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Feb 08, 2024

Rotator Cuff Physical Therapy Treatment and Prevention

woman speaking to her physical therapist about her rotator cuff injury -- inquiring about treatment and prevention

Many of the movements of your shoulder relate to the rotator cuff. This is a grouping of tendons and muscles that help to support the movement of the joint, allowing your shoulder to move when you need to reach, pull, or stretch. This muscle group also holds the upper arm bone in place since the joint socket in this area is rather shallow. If you develop pain in this area, it could be due to damage to the rotator cuff.

Rotator Cuff Injuries

Injury to the rotator cuff can range from mild to severe and can impact any of the four muscles that make up this grouping.

What is a rotator cuff injury?

Injuries to the rotator cuff may include:

  • A partial or complete tear
  • An acute tear
  • Tendonitis
  • Tendinosis
  • Impingement

Causes and risk factors

Most people do not suffer injuries or damage to the rotator cuff simply because of the strength of the muscles. However, injuries can happen to anyone often due to strain. Some of the most common causes and risk factors include:

  • Being over the age of 60, due to the breakdown and weakening of the muscle tissues
  • Repeated motions that lead to the overuse of the muscles and the shoulder in general
  • Trauma to the shoulder or muscles, such as straining too hard or falling while your arm is outstretched

Those who engage in sports do hard labor work with their arms, or those prone to accidents are at a higher likelihood of suffering damage to this area of the body.

Symptoms and signs

The following are some of the most common signs and symptoms of rotator cuff injury:

  • Swelling or the development of new pain at the front of the shoulder, often moving down the arm
  • Pain when raising or lowering the arm
  • A clicking or popping sound from the joint when moving the arm
  • Feeling as if the arm is heavy and hard to move
  • Weakness in the arm
  • Pain that wakes you up at night
  • Trouble reaching behind

Rotator Cuff Therapy and Exercise

Many people can see significant improvement in the function of their rotator cuff and shoulder joint with a conditioning program, a process of building strength and flexibility within these muscles. Though a doctor should be consulted in any situation related to injury to the rotator cuff, these exercises can provide significant improvement for many people.

Getting Started

After warming up with light stretching, consider these exercises to provide some improvement. You can use these if you have chronic pain but should seek medical care for acute pain.

woman receiving treatment for her rotator cuff injury

Pendulum swing

This exercise will work the supraspinatus, deltoids, infraspinatus, and subscapularis muscles that make up the rotator cuff. To do this:

  • Lean forward and place one hand on a stable surface to support you. Allow the other arm to hang at your side.
  • Move the hanging arm forward and backward slowly but with purpose.
  • Move the hanging arm from side to side.
  • Repeat the process with the other arm.

Cross arm stretches

This exercise works to stretch out the muscle along your back, called the posterior deltoid.

  • Stand squared and relax your shoulders.
  • Pull one arm across your chest so it lays from shoulder to shoulder. Use your other arm to hold it in place.
  • Stretch as far as you can and hold this position for 30 seconds.
  • Repeat with your other arm.

The Rotator Cuff Tear: Diagnosis and Treatment

A rotator cuff tear is a type of acute injury, typically meaning that the muscle has an actual tear in it and is not just overstretched or damaged. Symptoms of a tear include:

  • Recurrent pain that worsens with some activities
  • Muscle weakness
  • Pain that limits sleep on the injured side
  • Trouble moving the arm

Diagnosis is done with the help of a doctor and may include the use of X-rays, ultrasound, or an MRI. Your doctor may also manipulate your arm in various ways to determine what has occurred.

For many people with a tear, physical therapy is an option. It is typically one of the first treatments used because it can be tailored to address the specific areas of concern related to the rotator cuff. Physical therapy after an injury like this can also be beneficial because it improves flexibility while building up the strength of the muscle group without causing pain and discomfort.

Recovery and Prevention

Woman learning about prevention of rotator cuff deterioration from her physical therapist

Recovery from rotator cuff tears or surgery to repair it can be done through additional physical therapy strategies. Typically, it can take several weeks for this to occur. Rehabilitation typically is done in phases, guided by your physical therapist to slowly work to strengthen the muscles.

  • Gentle range of motion exercises are the starting point
  • In moderate exercises, the goal will be to exercise the shoulder blade to build stability
  • Once continued healing occurs, the next step is to add weight to the treatment to help strengthen the muscles
  • Returning to activity, especially activities like sports, is often the physical phase in the recovery process, requiring a gradual process itself

It is critical during this process to work closely with your physical therapist. You should not try to recover from tears without the guidance of a professional.

When to Seek a Professional

If you have pain in your rotator cuff or any of the signs and symptoms here, rest the area and give it time to heal. If the pain is limiting your ability to do the activities that you need to, is waking you up at night, or is otherwise limiting your quality of life, it is helpful to seek out a physical therapist. Any type of acute pain that does not improve should be treated by a professional.

At Rock Valley Physical Therapy, our team of highly skilled therapists can work closely with you to create a treatment plan that addresses your needs. Find a clinic near you now. Then, set up a visit to find out what we can do to help you see improvement.