The rotator cuff, consisting of four muscles and their tendons, is responsible for much of the motion of the shoulder. According to studies, most people in the United States will develop some form of rotator cuff tendinopathy at some point, because aging and normal wear and tear is a common cause of this. However, younger people are at risk if they play a sport requiring overhead arm motions – this includes activities as diverse as football, tennis, shot put, swimming, and many others.
Injuries to this area are not just very painful, they can make using the affected arm impossible until healing is underway. Moreover, many people need an operation for tissue repair if they tear their rotator cuff. In this case, physical therapy before and after the surgery can be a great help in lowering shoulder pain levels and getting normal limb movement back.
At JAG Physical Therapy, New York, New Jersey, and Pennsylvania’s source for specialized PT care, we have helped countless patients recover from rotator cuff injuries. From older adults to athletes at all levels, our team is experienced at treating people from all walks of life and passionate about helping you move better and return to your routine. Schedule your appointment with us today, find your closest JAG PT location, or read more below on the steps to rotator cuff rehab PT.
What Are the Goals of Physical Therapy After Rotator Cuff Surgery?
Once you undergo rotator cuff surgery, your physical therapist will work with you with a few specific goals in mind. As with all post-operative PT care, pain management will be among the most important of these. After all, if you get a torn tendon reattached but it still hurts every time you move the associated muscles, the surgery has not really improved your quality of life.
Specific to the process of rotator cuff healing is an emphasis on range of motion and stability. The shoulder is normally the human body’s most mobile joint, allowing our arms to do diverse tasks such as turning a steering wheel or reaching up to a high shelf. Under the guidance of a physical therapist, a full regimen of stretching and exercise can bring back the arm’s capacity for all these types of movement while avoiding stiffness. Meanwhile, stabilization is a main function of the healthy rotator cuff – various kinds of strengthening techniques in PT help in regaining this functionality while also avoiding further injury.
What Are the Phases of Post-Surgical Rotator Cuff Recovery?
If you are scheduled for rotator cuff surgery, the healing period begins as soon as you are discharged, but it will continue for 12 weeks or more. The rotator cuff is both an important body structure and a sensitive, complicated one – rehabilitating it has multiple phases, each intended to renew the function of the shoulder in its own way. Until your regimen is over, it’s absolutely essential to adhere to everything your physical therapist and surgeon have told you – if you don’t, you put yourself at risk of health complications.
While the timeline for rotator cuff physical therapy may differ from patient to patient, it generally unfolds in this way:
- Phase 1 (0-6 Weeks): Your usage of your shoulder and arm will be most limited in this first phase, which primarily involves passive range of motion. Gentleness is key, as the main idea is simply to protect the tendons as they heal. You will probably have to keep your arm in a sling for about 4 weeks or more, depending on physician instructions. However, your physical therapist will show you how to safely remove and replace the sling for exercise purposes. During this stage, you’ll have to avoid all forms of active shoulder movement, but you may receive extensive manual therapy for soft tissue mobilization. The exercises you are likely to do will include pendulums, isometrics with your arm at your side, and working with a squeeze ball.
- Phase 2 (6-12 Weeks): Much of the progress in your rehabilitation will be made in the second phase, in which your PT will help you build up your active motion. You’ll no longer need a sling at this point in time, but you will have to work up to moving your arm like you are used to, beginning with therapist-assisted range of motion. Your physical therapist may additionally treat the shoulder joint with devices such as strapping tape to help reinforce it. You should only raise your arm forward and not to the side, and you shouldn’t pick up objects yet, exercising only against gravity. Important exercises at this stage include table slides and wall slides using shoulder flexion, prone rows, and internal and external arm rotation under PT guidance.
- Phase 3 (12+ Weeks): In the third of the post-operative rotator cuff recovery stages, you’ll finally be able to move your arm in multiple directions as well as pick increasingly heavy things up and carry them. This is the point when your daily activities will look and feel close to the pre-injury norm. With the instruction of your PT, you’ll likely perform more complex and varied exercises, like scapular retraction and plane-of-motion drills with a dumbbell or resistance band. For optimal strengthening, with a level of challenge that increases as you heal more, your therapist may recommend proprioception exercises like ball-on-a-wall balancing, rhythmic stabilization, and others. If you’re an athlete, after 24 weeks or more have elapsed without major setbacks, you’ll be advised on returning to playing sports.
What Exercises Aid in Rotator Cuff Recovery?
If you are still rehabilitating from a shoulder operation, you should only exercise after consulting your physical therapist. However, your PT program will include instructions on exercising daily at home, and once your rehab period is complete, you’ll probably want to keep strengthening your rotator cuff and working on your flexibility. Consistency and moderation are key: Don’t skip any exercises or needlessly cut repetitions short, but stop as soon as you feel any hint of pain.
Safe and useful exercises for rotator cuff recovery include the following:
- Pendulum Swings: This exercise is simple and fundamental enough that your PT will have you start it early in your recovery. Leaning forward at the waist, hold on to the edge of a chair or table with the hand of your uninjured arm. Relax the opposite shoulder and let the entire arm dangle downward as freely as possible. Use either your legs or hips to rock back and forth, causing your arm to swing. This technique allows gravity and momentum to provide a gentle but persistent stretch, and you can utilize it to move your arm in circles to begin your range of motion exercises as well.
- Doorway Stretches: In the middle and late phases of rotator cuff recovery, doorway stretches are a good preliminary exercise to make sure your shoulder muscles and tendons are limber and warmed up for the more intensive parts of your regimen. Standing in the center of a doorway, raise your hands to a bit below shoulder height and hold on to both sides of the frame. Straighten your back and shift your weight forward, return to start, shift backward, then return to start again.
- Shoulder Blade Squeezes: The motion of bringing the shoulders backward may seem unimportant in the day-to-day, but it’s still an entire direction that the shoulders can move in. For this reason, shoulder blade squeezes should be part of your range of motion exercises. The movement is simple: Taking care to relax your shoulders, simultaneously move your shoulder blades together and as far downward as possible. You can hold for about 6 seconds before you release.
- Resistance Rows and Lawnmower Pulls: These two exercises are related because both involve a backward pull on a resistance band. You should only begin using equipment such as resistance bands after your physical therapist gives you the okay, but both of these techniques are low-stress ways to work on strength and healthy blood flow. In resistance rows, have one end of the resistance band anchored by another person or a sturdy object at your waist level. Facing straight forward, hold the band in both hands and pull backward with relaxed shoulders, allowing your elbows to move along your waist before returning to start. For lawnmower pulls, place one foot forward and step on the center of the resistance band, your feet hip-width apart. Bend at the waist, reaching forward with the opposite hand of your forward foot with the other hand resting on your hip. Grab the ends of the band and stand back up at the waist while raising your elbow backwards and rotating your torso to the side of the forward foot. This should be done in one smooth motion, like starting up a lawnmower, but not with much force at all.
Why Is JAG Physical Therapy the Best Choice for Rotator Cuff Recovery?
One of our top specializations at JAG Physical Therapy is post-surgical PT. Our skilled, empathetic team has many years of experience in restoring patients’ mobility to normal after an operation, and moreover, we always use individualized, targeted treatment plans. Our clinic locations are outfitted to make advanced, effective post-operative rehab possible.
When you have your rotator cuff procedure, we’ll talk over your concerns with you, take all of your health conditions and lifestyle considerations into account, and get you started with a PT regimen made to quickly and safely let you return to work, sports, and any other everyday activities.
Start Your Rotator Cuff Recovery Journey with JAG Physical Therapy
Healing from a rotator cuff tear can pose a major challenge, which is why it’s best to have the help of experienced and compassionate physical therapy professionals. The team at JAG PT is here to make sure your shoulder surgery rehabilitation has faster progress and less pain.
Ready to get your arm strength and flexibility back after rotator cuff surgery? Book an appointment at your nearest JAG PT location today to begin your personalized shoulder rehabilitation plan!