Physical Rehabilitation
Physical Therapy helps in reducing pain in the soft tissues, improves function, and builds muscle strength.
A physical rehabilitation program for rotator cuff injuries should be developed by a physical therapist. A strengthening program should be followed to improve the strength and balance in the tendons. Given the complexity of shoulder joint, it is most susceptible to dislocations and injuries and disorders like Impingement Syndrome, Tendinitis Bursitis or a Frozen Shoulder (Adhesive Capsulitis). In any of the problem related to shoulder, shoulder cuff tendons get weakened.
A rehabilitation program following surgery should be strictly followed. A regular and well-planned exercise routine helps in restoring the strength of rotator cuff muscles and restoring the functionality of the shoulder region. It is important to exercise under the supervision of a therapist to make sure that rotator cuff tendons are exercised and not the deltoid.
The exercises mentioned below should be performed only under the supervision, guidance and advice of an experienced therapist:
Tube External Rotation
Position a resistance tube a few inches above waist level such that its one end remains fixed and another end is mobile. Now grab the end of the tube and walk away from the origin of resistance. Stop at the point where there is medium level of resistance or at the point you start experiencing pain in the tendons. Slowly externally rotate your arm till the point of pain and then relax and move back to the starting position.
Lying Dumbbell External Rotation
Lie either on the floor or a weight bench with your upper arm at your side. Your elbow should be around your hip. Keep your elbow against your side and slowly externally rotate the dumbbell as far as it goes. Pause for a split second and lower the dumbbell slowly back to the original position and repeat.
Tube Internal Rotation
Position a thera-band at around the same level as your belly button. Grab the handle and walk away until you feel there is no slack left in the tube. Slowly internally rotate your arm until your palm of your hand touches your belly button. Let your arm externally rotate back to the original position under resistance.
Lying Dumbbell Internal Rotation
Lie on your side on a weight bench. Position your lower arm slightly in front of your body with a dumbbell in your hand. Keep your elbow against the bench in a relaxed position and externally rotate your arm as far as possible till the point of discomfort. Slowly internally rotate your arm raising the dumbbell until your arm is perpendicular to the floor. Lower your arm very slowly and back to the original position.
Internal Rotation
In a standing position, start with your right arm halfway between the front and the side of your body, thumbs down. Raise your right arm to the level of 45°. Don't lift beyond the point of pain. Slowly lower your arm. Repeat the exercise 10 times.
Isometric Internal Rotation
Stand near outer corner of wall. Bend elbow to 90-degree angle and keep elbow close to body. Next, lower your arm and press your palm of hand into wall for 10 seconds. Repeat exercise on other side.
Internal Rotation using Resistance Band
Attach resistance band to wall. Stand with your right side towards the wall. Hold resistance band with right hand. Bend your elbow to 90-degree angle, hand facing towards front and elbow close to body. Now, slowly rotate your hand towards the middle of the body and then return to the starting position. Repeat 10 times on both side.
Isometric External Rotation
Stand with your side towards the wall. Bend your elbow to 90-degree angle keeping elbow close to the body. Press back of hand into the wall for 10 seconds. Repeat exercise on other side.
External Rotation using Dumbbells
Lie on your left side. With right arm, hold dumbbell next to body with your elbow bent 90-degrees. Slowly lift your arm upwards until back of hand faces backward. Return to the starting position. Repeat 10 times on both sides.
External Rotation using Resistance Band
Attach resistance band to wall. Stand with your left side towards the wall. Hold resistance band with right hand and with elbow bent 90-degrees, slowly stretch the band by moving arm outwards until the back of your hand faces backwards. Repeat exercise on other side.
Lateral Raise using Dumbbell
Stand with arms at side and thumbs pointed upward. Now, slowly raise your arm to the side at about a 30 degree angle to the front of the body until almost shoulder level. Repeat 10 times.
Lying Lateral Raise using Dumbbell
Lie on left side and hold the dumbbell in right hand placed in front of thigh, palm facing leg. Keep your elbow slightly bent. Raise the dumbbell slowly until your arm is at 45-degree angle. Return to the starting position. Repeat the exercise on other side.
Lateral Raise with Internal Rotation using Dumbbell
Stand with arms at side and thumbs pointed towards ground. Slowly raise your arm to the sides at about a 30 degree angle to the front of the body until almost to the shoulder level.
Repeat the same 10 times. Shoulder Roll
May use light dumbbells. Stand, arms at side. Move shoulders forward, shrug shoulders up, and move shoulders backward - squeezing shoulder blades together, pull shoulders downward. Repeat this exercise 5-10 times.
Wall push-ups
Stand 18 inches away from the wall and place your hands on the wall at shoulder level. Now, slowly lower yourself towards the wall and return to the starting position.
Pendulum Swings
Stand and lean over with arm hanging. Begin swinging your arm in small circles and gradually enlarge the size of the circles. Repeat 10 times.
Rotator Cuff Stretch
Bend your elbow at 90-degree angle, keeping your elbows close to your body. Position your arms parallel to the floor with thumbs pointed up. Move your hands away from the body until a stretch is felt in the shoulder. Hold this stretch for 30 seconds. Rest and repeat.
Back of shoulder stretch
Reach your arm right across chest using your left hand to grasp arm just above elbow and gently pull your arm farther across your body until you feel a stretch in the back of the shoulder. Hold the stretch for 30 seconds, relax and repeat on other side.
Towel Stretch - External Rotation
Place your right hand behind your back. With the left hand, dangle a towel behind the back. Grasp the towel with the right hand and pull right hand downward to stretch the left shoulder. Repeat on other side.
Wall Climb
Stand about 18 inches from the wall. Face the wall and place your fingertips against the wall and walk the fingers up the wall until you feel a stretch in your shoulders. Hold the stretch for a count of ten and repeat ten times.
Chest Stretch
Place hands behind your back while standing with fingers interlaced. Turn your palms up and extend the arms backward until you feel a stretch in the chest Hold for 10 seconds. Repeat 10 times.
Neck Stretch
Tilt head sideways until you feel a gentle stretch through the side of neck and above the shoulder. Hold for 30 seconds and repeat on other side.
Neck Stretch
Tilt your head forwards and let it hang, keeping the neck and shoulders relaxed. Now slowly roll your head to one side, then return your head to the front and then roll to the other side. Do not overstretch. Do not roll the neck backwards. Repeat 10 times.
