Rehabilitation for Rotator Cuff Injury
The rotator cuff is the thick band of muscles and associated tendons that cover the top of the upper arm and hold in it place, providing support and stability to the shoulder joint. The rotator cuff allows the arm full range of motion, while keeping the ball of the arm bone in the shoulder socket. The tendons of the rotator cuff can be injured or torn, usually from overuse over a long period of time, but also from trauma. Rotator cuff injuries typically affect people older than 40, and athletes or others who engage in repetitive lifting or overhead activities.
Treatment varies, and includes conservative treatments such as rest, ice and physical therapy. Severe cases may require surgery. Although the methods used to treat rotator cuff injuries vary, rehabilitation, which is designed to restore full movement and mobility to the arm and shoulder, and help the patient return to all usual activities, is always necessary after initial treatment.
In some cases, rotator cuff injuries can be treated with nonsurgical methods that focus on relieving pain and restoring function to the shoulder. They include resting, wearing a sling, taking anti-inflammatory medication, getting steroid injections and undergoing physical therapy. Physical therapy exercises focus on improving the strength and control of the rotator cuff muscles and the muscles around the shoulder blade. Treatment includes the following:
- Muscle-strengthening exercises
- Weight-bearing activities (weight is gradually increased)
- Range-of-motion exercises
The physical therapist may also make suggestions and create exercises for improving posture and shoulder alignment.
In most cases, surgery is recommended for tears that cause severe pain, or do not respond to more-conservative treatments. The type of surgery performed depends on the size and location of the tear, but often involves trimming torn edges or suturing the tendon back together. Physical therapy often begins shortly after surgery; it is designed to help restore strength and movement, and allow patients to gradually resume their regular activities. Initial physical therapy includes ice, electrical stimulation and massage, which help control pain and swelling. As healing begins, muscle-strengthening and range-of-motion exercises may be used to increase movement and mobility.
Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. After surgery, physical therapy may be necessary for up to 4 months, and full recovery may take up to 6 months.