About Physical Therapy for Rotator Cuff Injury

A torn rotator cuff is one of the most common upper-body injuries. Since the rotator cuff is actually composed of four muscles, it's easy to see why this area can be subject to injury. The four muscle groups of the rotator group include the supraspinatus, which is responsible for shoulder elevation; the infraspinatus and the teres minor, which externally rotate the shoulder joint; and the subscapularis, which elevates the arm. The exercises included below are the ones most commonly used in rotator cuff physical therapy. However, before you attempt to perform them, it's extremely important to have the injury evaluated by a physician. Rotator cuff problems have similar symptoms to other injuries, which may require a different type of treatment. Thus, an accurate evaluation is crucial. According to an article in the May 2009 issue of the Journal of Joint and Bone Surgery, certain people may have a genetic predisposition to rotator cuff tears. As such, it is suggested that these folks practice physical therapy exercises as preventive medicine.

Physical Therapy for Rotator Cuff Surgery

• In most case, for severe tears, surgery is the best option for rotator cuff injuries. However, it might take as long as six months after surgery for the shoulder to be fully functional. Post-operation physical therapy is crucial to the healing process. But even after you have completed your allotted number of physical therapy sessions, you will need to practice the exercises at home. Pre-surgery physical therapy is an extremely controversial subject, and usually depends on the severity of the injury. In some cases, total immobilization will be needed.

Resistance Band Physical Therapy Exercises

• Resistance band exercises are the most common form of therapeutic exercise used by physical therapists. For external rotation, hold a resistance band in one hand, and attach it to a stable object. Use the hand that is farthest away from the attachment point. For example, if the attachment point is closest to the right side of your body, the band should be held with your left hand. Place a towel under your elbow in order to keep it stable. Bend your elbow at a 90-degree angle. Begin by bringing your hand toward the center of your body. Then, inhale to prepare. As you exhale, rotate your forearm to the side, without allowing the elbow to leave your waist.

  For internal rotation, you will hold the band in the hand that is closest to the attachment point. This time, begin with your forearm rotated to the side. Inhale to prepare, and as you exhale, draw the forearm toward the midline of your body.

Side Lying Abduction

• Side lying abduction is another common physical therapy technique. This exercise requires the use of an extremely light weight. Lie on your side and place a towel under your elbow. Hold a weight in you hand, and attach your elbow to your waist. Begin with your hand next to your belly button. Inhale to prepare. As you exhale, rotate your forearm until your fist is facing the ceiling. Inhale as you return.

Prone Exercises

• These common physical therapy exercises are performed while lying prone on a table or bed. They are featured in the Prone Rotator Cuff exercise video listed in the resource section. The first is performed with your elbows bent, and your finger pointing toward your ears. Inhale to prepare. As you exhale, squeeze your shoulder blades together and lift your elbows and forearms from the table. Inhale to return. To perform the prone arm lift, lie on your stomach with your hands by your side. Your arms will be straight, and your palms should face the ceiling. Inhale to prepare. As you exhale, lift your hands and arms from the table. Inhale to return.

  You can also perform a Prone Overhead Arm Lift. Lie on your stomach with your arms overhead, and your palms facing each other. Inhale to prepare. As you exhale, lift both arms from the table. Inhale to return.

Physical Therapy for 12 Weeks After Surgery

• For the first 12 weeks after surgery, you will need to perform your physical therapy exercises on a regular basis. Moving your arm through its full range of motion is the only way to prevent scarring and stiffness. However, when not performing your exercises, your arm will need to be stabilized in a sling.

Passive vs. Active Physical Therapy

• During your physical therapy sessions, your therapist will have you perform two types of therapeutic exercise. During passive exercises, your therapist will attempt to take your arm through the full range of motion. These are usually performed in the early post-operative stages. During active exercises, you will move your arm without any assistance.

Physical Therapy vs. Surgery

• According to the American Academy of Orthopedic Surgeons, many patients wonder if they can rely exclusively on physical therapy and avoid having surgery. The answer lies in how active you plan to be after the injury. A professional athlete who frequently will be using his upper body will require surgery. If you decide not to have surgery, you will need to be extremely careful about performing activities such as throwing objects and reaching overhead.