In a sprain of the shoulder or rotator cuff, what is the typical initial management?

• A. Physical therapy
• B. Immobilization in a sling
• C. Immediate arthroscopic subacromial decompression
• D. Conservative therapy

Answer: (D)

Conservative therapy is the typical initial approach because most shoulder sprains and rotator cuff injuries heal without surgery. The plan focuses on pain relief, protection, and gradual return of function. Start with rest and support for the shoulder, often using a sling for a short period to reduce pain and prevent further injury. Nonsteroidal anti-inflammatory drugs can help with pain and inflammation. After a brief immobilization, begin a structured physical therapy program to restore range of motion, then progress to strengthening the rotator cuff and scapular stabilizers. Surgical intervention is reserved for cases with persistent weakness or function loss, or when there is a high suspicion of a complete tear or other complication.