Introduction
After rotator cuff surgery, an exercise rehabilitation program will aid in your recovery, help you return to daily activities, and eventually will lead to your return to recreational activities and sports.
This is a general rehabilitation program meant to be undertaken 4-6 weeks post-operation. Consult with your doctor or physical therapist to ensure you are ready for this program that provides a collection of stretches and exercises. However, not all exercises are recommended for all rotator cuff surgery patients. You should consult with your doctor or physical therapist before undergoing this program.
In order to regain full athletic ability, two criteria must be improved:
Muscular Strength
Strengthening the muscles that surround the Glenohumoral (shoulder) joint will keep the joint stable. This will also help prevent further injury to the joint and/or the muscles surrounding it.
Flexibility
Stretching the muscles that surround the joint will help improve your range of motion and help you return to regular daily activities. It will also prevent further injury.
Muscles targeted:
• Biceps Brachii
• Triceps Brachii
• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres muscles (minor and major)
• Rhomboids (minor and major)
• Deltoids (Posterior, lateral, and anterior)
• Trapezius
Before we begin
Here are a few pointers before you begin your workouts:
Warmup
Before beginning this program, warm up by doing light activity such as riding a stationary bike for 5-10 minutes.
Pain
Do not ignore pain, if these stretches or exercises cause pain anywhere (especially in your shoulder), consult your doctor or physical therapist.
Stretches
1. Passive external rotation
Equipment:
Hockey stick, golf club, etc.
Direct...
... middle of paper ...
...push your hips out to relieve pressure on your lower back
2. Pull cable back to your side while pulling your shoulder back and pushing your chest slightly forward
3. Slowly lower until arm is fully extended and shoulder is pulled slightly forward
4. Repeat
5. Repeat with your other arm
6. Bent over horizontal abduction
Equipment:
Dumbbell, weight bench or other, table-like flat surface
Directions:
1. Lie flat on your stomach with your target shoulder on the edge of the bench or table
2. Slowly lift your arm out to side until completely horizontal
3. Return to starting position by slowly lowering weight
Notes:
• You can place either a towel or you hand under you chin for added comfort
• This exercise can also be performed on one knee if needed
• Lift your arm no higher than the level of your body
• Keep your palm facing down throughout the entire exercise
Many factors like patients age, symptoms, size of the tear, and nature of onset (traumatic or degenerative) are responsible for determining the prognosis of the physical therapy treatment 9. Since it’s a partial thickness tear of the rotator cuff, the non-operative treatment is reasonable unlike, a full thickness tear where surgery will be required to treat the patient 9. The patient shows symptoms of moderate irritability without significant functional deficit which makes him a good candidate for conservative treatment 10. The pain reported by the patient is 6/10 so the patient participates well in physical therapy exercise to increase shoulder strength, and flexibility. There was a study done from Finland which asserted that physical therapy alone can produce results which are equal to those produced by arthroscopic surgery and open surgical repair in cases of rotator cuff tears 11. In this case, with three weeks of physical therapy the patient has showed a decrease in pain and reported it as 4/10 on pain rating scale and showed improvements in abduction (140̊) and external rotation (65̊). The MMT for shoulder abduction was 4-/5 and external rotation is still same as
... It is not completely clear how it is that a tendon becomes a ligament, although Dr. Akizuki thinks that range of motion exercises help the tendon learn that it is being used as a ligament now and that it needs to adopt. Surgeons don't go back in to biopsy the repaired elbow to see how the tissue has changed, but follow-up MRIs show that the new tissue is acting as a ligament should.
Witvrouw, E., Mahieu, N., Roosen, P., & McNair, P. (2007). The role of stretching in tendon injuries. British journal of Sports Medicine , 224-226.
A rotator cuff is simply a group of four tendons and muscles that are located right on the shoulder and on top of the humerus bone. (Source 1) The rotator cuff is what controls the shoulder and allows it to move and be mobile. The four main muscles that consist of the tendons are the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. (Source 2). Too much wear and tear on these muscles (such as too many thrown fastballs) is precisely what causes the rotator cuff to begin to tear, as well as swelling in the tendons.
The four progressive resistive exercises I chose are, Thera-band tubing shoulder flexion, Thera-band shoulder diagonal, Thera-band shoulder Extension, and Thera-band shoulder external rotation at 90 degrees.
Graston instrument-assisted soft tissue mobilization (GITSM) is a tool used by therapists and chiropractors to help break up the scar tissue and replace it with fibroblast, allowing for faster recoveries (Black 2010). A series of heat, GISTM, strength and flexibility training are required (Black 2010). Numerous studies have been conducted, by certified therapists qualified in GISTM, to examine the styles and recovery periods after an injury. After going through the treatment, patients are measured by their range of motion (ROM) to see if the treatments were effective or not (Black 2010). ROM can vary depending on the region of the body that is being treated, but the overall goal of GISTM is to allow a person to get back to the regular routines they had before their injury.
There are some misconceptions though about the after part of the surgery.... ... middle of paper ... ... Months 8-14: You will now be able to start practicing in baseball conditions and gradually return to competition. It is a very long process as you can see and normally takes a pitcher a good full season to feel as good as you did before the injury.
One of the functions of the rotator cuff muscles and the long head of the biceps, is to pull the head of the humerus down from the acromion process, to prevent impingement. Strengthening the subscapularis, infraspinatus and teres minor can help with this function. Dr. Fishman discovered a technique when doing yoga and experienced relief of his own rotator cuff pain.
Exhale and bend your left knee over the left ankle, causing the shin to be perpendicular to the floor.
Rotator cuff tear – The muscles adjoining the shoulder joint are required for rotating the shoulder, amid other movements. The tendons of these muscles furthermore influence the structural strength of the shoulder joint. Harsh, rapid actions, for example in tennis and baseball, can result in tearing of one of these tendons. This then causes pain as well as a decline in range of motion. Surgery possibly will be necessary to repair a torn
Stand with the feet shoulder width distance apart and place two kettlebells either side of your feet. The entire body is in alignment with the head and neck neutral, the pelvis level and the spine tall.
· Take the arm over your head keeping your elbow as close to your ears
Getting the support muscles of my legs in shape is one good way to lower the risk of knee injury. Therefore, a good conditioning program is needed. Exercises are certainly one answer, but all too often people consider exercise and activity as being synonymous. A good exercise regimen will provide overall muscular improvement.
typically remove bone spurs from the underside of the acromion; this procedure is also known as an acromioplasty (Armstrong, 2017). The next surgical procedure that surgeons use is an arthroscopic repair. An arthroscopic repair is when the surgeon inserts a small camera into the glenohumeral joint. The camera displays images on a screen in order for the surgeon to guide miniature surgical instruments through small incisions. Most surgeons prefer this method because it is not invasive and the small camera can move around to see if all the structures in the shoulder are good and do not need to be addressed. Also the arthroscopic approach spares the deltoid muscle from being detached. The final option called the mini open repair uses newer technology
Six participants had land-based exercises, and twelve participants did a combination of land-based and aquatic exercises. The study outcome was measured by the Western Ontario Rotator Cuff scores and the range of motion measure.14 The results showed that aquatic therapy improved range of motion measures at pre-surgical, three weeks, six weeks, twelve weeks, and post-surgical. 14 The Study proved land-based and aquatic physical therapy exercises after rotator cuff repair is a good therapeutic intervention. Burmaster, Eckenrode, and Stiebel did a case study on one participant with an arthroscopic rotator cuff repair. The outcomes were measured by Penn Shoulder Score, Disability Index, and the Shoulder Pain. The participant did physical therapy sessions three times a week with eight land-based sessions and ten aquatic sessions. The participant pain level at rest was at four out of ten in the initial evaluation, and with activity nine out of ten. The results showed the shoulder range of motion and strength increased over the study.15 Also, the pain at a resting level went to two