recommended, with continuation of physiotherapy for a further 6 weeks if improvement occurs.
• Consideration of subacromial corticosteroid injections in the first 8 weeks for severe pain or limited progress, used alongside physiotherapy and analgesia, with shared decision-making and appropriate expertise.

These strategies aim to restore function, reduce pain, and promote healing in rotator cuff injuries managed in primary care settings.

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