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Rotator Cuff Injuries in the Workplace: Prevention, Treatment, and Return to Work
Rotator cuff disorders are among the most common work-related musculoskeletal disorders, particularly in occupations requiring repetitive overhead activity, forceful exertion, or heavy lifting. Workers performing frequent overhead work or heavy lifting have a 1.5- to 4-fold increased risk of developing rotator cuff disease compared with workers without these exposures.
Occupations with the highest risk:
- Construction workers
- Carpenters
- Electricians
- Painters
- Plumbers
- Mechanics
- Warehouse and material handlers
- Manufacturing workers
Ways of Prevention
- Optimize workplace ergonomics
- Minimize work performed above shoulder height
- Position tools between waist and chest level
- Avoid heavy lifting away from the body
- Employ mechanical lifts or assistive devices for heavy loads
- Limit repetitive overhead activity
- Rotate job tasks
- Incorporate breaks
- Alternate overhead activity with other activities
- Reduce heavy lifting
- Lift with two people
- Keep loads close to the body
- Use carts, hoists, or forklifts
- Early recognition of symptoms
- Shoulder pain with overhead activity
- Night pain
- Weakness
- Loss of endurance
- Worker education
- Early warning signs
- Proper ergonomics
- Safe lifting
- Importance of strengthening and flexibility
- When to seek medical evaluation
Treatment
Rotator cuff injuries can range from rotator cuff tendinitis (inflammation) to partial tearing, to full-thickness rotator cuff tears. Treatment typically starts with conservative management, as many rotator cuff disorders can improve without surgery.
Activity modification
- Temporary lifting restrictions
- Avoid repetitive overhead work
- Gradual return to activity as symptoms improve
Physical therapy
- Restore range of motion
- Rotator cuff strengthening
- Scapular stabilization
- Work-specific conditioning
Medications
- Acetaminophen
- NSAIDs
- Topical anti-inflammatories
Corticosteroid injections
- Relieve pain and decrease inflammation to facilitate rehabilitation
If symptoms do not improve with conservative management, surgery may be recommended to repair the rotator cuff.
Return to Work
Structured rehabilitation is critical after both nonoperative and operative management of rotator cuff disease. Gradual return to work with temporary restrictions helps optimize recovery and reduce the risk of reinjury. Collaboration between the patient, employer, therapist, and physician is essential to achieving safe and durable return to the workplace.
Lindsay Barrera is an orthopedic surgeon at OrthoGeorgia, fellowship-trained in sports medicine. Her interests include hip, knee, and shoulder arthroscopy; ACL reconstruction; and total knee and shoulder reconstruction. She earned a B.S. in Biobehavioral Health from Pennsylvania State University, where she competed on the Division I women’s gymnastics team. She treats Workers’ Compensation injuries.
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