Emergency Department Care

It may be clinically impossible to differentiate an acute rotator cuff strain from a partial-thickness or full-thickness rotator cuff tear. The immediate goal of emergency care for suspected rotator cuff injuries is to provide support, protection, pain relief, and most important, to help prevent further dysfunction and disability. An arm sling can be provided for support and comfort until acute symptoms subside. However, the perils of prolonged immobilization—stiffness, weakness, and loss of motion—should be emphasized to the patient. Appropriate analgesia should be provided, as should instruction in the proper use of ice two to three times per day to reduce pain and inflammation. When symptoms allow, gentle range-of-motion exercises such as pendulum swings and walking the fingers up the wall should be started.

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