Rotator Cuff TendinopathY home exercise program
Rotator cuff injuries are very common. Patients generally get pain in the side of their shoulder with overhead movements.1 The following exercise program should help improve your symptoms gradually over time. It should be done once through every day.
Stretching:
Lack of flexibility is a large part of the problem in rotator cuff disease. It causes you changes in posture that upset the balance of the muscles in your rotator cuff. 2,3
All stretches should be 3-5 minutes, held gently to the point of stretch but not pain, and should involve consistent pressure (no bouncing).
Anterior shoulder stretch: place your forearms against door frame with area from elbows to hands contacting door frame. Lean into the stretch feeling a pulling in the front of your chest.
Posterior shoulder stretch: bring your arm in front of you so it is parallel to the ground with your palm facing down. Bend your elbow to 90 degrees. Place your other arm on your elbow and gently push your arm to the opposite side of your body.
Strengthening: 2,3
The goal for each exercise should be 3 sets of 15 repetitions. Perform these exercises even if you experience some discomfort, but stop if you have pain. You likely will not get to 3 sets of 15 initially, so do not get discouraged. Just do as many as you can.
Scapular strengthening: lie flat on the ground, place your palms flat on the ground with your elbows close to your body. Lift your arms and squeeze your shoulder blades together. Hold for 5 seconds. Repeat.
Rotator cuff strengthening:
1) raise your arms so they are parallel to the ground, your elbows should be straight. Bring your arms out to the side so they are diagonal to your body. Turn your hands inward so that your thumbs are facing the ground and your palms are facing outward. Perform a quick down and up movement with your full arm. Focus on the quickly dropping your arms and raising them back up. Repeat. If this is too painful, turn your hands so your thumbs are facing upwards. If this is too painful still, bring your arms only as high as they will go (with thumbs facing up) and start there, trying over time to raise your arms to the position mentioned above.
2) lie on the unaffected side of your body. With your affected arm, tuck your elbow into your body with your forearm resting on your abdomen. Slowly rotate your shoulder to bring your hand up so that your hand is the highest point of your body. Repeat. If this becomes too easy, add a small weight with a can of soup and increase the weight from there gradually by one or two pound intervals.
Follow-up:
Please see your doctor again 6 weeks after starting this program. At that appointment they can check your progress.2 If you have had no improvement, your family doctor may decide you have more widespread dysfunction of the shoulder than a simple home exercise program can correct and may want to refer you to physiotherapy.3 They may also want to consider referring you to a sports medicine specialist if the diagnosis is unclear.
1. House J and Mooradian A. Evaluation and management of shoulder pain in primary care clinics. Southern Medical Journal. 2010;103;1129-35.
2. Kuhn JE. Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol.
J Shoulder Elbow Surg. 2009; 18:138-160.
3. Ellenbecker TD and Cools AM. Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review. Br J Sport Med. 2010;44:319-27.
