Thursday, 7 March 2013

Rotator cuff injury - exercises for rotator cuff injury

Rotator cuff exercises for rotator cuff injury


The rotator cuff muscles are generally responsible for rotating the shoulder, assisting with lifting the arm out to the side, and generally stabilising the shoulder joint. We demonstrate a few simple rotator cuff injury exercises which can be used as part of a rotator cuff injury rehab program.

The following guidelines regarding Rotator Cuff Injury strengthening exercises are for information purposes only. We recommend seeking professional advice before beginning rehabilitation. The best exercises for rotator cuff strain are outlined below and should always be done pain free.

Static exercises

Static (or isometric) exercises are some of the first torn rotator cuff exercises to be done as they do not involve any movement. The patient pushes against a stationary object such as a wall, doorframe, or resistance provided by another person.

Because there is no movement, static exercises can be performed soon after injury, usually within 3-7 days, provided they are pain-free. If any exercises are painful, then do not continue with them. Rest for a longer period until they are comfortable.

Lateral rotation

  • The video above shows static lateral rotation performed against a wall.
  • Push against the wall, start off gently, (e.g. about 50% max) and gradually increase the intensity.
  • Keep the shoulder and upper arm still. Aim to hold the position for 10 seconds, relax for three seconds and contract again for 10 seconds.
  • The duration of hold and number of repetitions can be increased until the athlete feels confident enough to move onto dynamic exercises.

Medial rotation

  • Stand facing the corner of the wall, with the palm and lower forearm against the wall (the other side from the photo opposite).
  • Push against the wall, as if trying to rotate the forearm towards the body, keep the shoulder and upper arm still.
  • Again, start off at 50% for 10 seconds, repeated twice.
  • Gradually increase the intensity, duration and repetitions.

Abduction

  • Stand side-on to a wall, with the elbow bent and side of the forearm against the wall.
  • Push outwards, against the wall, as it trying to lift the arm above the head.
  • Start at 50%, hold for 10 seconds and repeat twice.
  • Gradually increase as above.

Resistance band exercises

Resistance bands are great for strengthening the shoulder muscles. They can be used in many different positions and can easily be progressed as your strength improves. Tie one end of the band to something sturdy at waist height, such as a door handle (make sure the door is closed!). Always start with the band just taught to make sure you are working the muscles through the whole range. These exercises can replace the static exercises (above) as soon as pain allows (usually 7 days plus)

Lateral rotation

  • Hold the untied end of the band in the injured hand
  • Keep the elbow bent by your side and start with the forearm/hand close to your stomach
  • Make sure you keep the elbow in as you rotate the shoulder so that the arm moves away from the stomach as far as you can.
  • Slowly return to the start position
  • Repeat this 10 times initially (provided it is pain free).
  • Gradually increase the number you perform up to 20 and then increase the intensity by shortening the section of band you hold.

Medial rotation

  • Turn around so that the attachment point of the band is on the same side as your injured shoulder
  • Make sure the elbow is bent and by your side
  • Start with the arm laterally rotated, with the forearm away from the body (the end position of the above exercise)
  • Rotate the shoulder so that the forearm moves in towards your stomach as far as you can.
  • Keep your elbow still and by your side throughout.
  • Slowly return to the starting position.
  • Repeat 10 times initially and gradually increase as above.

Abduction

  • Stand with the bands attachment point on the opposite side to your injured shoulder.
  • Hold the free end of the band and start with the arm straight by your side.
  • Raise your arm out to the side and as high as you can - keep your elbow straight
  • Slowly return to the starting position.
  • Repeat 10 times initially and gradually increase as above.

Weight exercises

Once the strength in your shoulder is really improving, you may want to start performing weight exercises. The same movements can be repeated with a dumbbell:

Lateral rotation

  • With a small dumbbell (start at around 2-3kg), lay on your side on a bench, with the injured shoulder on top.
  • Position the arm with the upper arm against your body, elbow bent and forearm and hand pointing down to the bench.
  • Keep the elbow still as your rotate the shoulder so that the forearm moves up past horizontal and as far as you can.
  • Slowly return to the starting position and repeat 10 times initially.
  • Gradually increase the number to 20 and then slowly increase the weight you use.

Medial rotation

  • Lay on your side on a bench with the injured shoulder on the bottom.
  • Make sure the upper arm is supported and the elbow is bent to 90 degrees (the forearm will be horizontal).
  • Rotate from the shoulder so that the hand moves towards your body as far as you can.
  • Slowly return to the starting position.
  • Repeat 10 times initially and gradually increase

Abduction

  • Stand up and hold a small dumbbell in the hand of the injured shoulder.
  • With the elbow slightly bent, lift the arm up out to the side, to just above shoulder height.
  • Slowly return to the starting position.
  • Repeat 10 times initially and gradually increase as above.
  • At this point you can add in other shoulder strengthening weight exercises, such as shoulder presses and front raises.