This spotlight on injury will answer the most frequently asked questions about rotator cuff tears. You will also see some basic exercises used to rehab a tear or prevent a rotator cuff injury from progressing to a tear.
Q: What is a rotator cuff tear?
A: A rotator cuff tear is a tear of one or more of the tendons of the four rotator cuff muscles. A rotator cuff tear or injury is typically related to degeneration, instability, trauma, overuse and diminished strength – all associated with the aging process. However, younger individuals are also at risk for injury if they are involved in repetitive overhead sports or activities.
Q: What are the risk factors for a rotator cuff tear?
A: There are some risk factors for a rotator cuff tear that we can not change like body mass index and height and muscle degeneration. Other risk factors are activity based. Recurrent lifting and overhead motions are high on the list. People who have jobs that involve a lot of overhead work like, carpenters or painters, are at risk. So are people who play sports that involve overhead motions like swimming, baseball, tennis, and football quarterbacks. Functional athletes or people performing overhead lifting with heavy weights also have an increased chance for this injury.
Q: What is the rotator cuff?
A: The rotator cuff consists of four small muscles, which form a sleeve around the shoulder. these four muscles known as the supraspinatus, infraspinatus, trees minor and subscapularis allow us to raise our arm overhead effectively. They depress the head of the humerus (the ball in the ball & socket joint) and oppose the action of the larger deltoid muscle group. These muscles also have an important job of rotating the upper arm inward and outward. This is called internal and external rotation and will be shown in the rotator cuff exercise section below.
Q: What are the signs & symptoms of a rotator cuff tear?
A: The most common symptoms of a rotator cuff injury are:
1) The inability to raise the arm overhead
2) Pain with raising the arm overhead
3) Severe night pain especially when lying flat in bed.
Q: How does a rotator cuff tear occur?
A: A rotator cuff tear can occur following a trauma such as a fall. It can also happen as a result of “wear & tear”. In this case, you may have had pain or symptoms from a milder rotator cuff injury such as tendonitis before the actual tear occurred.
Q: How is a rotator cuff tear diagnosed and treated?
A: A rotator cuff tear can be diagnosed through a series of special tests performed by a physical therapist or physician. The diagnosis can then be confirmed by a MRI or diagnostic ultrasound. Once diagnosed, the choice is made to rehab the shoulder with physical therapy or to have surfer. This decision is made based on the size of the tear, your age, and your activity level.
Q: How long does it take to recover from a rotator cuff tear?
A: Patients who choose conservative physical therapy rehab will generally participate in a 2-3 month rehab program. Continual strengthening will then be recommended to maintain the strength of the shoulder over time. For those who undergo a surgical repair of the rotator cuff, the protocol usually entails 3-4 months of therapy following surgery. Typically, patients report being back to their activities of choice 4-6 months after their surgery.
Q: What are some common rotator cuff exercises?
A: These exercises represent the most commonly prescribed exercises for rehabing rotator cuff tears or preventing them. If you have had surgery it is important to perform these exercises at the correct time period following your surgery and under the supervision of a medical professional. Also remember to stop and contact a physical therapist or physician if you experience any increase in pain with these exercises.
1) Shoulder external rotation: Lie on your unaffected side. Place a towel roll between your top elbow and your side. With your elbow bent to 90 degrees, slowly lift your hand up towards the ceiling. You can use a small weight or soup can for resistance. Don’t let your arm come off the towel roll. Repeat 10 times and perform up to 3 reps.
2) “Y’s” & “T’s”: Lie on your stomach with your head at the corner of a bed so your arms are hanging down. Lift your arms up towards the ceiling at a 90 degree angle from your body. (Your arms are crossing your body like a “t”). You can vary this exercise by pointing your thumbs up or down. You can also repeat this exercise bringing your arms slightly in front of you like you are making the letter “Y” with your body. Repeat 10 times with a small weight. Perform 1-3 reps.
3) Wall Angels: Stand with your back against the wall. Place your elbows and back of your hands against the wall. Move your arms up and down with a bend in your elbow. Do not let your back come away from the wall. Repeat 10-15 times
4) Corner Stretch: Stand in a corner with one foot in front. Place each forearm on a wall and lunge forward to feel a stretch in your pecs/chest area. Hold 10 seconds and repeat 5-10 times.
5 ) Sleeper stretch: Lie on your affected side with your arm in front of your body. Use your top hand to gently push your bottom hand toward the floor or bed until you feel a stretch. Hold for 10-30 seconds and repeat 3-5 times.
6) Empty Can exercise: Stand with legs shoulder width apart. Hold a light weight in your hand and lift your arm at a 45 degree angle with your thumb pointing down. Repeat 10 times and perform up to 3 sets.
If you have specific questions about your shoulder recovery or pain please feel free to contact one of Landmark Physical Therapy’s Scottsdale therapists at (480) 661-1124 or email email@example.com. Or click here to request a free 15 minute injury screen by a licensed physical therapist.