Oftentimes it is difficult to realize you’ve sustained a rotator cuff injury because it is more often than not a chronic injury that develops. However in the latter stages of the injury, if nothing is done, a more severe rotator cuff tear can happen which will obviously require much more attention to treat (even surgery if severe enough). This is why it is important to start physical therapy for a rotator cuff injury as soon as any discomfort – however mild – shows up. Better yet, perform exercises for rotator cuff before even the problem occurs.
In the initial stages once you’ve recognized the injury – depending on the severity – if you can still easily move and rotate your arm you should keep it active but give it some recovery time. Stop any weight training involving the shoulders or any activities that load the shoulder. Work on your shoulder’s mobility over the next week (or more – you be the judge) and do not over-exert it. The shoulder is designed for maximum mobility at the expense of stability. It is for this reason that we should concentrate on keeping and perhaps increasing mobility while the rotator cuff injury repairs itself.
Allow the muscle to rest during this time but allocate a bit of time each day to moving the joint:
- Start with arm small arm circles and slowly increase it larger circles without aggravating the shoulder too much.
- Hold your left arm up 45˚ at your side and extended with your hands open. Point your thumb upwards. At the same time position your right arm 45˚ downwards with your thumb pointing down. Now bring them across your body in a straight line that connects both hands and as you do, switch your thumbs from up to down and down to up. Repeat several times and perform the opposite motion fo the other side.
- Swing your arms across your body in front of you.
- Swing your arms upwards as high as you can and try and increase range of motion gradually.
At least 3X/week, perform a general warm up to get your blood flowing and increase your body’s temperature – a light sweat is usually a good sign. Perform the above mobility drills and attempt at increasing the range of motion without too much pain.
Now is the time to stretch.
Stretch the chest and anterior deltoid (this should be prioritized over the others)
Stretch the lats
As the pain starts to subside a bit, continue the above regimen and start to perform high rep (on the order of ~100 reps) external rotations with some tubing. Increase the frequency if it is well tolerated.
When you’re ready, you can increase the load on your external rotations (just back up if your using elastic resistance like tubes or bands). The next stage is to strengthen the shoulder’s surrounding musculature to reinforce the joint’s stability. Make sure to continue the stretching and mobility exercises. The strengthening exercises will be given in a separate post because they can and should be included for prehab and not just treatment.