The rotator cuff, comprising four muscles – the supraspinatus, infraspinatus, subscapularis and teres minor – plays a role in each and every movement of the shoulders. Factors like overuse, repetitive arm movements, inadequate strengthening as well as muscle weakness and imbalance can cause rotator cuff injuries, which severely limit the range of motion of the arms. Rehab for rotator cuff injuries requires a phased approach, say experts.
People of all ages may develop rotator cuff injuries, and some are more prone to them than others, says Kochi-based sports medicine consultant, Dr Sidharth Unnithan.
“People who repeatedly do household chores without taking breaks, those who lift weights incorrectly or those with metabolic disorders like diabetes or thyroid problems are all susceptible to rotator cuff injuries in the absence of any kind of strengthening exercise,” adds Dr Unnithan.
Rehab for rotator cuff injuries
When the first signs manifest in the form of shoulder pain and difficulty moving your arms in specific directions, seek professional help.
Rehabilitation for rotator cuff injuries involves a progressive approach that includes pain management and exercises. “In both acute and chronic cases of rotator cuff injuries, we first employ modalities to subside pain and edema [swelling caused by fluid buildup in the tissues, which is a secondary symptom in some cases of rotator cuff injuries]. Then, we go for exercises,” says Sumananand Jha, a physiotherapist and certified structural integrator from Dhanbad, Jharkhand.
“In acute conditions, modalities like icepacks or transcutaneous electrical nerve stimulation [TENS, a technique that uses low-voltage electric currents to treat pain] are used to reduce pain and edema. In chronic situations, contrast bath therapy [which involves taking baths in warm and cold water] as well as alternate heat and cold compressions are used,” adds Jha.
Whether chronic or acute, exercises are crucial in the treatment of rotator cuff injuries as they strengthen the muscles surrounding the shoulder joint and enhance its stability and functionality.
Exercises for rotator cuff injury
According to experts, exercises that are essential for overcoming rotator cuff injuries include:
♦ Scapular exercises: Scapular exercises are crucial in the rehabilitation of rotator cuff injuries. “The scapular muscle group, located opposite your rotator cuff, provides support to it. Most rotator cuff injuries, particularly tears and strains, can be avoided by focusing on scapular exercises,” says Dr Unnithan.
Scapular retraction, scapular depression, scapular protraction, scapular clocks and scapular wall sides are some of the commonly recommended scapular exercises for rotator cuff injury rehabilitation.
♦ Codman’s pendulum exercise: Codman’s pendulum exercise works on the idea of using gravity to help move the shoulder joint through its range of motion without actively engaging the shoulder muscles.
Explaining how to perform the exercise, Jha says, “Stand or sit with your feet shoulder-width apart. Keep your injured or affected arm relaxed and hang it down by your side. Finally, let the arm sway gently in a small circular motion.” Beginning with small circles, you can gradually increase the circle size as you get comfortable, he adds.
♦ Shoulder capsule stretch: In most cases of chronic rotator cuff injury, the shoulder capsule can become tight, resulting in pain. This exercise improves circulation and gently mobilizes the shoulder joint, which can speed up the healing process.
Stretching the shoulder capsule can be done in diverse ways, including cross-body and behind-the-back stretches. You can figure out what is appropriate for you and stick to it with the help of your physio or doctor.
Progressive resistance is crucial
Even though exercise is essential for healing rotator cuff injuries, it is crucial to consult a specialist to determine the ideal exercises for your specific case. The type of exercise to undertake depends on the severity of the injury and the strength of the muscles. Adopting the wrong exercise can aggravate the injury.
“People start resistance workouts by lifting weights whenever they have pain because they think there is muscle weakness,” says Jha. “Doing resistance exercises without healing the tendon can worsen a rotator cuff injury. Hence, it is important to advance the workouts gradually with a professional’s help.”
Adhering to the principle of progressive resistance should take precedence while exercising for rotator cuff injuries. Progressive resistance refers to the process of gradually increasing the level of resistance or load while performing the exercises, which helps you regain strength and function.
“It helps you to progress and increase the resistance based on variables like the level of pain, comfort and strength,” says Dr Unnithan. “All these variables vary from person to person. For instance, my strength may vary from your strength, and what is comfortable for me may not be comfortable for you. Based on the individual levels, your doctor or physiotherapist advises you on progressing with your exercise.”
- Rotator cuff injuries significantly restrict your arm movement. They are caused by overuse, muscle weakness, repetitive arm movements and muscle imbalance.
- Exercise is essential in the rehabilitation of rotator cuff injuries as it strengthens the muscles that surround the shoulder joint and improves its stability and functionality.
- Experts recommend scapular exercises, Codman’s pendulum exercise and shoulder capsule stretch to rehab rotator cuff injuries.
- While exercises are essential, it is crucial to consult with a professional to find the appropriate exercises and their progression for your specific case.