Patient normally comes in clinic with complain of pain. Physiotherapist had vital role to diagnose the reason of pain. Physiotherapy in rotator cuff injury will give instant relief in pain. Rotator cuff tear is the common reason of shoulder pain. Inspect or examine the patient will help to find the cause. Range of motion (active and passive movement) and Strength testing are helpful to diagnose. Physiotherapy helps you to increase the range of motion and muscles strengthening. Physiotherapist is also using different types of equipment for pain relief.
What is Rotator Cuff?
The rotator cuff contains four muscles. These muscles are responsible for internal and external rotation of the shoulder. It stabilize the shoulder, including Infraspinatus, Supraspinatus, Teres Minor and Subscapularis. These muscles are connected the scapula to the humerus. The most common muscle in rotator Cuff tear is supraspinatus. The tendons of these muscles in rotator cuff tear become rupture because the excessive stress on the shoulder. It is leading to pain and limited mobility of the region.
Causes of Rotator Cuff Injury
- Falls or Injury
- Over use of shoulder
- Aging process
Symptoms of Rotator Cuff Injury
- Pain in specific movement
- Sharp shooting pain especially at night
- Restrict the shoulder movement
- Muscle weakness
Exercises in Rotator Cuff Injury
Physiotherapy in Rotator Cuff Injury are;
Shoulder rotation
Raise your elbows up about 30 degrees. Externally rotate one arm and internally rotating the bottom arm. Hold it for five seconds and then switch sides. Make sure the scapula is posteriorly tilted for the whole exercise.
Side Lying External Rotation
Lie on your side. Place rolled up towel between your elbow and the side of your body. Grab a weight with a good strong grip. Then externally rotate to the full range of motion. Hold for three seconds then do the same again.
Shoulder Circle to Crossover
Put the shoulder at the back of your hands. Extend the shoulder reaching back behind you. When, the arms get to the overhead position then cross your arms over in front of you. Keep your elbows straight. Come back to starting position.
Shoulder Extension and Flexion
Stand up straight. The first movement is shoulder extension. Tuck the lower edge of the scapula into your rib cage. Hold for five seconds. Keep trying to increase the range of motion. Then move to shoulder flexion. Reaching your arms up in front of you overhead and keeping the rib cage down. Hold for another five seconds.
Cuff Isometrics
Stand straight with your elbows bent 90 degrees. Do this exercise with help of anyone. Place a hand of your attendant just right with your hand and push it. Hold it for five seconds and relax. Do right – left and up – down.
Pendulum
Bend over at the waist. Hang your arm. The gravity is distracting your shoulder. Open the joint and swaying your body. Move your hand in little circles clockwise and anti-clockwise. Do three sets of ten.
Tips to Avoid Rotator Cuff Tear
Posture Alignment
Alignment of the shoulder girdle is really important. Poor posture affects the space that the rotator cuff travels through. Rounded shoulder are decreasing the space of rotator cuff and leading to increase the chances of rotator cuff tendon.
Posterior capsular contracture
The capsule joins the ball of the humerus and the glenoid. The back of that capsule gets stiff, it changes the alignment of the shoulder. So, when you lift your arm over your head, the tight posterior capsule actually pushes the humeral head up and leads to impingement of your rotator cuff. If you have posterior capsular contracture, you can’t bring the arm in front of your body.
It is really important to maintain the posture and alignment of the shoulder to avoid rotator cuff tear.
