The rotator cuff is a grouping of muscles, tendons and ligaments in the shoulder, responsible for allowing you to throw a baseball, reach overhead and perform everyday movements like vacuuming or carrying groceries. Massive injuries to the rotator cuff need surgical repair and require you to undergo postoperative physical therapy exercises to regain strength and flexibility.
Description
The rotator cuff is comprised of four muscles located at the shoulder joint junction, including the subscapularis, the teres minor, the supraspinatus and the infraspinatus muscles. These muscles converge and cover the head of the humerus, the top of the upper arm bone where it connects to the clavicle, or collarbone, and holds the humerus in place within the shoulder socket. The rotator cuff allows the shoulder to rotate, lift the arm and perform swinging movements, such as throwing a baseball or lifting groceries.
Passive Range of Motion
Physical therapy exercises may help encourage healing and help you regain better function of the rotator cuff musculature. Therapy start date will be determined by the diagnosis and prognosis you've received from your doctor and the nature of your injury and surgical repair. For smaller tears, passive range-of-motion and strengthening exercises are almost always recommended. Larger tears require surgical intervention and a customized postoperative exercise program. Beginning with the basics, you can perform a simple passive shoulder rotation exercise as the physical therapist braces your affected arm at the elbow and wrist. Extend your arm to the side of the body at shoulder height, or a height that does not cause pain. The therapist rotates your hand so the thumb points down toward the floor. Then your hand will be rotated until the thumb faces upward, toward the ceiling.
Side-to-Side Shoulder Exercise
Another passive range-of-motion exercise offers fuller arm extension. The therapist, bracing your affected arm above and below the shoulder, will extend your arm away from the body at shoulder level. She will slowly lift your arm upward. Eventually, you'll be able to raise your arm above the shoulder joint, close to your head. After the therapist lowers the arm back to shoulder level, she will move the arm across your chest. After holding the stretch for several seconds, she'll lower your arm back down to its starting position.
Active Range of Motion
Rehabilitative therapies and exercises are designed to increase strength, range of motion and function of the hand, arm and shoulder following a rotator cuff injury. Active range-of-motion exercises can be performed by yourself. For example, stand with your arms down by your sides. Slowly and gently swing the affected arm out in front of your body. Hold at the shoulder level and then, if you can do so without pain, continue to lift the arm upward in front of your body until your hand is directly above your shoulder. Slowly lower your arm until it's returned to your side and then press or hyperextend it behind you as far as you can without causing pain.
Caution
Resist performing any reaching movements until your shoulder has healed adequately. Your physical therapist will advise you regarding safe movements depending on your rotator cuff injury. Most strengthening exercise programs for injured rotator cuff start within 6 weeks of surgical procedures. Until then, avoid lifting moderate to heavy objects or performing large stretching motions, sudden movements or shoulder extension exercises. Don't place the hand of the affected arm behind your back and avoid positions, even while lying down, that place weight on the affected shoulder.
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