The Complete Guide to Rehabilitating Your Rotator Cuff
The shoulder joint is complicated business, allowing us to twist and rotate our arms and reach them up, down, forward, and back. Holding it all in place and allowing for this wide range of movement is a group of muscles and tendons known as the rotator cuff. When things go wrong in this area, it’s important to take rotator cuff rehabilitation seriously before the problem gets worse and requires more extensive intervention, such as surgery.
Common Rotator Cuff Injuries
Rotator cuff problems are often the result of repetitive use injuries. Construction workers, painters, and anyone else who spends a lot of time reaching overhead are especially susceptible. Risk of rotator cuff injury increases as we get older, and there may also be a genetic component.
Tendinitis, bursitis, inflammation, and bone spurs can all play a part in impingement of the rotator cuff, where the parts that used to glide smoothly past one another are now pinching and aggravated by movement.
The other main rotator cuff injury is a tear of a muscle or tendon. Less common than impingement, tears can be the result of either overuse or trauma injury, such as a fall.
Symptoms of Rotator Cuff Injury
A rotator cuff injury can range from being a minor inconvenience to a major problem. It can begin as a dull ache in the shoulder, possibly accompanied by arm weakness. The pain can sometimes disrupt your sleep. Simple movements such as reaching behind your back or combing your hair can be difficult.
If your shoulder pain is complicating your ability to perform everyday tasks, or if it is the result of a sudden, traumatic injury, you’ll want to see your doctor for evaluation and treatment options. In extreme cases, surgery may be necessary. Fortunately, though, most problems can be treated and resolved with a combination of rest and rotator cuff rehabilitation.
Guide to Rotator Cuff Rehabilitation
Rest and physical therapy are the keys to rotator cuff rehabilitation. You’ve probably already figured this out, but you need to stop doing the things that hurt. Give your muscles and tendons time to recover from all that overhead lifting that caused the problem. This could be difficult if it’s part of your job, but the alternative—a minor injury that becomes major or permanent because you didn’t let it heal—is much worse. A full recovery can take up to six months, so plan accordingly.
The other keys to recovery are physical therapy exercises. Yes, we just said to rest. But your physical therapist will also be able to suggest appropriate exercises that can strengthen your rotator cuff without aggravating your existing injuries. These exercises may be as simple as using a shoulder pulley to maintain passive range of motion during your recovery.
Working to maintain range of motion is especially important after surgery or during times of extensive shoulder immobilization to prevent a condition known as frozen shoulder.
Additional exercises to strengthen and rehabilitate your rotator cuff will vary depending on your specific injury, so let your physical therapist be your guide. These exercises can be performed with light weights, resistance bands, or some with no equipment at all. Even after rotator cuff rehabilitation, it’s important to continue your exercises to keep the rotator cuff strong and prevent future injuries. Some of the exercises you might come across include:
- Pendulums — Lean over to support yourself with one arm while letting the arm of the shoulder you want to exercise hang relaxed, holding a light weight. Move your body side to side, front to back, or in circles to let the arm gently swing.
- Isometric Internal and External Rotation — Use isometric exercises to work muscles during times when you can’t or don’t want to move your shoulder because of pain or reinjury risk. Instead of moving your arm through the motion of a standard internal or external rotation, contract the muscles but use a wall, door jamb, or your other arm to maintain the exercising arm in a fixed position.
- Internal and External Rotation with Weight or Resistance — Advancing beyond the isometric rotations, you can perform weighted rotations while lying on your side or you can use anchored resistance bands to perform rotations while standing.
- I, T, Y, W — These exercises are performed while lying face down and lifting your arms slightly off the ground. Make the shape of the different letters with your arms for variations of the exercise (I with your arms stretched out above your head; T with your arms stretched out to the sides; Y with your arms out like a Y, sort of halfway between an I and a T; and W with your arms bent, you get it, like a W).
- Rows — Perform seated rows with a resistance band either anchored to a wall attachment or door, or wrapped around your feet.
The video below is a nice overview of these and more exercises designed for rotator cuff rehabilitation and strengthening.