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Rotator
cuff rehabilitation
Rehabilitation
exercises
Alternative
exercises
Rehabilitation
after surgery
How
long will the effects of the injury last?
When can I return to my sport or activity?
Read
more about rotator cuff injuries
Rotator cuff rehabilitation
As an athlete, your number one concern is getting back to full strength
as soon as possible so that you can return to training and competition.
That is why appropriate rehabilitation is extremely important. Rehabilitation
for a torn rotator cuff or impingement often includes the following:
- rest during the
acute phase
- ice injury multiple
times per day
- compression of
the injured shoulder with an elastic compression bandage (ACE bandage)
to limit swelling and pain
- use of anti-inflammatory
medications such as ibuprofen to reduce inflammation and speed up recovery
Many rotator cuff
injuries can be rehabilitated with a sling to immobilize your arm and
shoulder. You also may be required to temporarily wear a shoulder brace
when you return to your sport. These devices help hold the shoulder in
place while the rotator cuff heals. Your doctor also may prescribe rehabilitation
exercises once the sling is removed.
The major objectives
of rehabilitation from a rotator cuff injury are to increase flexibility,
obtain pain-free range of motion, and strengthen the muscles of the shoulders,
upper back, front chest, and upper arms. In severe cases, you should avoid
activity that causes shoulder pain altogether. In these cases, you can
still maintain cardiovascular fitness by cycling, unless otherwise prescribed
by your doctor.
Surgery is rarely
needed to repair a shoulder impingement. However, it may be needed to
repair very serious bursitis or torn rotator cuff.
Keep in mind that
rehabilitation for bursitis may be much more involved. In these cases,
your doctor may prescribe special physical therapy and recovery time will
vary.
Rehabilitation
exercises
Rehabilitation exercises often prescribed by your doctor may include stretching
and strengthening exercises such as the following:
- Overhead stretch
Lie on your back with your arms at your sides. Lift one arm straight
up and over your head. Grab your elbow with your other arm and exert
gentle pressure to stretch the arm as far as you can.
- Cross-body reach
Stand and lift one arm straight out to the side. Keeping the arm at
the same height, bring it to the front and across your body. As it passes
the front of your body, grab the elbow with your other arm and exert
gentle pressure to stretch the shoulder.
- Towel stretch
Drape a towel over the opposite shoulder, and grab it with your hand
behind your back. Gently pull the towel upward with your other hand.
You should feel the stretch in your shoulder and upper arm.
- Shrugs
Stand with hands at sides with no weight in either hand. Raise shoulders
to the point of pain and hold for five seconds. Relax for five seconds.
Perform this sequence 10 times, 3 times daily. As pain permits, hold
dumbbells of equal weight in each hand while performing this exercise.
Add weight by using hand-held dumbbells as pain permits.
- Bicep curls
Stand with arms fully extended at sides while grasping 2- to 5-pound
weights in each hand, held palm forward. Flex the arms at the elbow
to approximately 100 degrees, or to the point of pain, whichever comes
first. Hold this position for 5 to 10 seconds. Return to the start position.
Rest for 5 seconds. Repeat this exercise 10 times. You can increase
the weight as pain allows and strength develops.
- Triceps curls
Stand with elbows directed upward over the shoulders and with arms relaxed.
Extend arms at the elbow so that the hands proceed upward to the point
of pain. Hold this position for five seconds. Return to the starting
position and relax for five seconds. Perform this sequence 10 times,
3 times daily. As pain permits, add weight by using hand-held dumbbells.
- Chest raises
Lie on belly with hands extended along sides of the body. Raise the
upper chest from the floor to the point of pain and hold this position
for 5 seconds. Return to the start position and relax for 10 seconds.
Repeat this sequence 10 times, 3 times daily.
- Saws
Reach out and place the unaffected side hand on a corner of a table.
Bend at the waist. Flex the injured side arm at the elbow and pull the
injured side arm backward and upward as if sawing wood. Slowly bring
the shoulder blades as close together as pain will permit. Slowly bring
the injured side arm down to its beginning position. Repeat this sequence
10 times, at least three times daily.
- Pendulum swings
Stand with the hand of the unaffected arm resting on the corner of a
table and supporting some of the body weight. Slightly bend the knee
on the unaffected side and extend the other leg sideways. Allow the
injured arm to hang loosely over the unaffected side foot. By shifting
the body weight, cause the relaxed injured arm to swing in circles to
the fullest extent possible as limited by pain. Perform 25 swings in
a clockwise direction. Allow the injured arm to cease swinging. Perform
25 swings of the injured arm in a counterclockwise direction. Repeat
this sequence at least three times daily.
- Shoulder rotation
Stand in a doorway with affected side arm bent at the elbow and the
palm of the hand against the doorframe. Turn the body away from the
injured side hand until a stretching sensation is felt in the injured
shoulder. Hold this position for 10 seconds. Return to the starting
position. Relax for 10 seconds. Repeat this sequence 10 times at least
three times a day.
- Shoulder flexion
Stand erect close to a wall. With the palm of the injured side arm turned
so as to face you, slowly slide the forearm and then the upper arm up
the wall by moving closer to the wall. Slide the arm upward to the point
of initial significant pain. Hold this position for 10 seconds. Return
to the starting position and relax for 10 seconds. Repeat this sequence
10 times, at least three times daily.
- Flexed elbow pull
Bend and raise the injured side elbow to shoulder height. Grasp the
injured side elbow with the uninjured side hand. Gently pull the injured
side elbow toward the opposite shoulder until limited by first significant
pain. Hold this position for 10 seconds. Relax for 10 seconds. Repeat
this sequence 10 times at least three times daily.
Alternative exercises
During the period when normal training should be avoided, alternative
exercises may be used. These activities should not require any actions
that create or intensify pain at the site of injury. They include:
Rehabilitation after surgery
Surgery may be needed to repair a shoulder impingement or severe rotator
cuff tear. In these cases, you will need to wear a sling or figure-of-eight
strap while your shoulder heals.
When your doctor decides
you are ready, you may start range-of-motion and strengthening exercises.
You may be referred to a physical therapist to assist you with these exercises
and under no circumstance should you return to sports activity until your
shoulder is fully healed.
A physical therapy
program usually begins with range-of-motion and resistive exercises, then
incorporates power, aerobic and muscular endurance, flexibility, and coordination
drills.
How long will the
effects of the injury last?
To some extent, the time to fully recover from a rotator cuff injury is
influenced by your dedication to your rehabilitation program. Typically,
athletes require anywhere from 2-12 weeks of healing time, depending on
the severity, before returning to their sport.
When can I return
to my sport or activity?
Return to full participation should be avoided until your rotator cuff
injury has healed and you can perform all skills and other requirements
of your sport without pain.
Remember: the goal
of rehabilitation is to return you to your sport or activity as soon as
is safely possible. If you return too soon you may worsen your injury,
which could lead to permanent damage. Everyone recovers from injury at
a different rate. Return to your activity is determined by how soon your
rotator cuff recovers, not by how many days or weeks it has been since
your injury occurred.
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