Frederick Wintermantel III, PTA
Rotator Cuff tears are a commonly seen injury of the shoulder in almost every Physical Therapy practice. While we often see these injuries in athletes (baseball and tennis players) and workers who hold their arms up constantly, such as painters, those in construction, etc., almost anyone can injure their rotator cuff. One of the easiest ways to injure it is by holding out your arm to catch yourself when you fall. Age and family history also play a role. Developing bone spurs in your shoulder can also facilitate the development of inflammation or a tear.
The Rotator Cuff is actually a group of muscles and tendons which encompass the shoulder joint. Its function is to hold the humerus (upper arm bone) in place in the shoulder socket, allowing you to move your shoulder in a variety of ways. Because it is utilized so much, the Rotator Cuff can easily become inflamed, partially torn, impinged upon or even ruptured. Physicians and patients rely on a qualified Physical Therapist to help them recover from these injuries, or to rehabilitate the shoulder after tendon repair surgery.
Rotator cuff problems can happen acutely, as the result of a sports injury, fall or accident, or they can develop over time. The most common symptom reported is a dull ache, which gets worse at night and if laid upon while trying to sleep. Your affected arm may be weak and it may be painful or impossible to reach behind you or to style your hair. Substantial tears may cause a complete loss of function. Because severe rotator cuff tears should be repaired right away to achieve the best recovery outcome, it is important to see a shoulder specialist immediately for diagnosis and the appropriate treatment.
Thankfully, the majority of rotator cuff problems can be treated conservatively, with some (not total) rest, ice, NSAIDs, steroid pills or injections, activity modifications and Physical Therapy. Your Physical Therapist will consult with your doctor about your level of injury and will work with you to develop a treatment plan that suits your lifestyle and activity level. The main goal of Physical Therapy is to restore function and movement to the shoulder joint. These are done with strengthening and mobility exercises, and also a variety of stretching exercises. We find that being mildly uncomfortable while exercising is usually okay for the patient, but we attempt to keep them in the pain-free range as strength and mobility is increased. We can also use a variety of modalities to aid in healing, including TENS, Ice packs, Ultrasound, Laser, Taping, etc.
If surgery is required to repair the rotator cuff, the physical therapist will still work to achieve the same goals with the patient after surgery. However, Physical Therapy will be delayed for at least two-three weeks while the shoulder is allowed to heal. Then, passive range of motion exercises will be allowed until about the sixth week post-op. Then from six-twelve weeks post-op, active range of motion exercises will be added. After twelve weeks post-op, a carefully staged and progressive strengthening program can be added.
Physical Therapy, for both non-surgical and surgical patients, will include at home exercises that the patient should complete between PT sessions and after the in-office consultations are completed. Patients who take an active role in their recovery see a much higher level of progress and return to the activities that they enjoy. The biggest part is to return you, the patient, back to doing what you want to be doing.
Read a few of our many testimonials regarding rotator cuff treatment: