Are Tylenol and Ibuprofen Weakening Your Rotator Cuff? The Hidden Impact on Muscle and Tendon Healing

Pain sucks, right? You don't want it to last for long, right? But how you handle pain could be causing your body, mind, heart and soul difficulties that you aren't seeing in the moment. Most people pop a few ibuprofen or tylenol for aches and pains, maybe even for a fever. But what if you knew that these medications could actually be making you weaker, or preventing you from gaining strength as you age?

(My belief is that "getting old", as we know it, is a lie. We have created far too many false beliefs of getting old that we allow ourselves to succumb to, and ultimately we perpetuate them. But that is for another blog post.)

Having spent the past 20 years as a PT, largely treating patients over the age of 50, I have seen thousands of patients with rotator cuff tears. (Here in the South its pretty standard to hear "Yeah, I tore my rotary cup". Funny.) Some of them come from falls (another topic for another blog post!). Some of them happen by what we call "insidious onset", meaning that we don't know what caused it or when it started or happened. Studies estimate that 30-50% of adults over 60 have some degree of a rotator cuff tear, even if they don’t always experience pain (Yamamoto et al., 2010).

One of the lies that most therapists, and most people over 50, believe is that rotator cuff tears are "just a common part of getting old."

"Falls are part of getting old."

"Losing your mental faculties is just part of getting old."

"Losing strength is just part of getting old."

"Losing your appetitie is just part of getting old."

Lies, lies, lies. But more on this in another blog post.

What is the Rotator Cuff?

The rotator cuff—a group of four muscles and their associated tendons that stabilize the shoulder joint and enable smooth movement of the arm. Whether you’re lifting a grocery bag, reaching overhead, or throwing a ball, your rotator cuff plays a crucial role in keeping your shoulder strong and functional.

When dealing with pain, many people instinctively reach for over-the-counter pain relievers like Tylenol (acetaminophen) or ibuprofen (a nonsteroidal anti-inflammatory drug, or NSAID). While these medications can provide temporary relief, research suggests they may actually hinder muscle and tendon healing—which is bad news for your rotator cuff.

How NSAIDs and Acetaminophen Inhibit Muscle and Tendon Healing

NSAIDs like ibuprofen and naproxen work by reducing inflammation, specifically by blocking prostaglandins—hormone-like substances involved in the healing process. However, prostaglandins are also critical for muscle and tendon protein synthesis, which means that long-term NSAID use could slow down recovery from injuries (Mikkelsen et al., 2019).

Acetaminophen, though not classified as an NSAID, has also been shown to interfere with muscle protein synthesis, though the mechanism is less understood (Trappe et al., 2016). The concern is that regular use of these medications could impair the body's ability to repair and strengthen the rotator cuff, potentially leading to weaker tendons, slower healing, and even an increased risk of re-injury. (Also, see the research article here.)

Natural Alternatives for Shoulder Pain Relief and Healing

Instead of relying solely on drugs like NSAIDs or acetaminophen (tylenol), consider addressing the root causes of pain and inflammation while supporting natural healing. Here are some effective, research-backed alternatives:

1. Optimize Your Diet for Anti-Inflammatory Support

- Turmeric and ginger contain powerful compounds that support joint and tendon health.

- Vitamin C is essential for collagen synthesis, which is crucial for tendon repair.

- Collagen peptides and gelatin may help strengthen connective tissue.

- Probiotics for gut health, so you can absorb all of these things properly!

- TEA! For a really good list of anti-inflammatory teas, look here.

2. Improve Shoulder Mobility and Strength

- Physical therapy exercises can improve rotator cuff strength and prevent stiffness.

- Myofascial release and soft tissue work (such as massage or cupping therapy) may relieve tension.

- Gentle movement, like yoga or resistance band exercises, promotes circulation and healing.

3. Consider Supplements That Support Tissue Repair

- Magnesium can aid in muscle relaxation and reduce tension-related pain.

- Boswellia serrata (Indian frankincense) has anti-inflammatory properties similar to NSAIDs but without the negative impact on healing.

4. Address Lifestyle Factors That May Be Contributing to Pain

- Chronic stress can increase systemic inflammation, making pain worse. Practicing meditation, deep breathing, or prayer may help. Psychological, emotional and spiritual dis-ease can absolutely result in body deterioration, poor posture that leads to dysfunction, and more. If you are emotionally or spiritually "carrying a lot", see a recommended licensed mental health professional.

- Poor posture and overuse can place excessive strain on the rotator cuff—adjusting daily movement patterns may prevent further damage. (Need help with your posture, ask me.)

A Smarter Approach to Rotator Cuff Health

While Tylenol and ibuprofen may provide short-term pain relief, they may also impair the very processes your body needs to heal your rotator cuff. Instead of masking pain with medication, consider a more holistic approach—one that supports muscle recovery, better posture for less muscle strain on the rotator cuff, reduces inflammation naturally, and strengthens the shoulder for long-term function.

Would you like to explore specific shoulder strengthening exercises or additional research on natural pain relief methods? What about how to improve your posture? Are you literally and emotionally carrying too much? Let's talk. Book a visit with me here.