Rotator Cuff Exercises

To recover full use of your shoulder requires both Stretching and Strengthening exercises.  You must be committed to both in your efforts to regain your life.

First, Stretching

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Now that you are in recovery, you know that the tissues of your shoulder are weak, painful, and frankly, just want to be left alone.   After all, haven't they already gone through enough?  Misled by the pain of movement, you may think you need to nurture the injury until the pain stops.  However, you must start movement, and then stretching, as soon as possible. That's why they have you doing those little circles with your arm immediately.  Your doctor will confirm what you can and cannot do, but the sooner you begin stretching, the better.  If you wait, scar tissue and other things will work against you to restrict your ability to fully recover. 

If you had extensive surgery, the contracture (shortening) of the muscles is extensive, and every movement feels like it will reopen the wound.  Again, a quick conversation with your doctor or therapist will most likely confirm that you won't.  Waiting for the pain to go away by itself so that you can THEN start stretching is a very bad idea.  To achieve the necessary results, you will need to work through it.  Of course your pain medications will help.  However, this will likely be one of the most uncomfortable experiences of your life.  Nevertheless, you will be motivated to press forward by two things:  First - regaining full mobility and your life.  Second, the knowledge that, as soon as you stop stretching at the end of each session, the discomfort will stop - in other words, it's only temporary.

The therapist will work with you on his or her table, pivoting you shoulder in several directions to lengthen each of the damaged tendons.  The challenge, of course, is that the therapist is counting on you to tell him when it is no longer bearable.  The only pain he can feel is when you slug him after he's taken you past your limit.  Also, he can only work so long on any given patient.  Hmmm, wouldn't it be nice if you had a self-therapy device
 that would aid you to regulate the intensity, duration, and frequency of such sessions?


Then, Strengthening

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Now that you have begun stretching, you may even be able to reach your arm above your head - if you're laying down.  However, if you cannot do this while standing, it's because the muscles are weak.  Isn't it amazing how many months and years are required to build muscle, but that you can appear to lose it all after only a couple weeks of non-use?  The good news is that you WILL regain your muscle, and much quicker than it took the first time - as long as you take ownership of your recovery and add strengthening exercises to your stretching routine.

Below are some of the key movements that you can employ to exercise each of the four Rotator Cuff muscles.  There are an extensive array of YouTube videos out there, so I am not going to try to reproduce them here, but have linked to one or two of them that I thought were most useful in describing the movements that must be employed.  These come and go, so the link(s) my change over time.

Though your physical therapist will have the use of much equipment at their office, they will also provide you with different strength rubber bands to use for your home therapy.  Take advantage of these in employing the exercises below.  Remember, the therapist gets paid whether you recover or not.  You need to be doing these strengthening exercises, just like the stretching exercises, a couple times a day if you are to see the progress you are now determined to achieve.


The Exercises
As with most repetitious exercises, 3 sets of 10 reps is a good goal, but consistency is more important that working up a sweat at this point.  If you cannnot do many repetitions or sets in a single session, but can exercise multiple sessions in a day - that's good.  Your progress will equal, or exceed, that of someone who works it hard, but only once a day.

The list below is by no means comprehensive.  Based on your particular injury, your therapist will no doubt have different or additional exercises for you to focus on.  However, the ones below are the standard set of exercises for this therapy, and they can be employed by patients at home.  Once you understand the movements involved and the muscles targeted, you will be able to employ variations of these movements to other equipment - like when you use equipment at the gym.


Single Video - 6 Exercises

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This video by 'Tim the Therapist' is quite compelling in its simple use of a rubber band to accomplish all of these basic strength movements.  These rubber bands come in different strengths, so you may want to get a couple different ones.  Please open the video and follow along with the explanation for each of them below.  And yes, Tim, we can see you just fine.

1) Adduction

Starting position: Arm extends straight out from the side, thumb up.
Movement: Pull against resistance straight down to your leg, keeping the elbow straight and the thumb in the up position.
Focus: Subscapularis  (angle 1)

2) Extension

Starting position: Arm extends straight out in front of you, thumb up.
Movement: Pull against resistance straight down to the side of your leg, keeping the elbow straight and the thumb in the up position.
Focus: Subscapularis (angle 2)

3) Internal Rotation

Starting position: With your arm down and at your side, raise your elbow with the palm open and up - just like when you're asking your daughter to hand over the car keys.  Your elbow will be tight at your side, but your forearm, with the upright palm, will now be pointed directly forward.
Movement: With the band anchored at waist level to your side, pull the arm straight across your waist until it rests across the front of your stomach.
Focus: Subscapularis  (angle 3)

4) External Rotation

Starting position: Same as for the Internal Rotation (#3) except that you are facing the opposite direction now since you will be rotating out instead of in.
Movement: Keeping your elbow anchored at your side, rotate the arm from in front of you to straight out to the side.  Though you will try to keep your elbow tucked at your side, you well need to let it move out a little in order to get the fullest rotation.
Focus: Infraspinatus & Teres Minor

5) Abduction

Starting position: Arm straight down at your side, thumb pointed out away from your body.
Movement: This is basically the opposite movement of #1, Adduction - this is Abduction. Lift your arm straight up out to your side.  The elbow must remain straight, and the thumb pointed up.  Note: It's very important that the shoulder not come up during this exercise.  Doing it in front of a mirror, watch yourself lift the arm until it's level with the floor while concentrating on keeping the shoulder level with the other one.
Focus: Supraspinatus (angle 1)

6) Flexion

Starting position: Arm straight down at your side, thumb pointed away, in front of you.
Movement: Lift your arm straight up in front of you until it is level with the floor - you needn't raise it above your head.  The elbow must remain straight, and the thumb pointed up.  Note: as with the Abduction movement (#5), the shoulder must not come up during this exercise.
Focus: Supraspinatus (angle 2)

If you would like to hear about my experience, and what helped me, please read on...
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