Rotator cuff and shoulder rehabilitation exercises. The best rotator cuff exercises and stretches medical news today. Do all exercises 15 to 20 times each, one to two times a day. In some patients, mobility could already be good, but this will depend on how bad the injury is. Jul, 2018 how to increase shoulder range of motion speciall shoulder abduction sideways movement of shoulder is main task. Passive range of motion 0 to 810 weeks goals patient education.
Mar 16, 2020 major contributor of rotator cuff tear. With time, a proper strengthening regimen can help you return to your normal activities and start feeling like yourself again. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Rotator cuff exercises mobility, stretching, strengthening. Postoperative rotator cuff repair rehabilitation protocol. Clinic appointments at 8 to 12 days, then at 6 weeks, 12 weeks, 18 weeks and possibly 24 weeks postop. Rotator cuff home exercise program this is a general conditioning program that provides a wide range of exercises. One of the more commonly used ex ercises after rotator cuff repair is the pendulum, which is also referred to as. Performing these exercises three times a day will help improve shoulder strength and range of motion after undergoing an operative procedure. A torn rotator cuff due to an injury is usually best treated by immediate surgical repair. Gentle rotator cuff exercises, designed to improve your shoulders mobility and increase strength in the injured muscle and the ones around it, can help improve your arms range of motion and decrease pain. Rotator cuff repair revised august 2008 postop days 1 21 immobilizer with abductor pillow x 46 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort hand squeezing exercises elbow and wrist active motion arom with shoulder in neutral position at side supported pendulum exercises. Gently stretching after strengthening exercises can help reduce muscle soreness and keep your muscles long and flexible. When the patient was free of pain, scapula and rotator cuff isotonic strengthening exercises were initiated.
Rotator cuff repair postsurgical rehabilitation protocol postop days 1 21 immobilizer with abductor pillow x 46 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort hand squeezing exercises elbow and wrist active motion arom with shoulder in neutral position at side. Poor posture and bad form, especially during exercise. After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health of your shoulders. Exercises you can do at home exercises are a very important part of treatment for a rotator cuff disorder. Exercises and physical therapy for rotator cuff tear. Weeks 0 6 no active range of motion rom exercises limited supine position passive rom only. Remove sling 5 times a day to work on range of motion exercises for the hand, wrist, and elbow and work on. Standing supraspinatus exercise to 90 degrees with gravity resistance only. Rehabilitation protocol for massive rotator cuff repair. Exercises your kaiser permanente care instructions here are some examples of typical rehabilitation exercises for your condition. Rotator cuff repair postoperative rehabilitation protocol. Your doctor, athletic trainer, or physical therapist can help guide you through this program, which is broken up into 3 parts. Others have suggested the use of various biological or artificial grafts or tendon transfers to bridge otherwise irreparable rotator cuff defects.
Summary table post op phasegoals range of motion therapeutic exercise precautions weeks 0 7 goals patient education re. Brace abduction bracesling, remove sling only to bathe and to complete exercises. Emphasize proper scapular position when performing all arm exercises. The rotator cuff is made up of four muscles supraspinatus, infraspinatus, subscapularis, and teres minor and their tendons. Move through your full range of motion to stretch the chest and scapular muscles. The rotator cuff is an integral part of the anatomy of the shoulder. It is no means intended to be a substitute for ones. Impingement syndrome rotator cuff tendinitis, bursitis. The effect of rotator cuff tear size on shoulder strength and. The shoulder is immediately weak and there is pain when trying to lift the arm. The effect of rotator cuff muscles exercises on range of motion, proprioception and electrical activity in male volleyball players with shoulder. Oct 31, 2019 the rehabilitation protocol consisted of active abduction in the scapular plane limited to 70 and 0 of external rotation in the first 4 to 6 weeks as tolerated. Pictures courtesy of simpleset, used with permission.
Supine rotator cuff program these exercises are intended for the initial strengthening of acute shoulder problems, andor longterm rehabilitation for massive rotator cuff tears and other conditions resulting in longterm severe weakness. Rotator cuff repair most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. Normally the humeral head gets closer to the acromion when the shoulder is moved, particularly as you reach overhead. The postoperative protocol after arthroscopic rotator cuff repair arcr is still controversial. If you prefer, you can cross your arms in front of your chest to increase the stretch. Work within a pain free range of motion at all times and do the exercises very slowly. The extent to which the presence of a rotator cuff tear and the size of the tear. Your doctor or physical therapist will tell you when you can start these exercises and which ones will work best for you. How to increase shoulder range of motion speciall shoulder abduction sideways movement of shoulder is main task. May 16, 2019 gentle rotator cuff exercises, designed to improve your shoulders mobility and increase strength in the injured muscle and the ones around it, can help improve your arms range of motion and decrease pain.
Famous physical therapists bob schrupp and brad heineck demonstrate the 10 best rotator cuff exercises for strengthening your shoulder from beginner to advanced. Pdf the effect of rotator cuff muscles exercises on range. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Rotator cuff exercises to improve shoulder mobility should begin as soon as pain allows. Jan, 2020 the four exercises in this stepbystep guide are meant to help improve the active range of motion around your shoulder. However, it is not clear that this more complicated approach has advantages over an expertly done direct open repair. After this, active range of motion exercises were started. It includes things like exercise, ice, heat, massage, and equipment to help return your shoulder back to its normal range of motion. Stick or wand exercises are the solution to increase shoulder mobility. The deltoid muscle is separated to expose the torn rotator cuff tendons. The rotator cuff can tear as an acute injury such as when lifting a heavy weight or falling on the shoulder or elbow.
There was a slightly higher rotator cuff healing rate in the delayed passive range of motion group compared with the early passive range of motion group 91% vs 85%. Rotator cuff repair protocol boston shoulder institute. If pain, weakness, and stiffness in your shoulder see figure in appendix are related to problems with your rotator cuff, a doctor will usually first recommend nonsurgical treatment. Theraband strengthening exercises are illustrated on a. Arthroscopic rotator cuff arc clinical trial rotator cuff home exercise program table of contents general instructions 1 passive motion exercises 2 active assisted range of motion exercises 3 active range of motion exercises 6 isometric exercises 8 resisted exercises 9 rotator cuff strengthening exercises 11 shoulder stretches. Famous physical therapists bob schrupp and brad heineck demonstrate the 10 best rotator cuff exercises for strengthening your shoulder. Most rotator cuff tears can be repaired surgically by reattaching the torn tendons to the humerus. Range of motion you should do this every day to help get your motion back. Pdf the effect of rotator cuff muscles exercises on range of. The goals are to first restore normal range of motion, then strengthen the rotator cuff initially below shoulder level and gradually increase resistance to all functional planes and range of motion without aggravating symptoms. Strengthening all exercises painfree rom only 3xweek max. Initial emphasis is on range of motion, both active and passive. To determine the effect of rotator cuff tear size on shoulder strength and range of motion.
The first phase of rehabilitation begins with flexibility. However, sometimes the arm can still be passively moved, meaning that someone else can lift the affected arm and rotate it through a complete range of motion. Same exercise but rotate the arm outwards and inwards. These exercises are intended for the initial strengthening of acute shoulder problems, andor longterm rehabilitation for massive rotator cuff tears and other conditions resulting in longterm severe weakness. The results of the statistical tests indicated that rotator cuff muscles specific exercises have had a significant effect on the range of motion, proprioception and electrical. It is prone to injury, but doing specific exercises can help prevent this. Once these exercises become easy, you may wish to progress to shoulder and rotator cuff strengthening exercises by performing these exercises with free weights. Attainment of full range of motion rotator cuff and scapular strengthening correction of postural imbalances hints o while performing exercises, keep shoulder rolled back and down o avoid any of the exercises that cause pain or increased symptoms o perform strengthening exercises on alternating days p. A person with an injured rotator cuff may not be able to move the arm through a normal range of motion. Your rotator cuff the rotator cuff is a group of tendons and. Rotator cuff and shoulder conditioning program orthoinfo aaos. The slower the motion, the better the muscle contraction is throughout the range of movement.
Theraband strengthening exercises are illustrated on a separate page. Rotator cuff sprain and strains university of california. Shoulder tendonitis center for sports medicine and. Patients may have an underlying coracoacromial bursitis, therefore rom exercises and muscle strengthening exercises should begin with the arm in less than. Shoulder rotator cuff tear center for sports medicine. Strengthening may begin after the 8th week with the standard rotator cuff rehabilitation protocol with gradual progression of weight. Limit strength exercises that work the rotator cuff at its end range of motion, and stretch when tight. Remember to apply ice to the affected shoulder after performing the exercise routine. Rotator cuff repair protocol page4 exercises phase 1 range of motion recommended parameters two sets of 10 reps, 5 timesday unless specified neck, wrist and hand range of motion to maintain range of motion look updown, turn to each side and bring. One of the more commonly used exercises after rotator cuff repair is the pendulum, which is also referred to as codmans exercise. Progressive early passive and active exercise therapy after. Rotator cuff repair the following is a protocol for postoperative patients following rotator cuff repair. Rotator cuff repair protocol page4 exercises phase 1 range of motion recommended parameters two sets of 10 reps, 5 timesday unless specified neck, wrist and hand range of motion to maintain range of motion look updown, turn to.
Patients are allowed full active motion of the shoulder, but are in. Patients are referred to physical therapy for initiation of rehabilitation phase. Start against gravity and gradually progress with weights. Some surgeons recommend slower rehabilitation in order to improve the integrity of the repair, while others prefer early rangeofmotion rom exercise to avoid postoperative stiffness. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic assistedminiopen rotator cuff repair.
All of the exercises should be performed with slow and controlled motion. Repair of rotator cuff tears uw orthopaedics and sports. Some have advocated the repair of rotator cuff tears using shoulder arthroscopy. You can combine this move with scapula circles to help boost your circulation and prepare your muscles for this routine of rotator cuff exercises.
Performing the exercises two to three days a week will maintain strength and range of motion in your shoulders. Normalizing scapulothoracic and glenohumeral rhythm may also be included. Target range of motion at 3 months after arthroscopic rotator. It provides stability and strength for the shoulder joint, anchoring the humerus upper arm bone to the scapula shoulder blade so that movements of the arm can occur in a. A torn rotator cuff due to an injury is usually best treated by immediate surgical. It is not a big operation to repair a torn rotator cuff, but the rehabilitation time can be long depending on the size of the tear and the quality of the tendonsmuscles. Your aim is to restore full, painfree mobility to your shoulder joint. Patients with rotator cuff pathology typically present with weakness and motion loss in various motions.