Injury to the rotator cuff muscles of your shoulder can be quite a painful experience. It can alter the normal mechanics in the shoulder joint as well as greatly limit your function due to the reduced mobility and strength. However, an advanced rehabilitation program can restore the natural gliding motion in the shoulder joint, strengthen your weakened muscles, and greatly enhance your function.
It is important to consult your physician prior to embarking on the following program.
General Considerations
Rotator cuff tears are common if you are over 40 years old. The design of a rehabilitation program for a rotator cuff injury takes the following factors into consideration: the quality of the tissue; integrity and extent of the repair; whether the injury is acute (new) or chronic (old); age, as the tissue is stronger if you are under age 50; the size of the tear; and an increased risk of having more fibrosis and pain with surgery. Newer repairs, less than four months old, generally respond better to therapy.
Advanced exercises begin 6-8 weeks Following Injury
After completing the early, passive shoulder mobility phase of your rotator cuff program, you are ready to progress to more advanced exercises for your shoulder if and when your resting pain is considerably decreased, your shoulder mobility is 75 percent restored, and the torn cuff tissue integrity is noticeably stronger. If these conditions are present, then your therapist will initiate enhanced mobilization exercises for your shoulder and instruct you to actively move your shoulder backwards, out to the side unless you have a large tear, and starting with your shoulder at your side with your elbow bent to 90 degrees and turning your lower arm outward within pain tolerance. It is also important to initiate stabilization exercises for your rotator cuff. The UBE, an upper extremity bike, is a great endurance activity. Overhead activities should be avoided.
Rehabilitation is Gradually Progressed 8-12 weeks Post-Tear
It is also important to strengthen muscles that help you stand more erect. Active strengthening for these scapular muscles, or pulling bent elbows back towards the trunk, begins four weeks after surgery for the small tear, six weeks for the medium and eight weeks for the large tear. Other active exercises that focus on cuff strengthening are initiated six weeks post-surgery and advance in difficulty around eight to 10 weeks following repair. For instance, turning the lower arm outward with the elbow bent is performed with increasing shoulder elevation from six to eight weeks for small and medium tears and 10 to 12 weeks for the larger tears. Activities such as jogging and swimming within the available motion of the shoulder also are permitted at this stage.
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