Rotator Cuff Strain Rehab

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This rehabilitation program is based around three stages from immediately post injury through to full competition recovery.

Rehabilitation of rotator cuff injuries consists of four elements; reducing the initial pain and inflammation, identifying and correcting any shoulder abnormalities that might increase the chance of rotator cuff injury, regaining full shoulder mobility and strengthening the rotator cuff muscles.

1. Reduce the pain and inflammation

  • This should begin immediately post injury and continued until normal daily activities are pain free.
  • Apply cold therapy or ice to the shoulder. This will help reduce pain and inflammation. Apply ice for up to 15 minutes every 2 hours, gradually reducing the frequency of applications as the shoulder improves. Specialist cold therapy wraps for shoulders can be bought which apply compression to the area as well. Otherwise a simple ice pack applied with some pressure will be effective.
  • Rest the shoulder. Do not do anything that causes pain. Every time you cause pain, you are making the injury worse. If you need to use a sling to restrict movement then do so but only for a few days.
  • NSAID's or anti-inflammatory medication (e.g. ibuprofen) may help in the early stages although it is argued they are not as effective later on or if the injury becomes chronic. Always check with your Doctor before taking medication if you are not sure.
  • Apply sports massage therapy. Simply applying pressure to the tendon initially may be all that is needed. As pain reduces, a massage therapist may apply cross friction techniques.

2. Identify possible causes

The chance of the injury recurring are increased by any of the following:

  • If you have an unstable shoulder joint. An unstable shoulder joint means that there is a lot of movement and weakness in the joint. If you are not sure, see a sports injury professional. Failure to recognise this may mean the injury is likely to recur.
  • If you have poor technique or bad training habits. Overuse or training too hard is just as likely to cause injury as poor technique. If you are not sure, find a good coach.
  • If you have weakness in the rotator cuff muscles
  • If you have poor posture.

3. Range of motion and strength

  • This stage usually starts from between 5 and 7 days post injury.
  • Improving range of motion is achieved through mobility exercises. These involves gradually increasing the range of motion the joint will go through without pain and specific stretching exercises to stretch all muscles around the shoulder joint.
  • Sports massage techniques can help to improve greatly the condition of the rotator cuff muscles, therefore allowing more joint flexibility and better response to strengthening exercises.
  • Strengthening exercises concentrate more specifically on the external rotator muscles (the ones that rotate the arm out) and the scapular stabilisers (muscles that support the shoulder blade). It is also important to strengthen the whole joint.
  • Strengthening exercises should only be done if they are pain free and in conjunction with stretching exercises.

4 - Return to competition

  • These exercises need to be specifically tailored to the athletes sport. For example, throwers would start throwing a tennis ball against a wall in five sets of 20 throws, gradually increasing the number of sets and number of repetitions assuming no pain during, after or the next day.
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