In the United States approximately 17 million people struggle with rotator cuff tears. Often, pain and an inability to raise the arm overhead becomes debilitating.¬† Both surgery and physical therapy are effective ways to treat small and massive rotator cuff tears.¬† Many factors, including the size and characteristics of your tear, determine your best course of treatment.
Older tears involving multiple tendons are classified as massive.¬† Not all massive rotator cuff tears can be repaired with surgery. Sometimes there is not enough healthy tissue left. In these cases, you are told to live with the pain.¬† However, there is now evidence that certain exercises can help people with massive rotator cuff tears.¬† This article describes how you can get started feeling better.
Physical Therapy Decreases Pain from Massive Rotator Cuff Tears
Would you prefer to avoid the risks associated with surgery?¬† Or maybe you are a poor surgical candidate because of other medical conditions?¬† If so, there is hope for you. Research out of Vanderbilt University has outlined a rehabilitation protocol with overall success rates as high as 96%.
This physical therapy protocol is proven to decrease pain, increase strength, and improve shoulder function.¬†¬† The protocol includes 12 weeks of physical therapy. The exercises focus on supine lying exercises with a gradual progression to standing upright.¬† In some cases, shoulder injections and anti-inflammatory medications are part of the treatment program.
Rotator Cuff Basics and Why This Program Works
Your rotator cuff is made of 4 muscles and their corresponding tendons.¬† Collectively, your rotator cuff keeps the ball of your shoulder joint in the socket.¬† Without a properly functioning rotator cuff, the ball leaves the socket.¬† This results in a shoulder shrug or a complete inability to raise your arm.
With a massive tear, your rotator cuff may be nonfunctional.¬† Attempting to strengthen your rotator cuff may provide only a little help.¬† Instead, you want to strengthen other muscles that will compensate for your torn rotator cuff.
We see many people with massive rotator cuff tears who can raise their arm overhead without pain.¬† This is because their deltoid muscle is strong enough to compensate.¬† The exercises outlined in his program retrain and strengthen your deltoid.¬† With consistent adherence to the program, expect to see gradual improvements in pain and raising your arm overhead.
Range of Motion Exercises
Your first goal is to improve your passive overhead range of motion without pain. Perform these exercises lying on your back. Start by using a cane or wand for assistance.¬† Then remove the assistance as you become stronger.¬† Gradually progress the exercises to an inclined and then upright position.
Perform 3 sets of 10 to 15 repetitions each day.¬† Don‚Äôt worry about holding the stretch.¬† Instead, perform the exercises in a smooth, slow, and controlled fashion.¬† If you experience pain during certain points in the range of motion, limit how far you go.
After you see improvements in your range of motion, incorporate deltoid and teres minor strengthening exercises.¬† Perform these exercises in sitting or standing.¬† Perform 3 sets of 15 to 20 repetitions each day.¬† Some discomfort is ok.¬† But you don‚Äôt want sharp pain when doing these exercises.
Your teres minor is the smallest of your rotator cuff muscles.¬† It is not involved in most massive rotator cuff tears.¬† Side-lying external rotation strengthens your teres minor.¬† Start with the weight of your arm.¬† After you can perform 3 sets of 15 repetitions incorporate a light 1 pound hand weight.
Final Thoughts on Exercises for Massive Rotator Cuff Tears
Progress will be slow at first.¬† Expect to see improvements within 3 to 6 months as long as you do the exercises consistently.¬† Not coincidently, this is about the same time frame it takes most people to recover from rotator cuff repair surgery.
For the best results, perform the exercises at least 5 days per week.¬† Perfect form is a must!¬† If you can‚Äôt do the exercises properly, you will experience more pain.¬† Let us know if you need help.¬† Call our office to schedule an appointment with your physical therapist.¬† We are here to help you move without pain.