Easy Exercises for Rotator Cuff Pain

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The rotator cuff, which is often improperly referred to as the rotator ‘cup’, is the section of your shoulder where four different muscles and tendons come together and connect to the upper arm bone or humerus.

These four separate muscles are the Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. These muscles come together to form a fanned-out cone-like shape, which can be likened to a flared shirt sleeve.

Each of these muscles has a slightly different function, and they work together to achieve various ranges of motion. This includes stabilising the head of the humerus in the shoulder joint, abducting or elevating the shoulder joint out to the side, externally rotating the shoulder joint and depressing the head of the humerus.

Essentially, all of the muscles work together to constantly ensure that the humerus remains fixed securely in the shoulder joint throughout the shoulder’s wide range of motion.

What Is a Rotator Cuff Injury?

Rotator cuff injury can occur when any one of the muscles that make up the rotator cuff get damaged. You will know immediately when you have injured your rotator cuff as you are very likely to experience pain or weakness when lifting your arms. However, in some rare instances, people who have a rotator cuff injury have no knowledge of it. Damage to the rotator cuff can be in the form of a rotator cuff tear, rotator cuff tendonitis, shoulder impingement, shoulder bursitis, shoulder labrum tear or shoulder separation.

The most common rotator cuff injuries are in the form of tears and impingements. Impingement happens when one of the rotator cuff muscles becomes inflamed, and the swelling then squeezes the space between the arm and the bone, causing pain. On the other hand, a tear is a more severe type of injury whereby the tendon or muscle gets torn.

These injuries can occur through a single traumatic event such as a fall or during sports or slow, progressive degeneration of the muscles over months or years. It can also happen if a mild injury is not given the proper time to heal.

What Can I do After Injuring My Rotator Cuff?

Following the injury of your rotator cuff, you should apply ice to reduce the pain and swelling. The ice will reduce inflammation and help with the pain. The cold stops cellular atrophy and reduces the formation of scar tissue. The icing should also be followed by ample rest during the initial phase immediately post-injury to prevent further exacerbation of the injury. Light exercises should follow this to regain full range of motion.

When Should I See a Doctor for a Rotator Cuff Injury?

You should see a doctor if your pain and swelling do not improve after the first day or so and you have difficulty raising or sleeping on your arm. This could be indicative that your injury is a tear and not just a sprain or impingement.

A tear that cannot be healed through the use of ice and exercise left untreated could become a permanent problem for you. Very sharp pains upon movement of your shoulder are tell-tale signs of a tear in your rotator cuff, and this should warrant you going to see a doctor as surgery may be required.

What Are Some Easy Exercises for Rotator Cuff Pain?

If your pain starts to fade or you’ve already seen the doctor, and they’ve told you that there’s no tear. You can start these exercises to nurse your rotator cuff back to full health.

We’ve included this video to show you some easy rotator cuff exercises that can be done anywhere and any time.

Alternatively, we’ve listed the steps for some other easy rotator cuff exercises if you’ve suffered from a rotator cuff injury.

Doorway Stretch 

  • Stand with your feet together.
  • Bend your elbows and extend your arms out to your side as if you were about to embrace someone.
  • Place one foot forward, lean into the doorway arches with both hands on the frame, and then grip the sides tightly. Continue leaning into the door and keep your grip tight on the frame.
  • Lean forward until you feel the stretch across your chest.
  • Hold this stretch for 5 deep breaths and repeat this 8 times.
  • Do 3 sets of this at least 3 times a week.

Sleeper Stretch

  • Lie down on your side and place your affected shoulder under your body. With your arm bent and out in front of you, and your fist facing straight up to the ceiling. You may use a pillow should you need to.
  • Use your other arm to hold the affected arm towards the ground. Stop this pressing motion as soon as you feel a stretch in the back of your affected shoulder.
  • Hold this position for 30 seconds, then relax your arm for 30 seconds and repeat this 8 times.
  • Do 3 sets of this at least 3 times a week.

Internal Rotation

  • Lie down on your side, place your affected shoulder slightly out, so it is not exactly under your body, and tuck your elbow into your ribs. You may use a pillow should you need to.
  • Hold your injured arm against your side keeping your elbow bent at a 90° angle. You may carry a lightweight in your arm, but you do not need to.
  • Make sure your elbow is fixed into your ribs, slowly rotate your arm at the shoulder, and raise your arm up and into your body.
  • Slowly lower the weight to the initial position and repeat this 8 times.
  • Do 3 sets of this at least 3 times a week.

Bent-Over Horizontal Abduction

  • Lie down on your belly on a raised platform such as a table or bed with enough space between the platform and the floor so that you can hang the entirety of your injured arm over the side of it.
  • Keep your arm hanging straight down and slowly raise it till it is parallel with the edge of the table and your body.
  • Slowly lower it back to the initial hanging position and repeat the arm raises 8 times.
  • Do 3 sets of this at least 3 times a week.

Reverse Fly

  • Stand with your feet shoulder-width apart and keep your knees slightly bent.
  • Make sure your back is straight but bend forward slightly.
  • You may choose to carry a light weight in each hand (but you do not need to) and extend your arms and raise them away from your body. This should resemble a flapping motion.
  • Do not lock your elbows. Squeeze your shoulder blades together with each rep and make sure not to raise your arms back past your shoulders and repeat this 8 times.
  • Do 3 sets of this at least 3 times a week.

How Can I Condition My Shoulder After a Rotator Cuff Injury?

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Rotator cuff injuries affect a large number of people every year and most commonly athletes or active hobbyists. Thus, conditioning the shoulder after the damage is extremely important. Shoulder conditioning is another term for physiotherapy and exercise. 

The better the conditioning program following the injury, the faster you can expect the injury to heal and be ready for full use once again.

 

What Is a Rotator Cuff Injury?

Rotator cuff injury occurs when any of the numerous muscles and tendons that make up the rotator cuff are injured. These are the muscles and tendons of the shoulder that connect to the upper arm bone of the humerus. 

The four separate muscles that make up the rotator cuff are the Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. These muscles come together and form the shape of a ‘cuff’.

 

These muscles all have slightly different uses, and they work together to provide the shoulder with different ranges and directions of motion. Almost all of the movements you can imagine when you feel your shoulders move are controlled by the rotator cuff. 

Primarily they hold together the humerus and the shoulder joint in its position throughout all the different ranges of motion that you use your shoulder to make.

What Is Shoulder Conditioning After a Rotator Cuff Injury?

Shoulder conditioning after a rotator cuff injury is the act of nursing and treating the shoulder through exercises and physiotherapy to reduce further damage and quicken the recovery time of the rotator cuff so that normal use of the rotator cuff can resume. 

These exercises intend to gradually rebuild the strength in the muscles and tendons of the rotator cuff, slowly increasing the strength of the muscles, speeding up the healing process. 

 

Shoulder conditioning after a rotator cuff injury is not an overnight process. A full recovery of the rotator cuff takes time and consistent effort. 

Sticking to a regular conditioning plan after your rotator cuff injury is the surest way to get your shoulder back to full health in the shortest time. It should be followed religiously by anyone who has recently injured their rotator cuff.

 

How Can I Condition My Shoulder After a Rotator Cuff Injury?

You can condition your shoulder after a rotator cuff injury by following these simple conditioning exercises described below. Remember to drink lots of water, eat well and take vitamins that improve your body’s natural healing ability, such as Vitamin C.

Watch this video for some easy rotator cuff exercises that you can do at home or at the office:

Alternatively, we’ve listed out the steps for various other exercises to help condition your shoulder after a rotator cuff injury.

External Rotation with Arm Abducted 90°

You will need an elastic stretch band of a comfortable resistance for this exercise. Depending on how bad your rotator cuff injury is, you can get a few of various resistances and test out which ones feel better for you. Start with the lowest resistance and then move up. 

  1. Make a 3-foot-long loop with your elastic stretch band and tie the ends together. Attach the loop to a fixed object such as a large table leg. You’ll want the object you are connecting it to to be immobile and not shift or move at all. Doorknobs may also be suitable, but you will need to make sure that the door is closed and that you are pulling in the opposite direction required for the door to swing open.
  2. Stand straight facing the object the band is tied to, hold the band and bend your elbow at 90° and raise to your shoulder level. This would mean that your elbow will be at your shoulder level with your arm facing outward in front of you.
  3. Now, while keeping your shoulder and elbow level with each other, pull back on the band until your hand is up to the same level as your head. Slowly return your hand to the starting position after this.
  4. Do 3 sets of 8 repetitions each time and do this 3 times per week as the exercise becomes easier to perform progress to 3 sets of 12 repetitions.

 

Internal Rotation

As with the previous exercise, you will need an elastic stretch band of comfortable resistance. Test which one feels best and then move up if necessary. 

  1. Make a 3-foot-long loop with your elastic stretch band and tie the ends together. Attach the loop to a fixed object such as a large table leg. You’ll want the object you are connecting it to to be immobile and not shift or move at all.
  2. Stand straight and parallel to the object that you tied the band to. This means that the object will be on your side with the elastic stretch band pulled away and your arm bent 90° as if you were holding a mug at your waist. The arm you are using should be the one closest to the object tied to the band.
  3. Now, while keeping your elbow close to your waist, bend your arm inwards and towards your body while keeping it straight. Slowly return your arm to the starting position after this.
  4. Do 3 sets of 8 repetitions each time and do this 3 times per week as the exercise becomes easier to perform progress to 3 sets of 12 repetitions.

 

External Rotation

As with the previous exercise, you will need an elastic stretch band of comfortable resistance. Test which one feels best and then move up, if necessary. 

  1. Make a 3-foot-long loop with your elastic stretch band and tie the ends together. Attach the loop to a fixed object such as a large table leg. You’ll want the object you are connecting it to to be immobile and not shift or move at all.
  2. This exercise is very similar to the previous movement, with the first difference being that the arm you will be using will be the arm that is furthest away from the object tied to the band.
  3. The second difference is that instead of moving your arm inwards towards your body, you move it outwards away from your body and to your side. Make sure to squeeze your shoulder blades together when moving your arm away from your body. Slowly return your arm to the starting position after this.
  4. Do 3 sets of 8 repetitions each time and do this 3 times per week as the exercise becomes easier to perform progress to 3 sets of 12 repetitions.

 

When Should I See a Doctor for a Rotator Cuff Injury?

You should see a doctor for your rotator cuff injury if your injury does not improve after the first few days or so and if you experience great difficulty raising or sleeping on your arm. This could mean that your rotator cuff is torn, and shoulder conditioning may not improve your situation.

Treatment Options For Massive Rotator Cuff Tears | PhysioActive Talk

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Date and Time: April 30 2021, 12:30pm – 2:00pm
Guest Speaker: Dr Desmond Ong, Consultant Orthopaedic/Shoulder Surgeon at Shoulder Elbow Orthopaedic Clinic

Dr Desmond Ong joined our partners at PhysioActive to discuss rotator cuff tears and how they are a common cause of shoulder pain.

Rotator cuff tears become more common with age and can rob many of their ability to do the things they enjoy and their independence in their golden years. Dr Desmond touched on how non-surgical treatment options can improve one’s pain.

Learn how to better care for patients suffering from rotator cuff tears and the various treatment options available and how each option brings its own set of benefits. For more information on rotator cuff tears and the respective treatment options go to https://sportsinortho.com/.

Dr Desmond Ong, Shoulder Elbow Orthopaedic, PhysioActive, Massive Rotator Cuff Tears, Treatment Options, Insight and Evidence

Dr Desmond Ong, Shoulder Elbow Orthopaedic, PhysioActive, Massive Rotator Cuff Tears, Treatment Options

Dr Desmond Ong, Shoulder Elbow Orthopaedic, PhysioActive, Joint Preserving Options, Classic Transfers

Latissimus Dorsi Transfer – Tendon Transfer to Repair Rotator Cuff

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What Is a Latissimus Dorsi Transfer?

Latissimus dorsi refers to one of the largest muscles in your back. You may have heard it being referred to as your ‘lats’. Your latissimus dorsi, or lats, control the movement of your shoulders. 

The latissimus dorsi transfer is a treatment option for massive or irreparable rotator cuff tears. It involves the “re-routing” of the latissimus dorsi to take over the function of the torn rotator cuff. 

 

Why Would Someone Need a Latissimus Dorsi Transfer?

Rotator cuff tears result from either injury or as a result of degeneration due to overuse or age. They cause pain and loss of shoulder motion, which thus reduces the quality of lives of patients. If picked up early, these can be repaired with arthroscopic, minimally invasive techniques. 

Despite advances in technology and techniques, there remains a group of patients whose tears cannot be repaired. The following reasons contribute to tears that cannot be repaired:

  1. Large tears which have retracted and cannot be reattached
  2. Tears involving two or more muscles of the rotator cuff
  3. Tears that have been left untreated for too long. This length of time varies from individuals to individuals and may be as short as a few months 
  4. Older patients whose tendons may have degenerated beyond repair

Irreparability does not mean living with life-long pain and disability in the right hands. Hence irreparability does not mean untreatable. 

 

How Does a Latissimus Dorsi Transfer Repair a Rotator Cuff Tear?

A latissimus dorsi transfer is a specialised operation performed under general anaesthesia. The latissimus dorsi muscle is first detached from its insertion on the humerus through a small incision in the armpit. 

The muscle is then mobilised to ensure it can reach the new insertion site at the rotator cuff. The tendon of the muscle is then prepared. Finally, the tendon is attached at the rotator cuff insertion arthroscopically using minimally invasive techniques. 

 

Postoperative Management After Undergoing a Latissimus Dorsi Transfer?

Immediately following surgery, patients are placed in a sling for comfort and to reduce the pain. Additionally, painkillers will be prescribed. With modern multimodal analgesia, pain can be reduced to a tolerable level, and most patients may be discharged from the hospital after a night’s stay. 

Patients are allowed to use their hands for simple activities of daily living to reduce the inconvenience following surgery. Shoulder blade movements may commence immediately after surgery. At two weeks, stitches will be removed, and physiotherapy will begin. 

The rehabilitative physiotherapy process is similar to that for rotator cuff repairs. Additionally, the length of time needed to restore function is similar or may even be shorter.