Exercises for rotator cuff injuries
Treatment of inflammation of the rotator cuff begins with an accurate diagnosis to rule out a tear of the cuff, followed by a combination of anti-inflammatory and strengthening exercises. Stretching of the shoulder rotator cuff muscles is performed both as treatment for inflammation and as a warm up before activity. Specific stretches are targeted to the desired activity. The physical therapist can help with this. Strengthening of the shoulder rotator cuff muscles is best performed by isolating each muscle group and selectively training that muscle. The subscapularis is the anterior stabilizer of the rotator cuff and responsible for internally rotating the shoulder. It is best strengthened by holding a light hand weight (about 3 pounds or less to start) in front of the body, with the arm flexed to 90 degrees, and rotating the hand to touch the belt. The exercise can be performed while lying on your back with the elbow close to your side and flexed ninety degrees. Lift the weight until it is pointing toward the ceiling and then lower it slowly. The supraspinatus is strengthened by holding a light weight (initially 3 lbs or less) out straight in front of the body, with the thumbs pointed toward the floor. If 3 pounds seems too heavy use soup cans instead. Slowly elevate the weight to above the head. Stop if pain is produced in any portion of this motion, as the rotator cuff is under maximal stress in this position. The infraspinatus is strengthened by holding the weight in a vertical position in your fist with the elbow bent at 90 degrees. By rotating the arm from the neutral straight ahead position, to the externally rotated (out to the side) position, the infraspinatus and teres minor are strengthened. Again, this exercise can also be performed while lying on your side with the elbow close to your hip, and flexed ninety degrees. Rotate the weight until it is pointing toward the ceiling. Shoulder exercises are best performed with relatively light weights and multiple repetitions. The reasoning behind stretching and strengthening the inflamed rotator cuff in order to speed healing and functional performance is as follows: inflamed tissue has increased fluid between the cells (edema), increased numbers of new blood vessels and inflammatory cells. As a result of this inflammatory reaction, new collagen tissue is laid down in an effort to heal the injured tissue. If the shoulder is immobilized during this time, the new collagen is laid down in a disorganized fashion, creating scar. The goal of gentle stretching, strengthening and anti-inflammatory medication, is to stimulate the cells to lay down collagen along the lines of stress, forming normal strong tendons, with a minimum of disorganized scar tissue. The combination of a good warm up, gentle stretching, strengthening below the limits of pain, icing after working out and anti-inflammatory medication has been consistently shown to speed recovery time in the best possible fashion. For more information on rotator cuff tendonitis, visit our sister site:
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