A rotator cuff tear in the tendons or shoulder muscles can cause pain and limit movement. It is a common injury, especially among athletes and people who do repetitive overhead activities. When these muscles and tendons are torn, it can cause pain and limit the movement of the shoulder.
Physical therapy is an important part of treating rotator cuff tears. Physiotherapy for rotator cuff tears can help restore flexibility and strength to the shoulder and help with the recovery process after rotator cuff surgery.
Physical therapy can also help with pain management, range of motion, and strengthening exercises. Additionally, rotator cuff tear physical therapy can help with activity-specific exercises to help prevent re-injury.
This article will discuss physical therapy for rotator cuff tears. So, without further ado, let’s discuss the exercises and rehabilitation process for the condition, which is discussed in detail below.
Initial Assessment and Diagnosis
During an initial assessment, a physical therapist will conduct a comprehensive physical examination of the patient. It may include tests to assess the patient’s range of motion, strength, balance, and coordination. The therapist may also evaluate the patient’s posture and gait and any pain or discomfort the patient may be experiencing.
Once the physical therapist has gathered this information, they can develop a personalised treatment plan tailored to the patient’s needs. This plan may include rotator cuff tear exercises, stretches, and other therapeutic interventions to improve the patient’s mobility, strength, and overall physical function.
Now, let’s discuss the tests and evaluations a physical therapist may perform to assess a rotator cuff tear.
- Range of Motion Test
This test evaluates the patient’s ability to move their shoulder in various directions. The therapist may ask the patient to raise their arm, out to the side, and behind their back and will assess how far the patient can move their arm without pain or discomfort.
- Strength Test
This test evaluates the patient’s shoulder strength. The therapist may ask the patient to push against their resistance or lift weights to assess their strength.
- Impingement Test
This test assesses impingement syndrome, a common condition in patients with rotator cuff tears. The therapist may ask the patient to raise their arm and will assess for any pain or discomfort that may occur as the arm is lifted.
- Diagnostic Imaging
In some cases, a physical therapist may use diagnostic imaging, such as an MRI, to get a more detailed view of the patient’s shoulder and assess the extent of the rotator cuff tear.
Early Stage Rehabilitation
Early rotator cuff tear rehabilitation aims to limit tissue damage, relieve pain, control the inflammatory response, protect the affected area, and restore the range of motion and function.
It is achieved through rest, immobilisation, medication, physical therapy, and other non-invasive treatments. The primary focus is promoting healing while preventing further injury to the affected area. Ultimately, the goal is to restore the full range of motion and function to the shoulder.
In early-stage rehabilitation, rotator cuff tear exercises and stretches are typically used to restore range of motion, increase strength, and improve flexibility. These exercises can be broken down into three categories:
- Range of Motion Exercises
Range of motion exercises involves moving the joints through their full range of motion to increase flexibility and reduce stiffness. Range-of-motion exercises include shoulder circles, wrist flexion and extension, ankle rotations, and knee bends. These rotator cuff tear exercises can be done standing or lying down and can be performed with or without resistance.
- Isometric Exercises
These exercises involve muscle contractions without moving the joint. These exercises build strength without putting too much stress on the joints. Examples of isometric exercises include wall sits, planks, and glute bridges.
- Soft Tissue Mobilization
Soft tissue mobilisation involves massage or other techniques to improve blood flow and reduce muscle tension. Examples of soft tissue mobilisation techniques include foam rolling, trigger point therapy, and myofascial release. These techniques can be performed using a foam roller, lacrosse ball, or other tools and targeted to specific muscle groups.
Intermediate Stage Rehabilitation
The intermediate stage rehabilitation of rotator cuff tears aims to achieve several goals. The first goal is to restore a full, pain-free range of motion in the shoulder joint. It is achieved through stretching and mobility exercises designed to increase flexibility and reduce stiffness.
The second goal is to achieve muscle balance by strengthening the rotator cuff muscles and the muscles that control the scapula. It helps to ensure that the shoulder joint is stable and functions properly, reducing the risk of further injury.
The third goal is to improve scapulothoracic and glenohumeral muscular control and stability. It involves exercises focusing on the muscles that control the scapula and the shoulder joint, improving their strength and coordination.
A few rotator cuff tear exercises and stretches can help rehabilitate rotator cuff tears at an intermediate stage. Some strengthening exercises include shoulder presses, lateral raises, and bent-over rows.
Neuromuscular re-education exercises such as shoulder blade squeeze, wall slides, and scapular retractions are also recommended. Additionally, stretches like the sleeper stretch, shoulder shrugs, and arm circles can be helpful.
Late Stage Rehabilitation
Late-stage rotator cuff rehabilitation tears typically restore the shoulder joint’s range of motion, strength, and function.
Regarding late-stage rehabilitation for rotator cuff tears, the main focus is getting your shoulder joint back to normal. It involves a two-pronged approach: advanced strengthening exercises and functional exercises.
Advanced strengthening exercises like V arm raises are often used to target a wide range of muscles in the shoulder girdle. Sleeper stretches are also employed to engage the infraspinatus and teres minor muscles.
Functional exercises, on the other hand, are designed to help you regain movement and function in your shoulder joint. Examples include ball throwing, commonly used in sports like baseball and cricket and using a racket, which is popular in tennis, badminton, and squash.
Conclusion
Physical therapy can help relieve pain, improve strength, and restore shoulder joint mechanics. Physical therapy exercises can help restore flexibility and strength to the shoulder and can be just as effective as surgery in some cases.
Rotator cuff tear exercises may include a range of motion, rotator cuff strengthening, and shoulder blade stability exercises. Cortisone injections and anti-inflammatory treatments are also used in addition to physical therapy.
Patients should seek out physical therapy as part of their recovery process for rotator cuff tears. Physical therapy can help reduce pain, improve strength, and restore shoulder joint mechanics. It is important to work with a physical therapist to ensure that the exercises are tailored to the specific location of the tear.