So maybe my rotator cuff is injured. What are my options?

You’re in luck, my friend. You have just that – options.

After a diagnosis, the majority of the time, conservative treatment is suggested initially. This includes therapy and pain management with steroid injections and use of NSAIDS (anti-inflammatories)

Studies have shown physical therapy is highly effective and beneficial for the management of rotator cuff tendonitis and tears, helping to decrease pain, increase strength and range of motion and most importantly, increase tolerance to your daily and recreational activities.

A recent study from Finland looked at 3 groups of patients all diagnosed with RC tears. (PT only, PT and acromioplasty and PT, acromioplasty and RC repair) The groups were similar in age ranges and gender. Each group was assessed at 3 months, 6 months and 1 year with similar outcomes in pain, satisfaction, and function!

So, what does this tell us? Can we get to the same outcome without going under the knife? The answer is sometimes! These studies do point to partial, single muscle tears can absolutely benefit from therapy as opposed to surgical intervention. So, don’t jump at going under the knife….

Even better, I tell all my patients who I see for rotator cuff tears/dysfunction that even if surgery is indicated in the future,  therapy is the RIGHT CHOICE for them, no matter what.  Research shows that patients that undergo physical therapy PRIOR to surgery report less pain, increased function and quicker return to prior level of function than those who do not. More on that below.

So, either way, checking in with a physical therapist prior to any surgical decision is never a bad choice.

What can you expect from physical therapy for your shoulder?

First, a thorough examination and plan of care will be established, customized to you. This plan of care can include:

  • Pain management by modification of exacerbating activities and motions
  • Restoration of range of motion
  • Rotator cuff, shoulder, mid back and core strengthening
  • Stability and motor control training to your arm
  • Addressing posture
  • Working towards task-specific, functional movement specific to YOU!

A therapist will help guide you through each of these topics, working towards better tolerance to activity, decrease in pain, and an overall return to life, pain-free.

I plan to have shoulder surgery. Is there anything that can help me benefit the most post surgery?

We have been able to pinpoint some things that tend to correlate with better success rates following surgery. These things can include:

Demographics – Older age has a negative effect on surgery. If surgery is potentially an option for you, “putting off as long as possible” might not bode well. Taking care of things early tends to lead to better results based on age!

Clinical Factors – Diabetes and poor bone density have been shown to result in poorer outcomes. Obesity has also been associated with 12% less success rate going into rotator cuff repair surgery. As stated earlier, general weakness, poor range of motion, as well as general aerobic capacity, directly affects your success. Obviously, not all of these things are controllable, but generally, the better you can be going into the surgery, allows for you to be better coming out!  Participating in a physical therapy program prior will allow you to address most of these things, leading to better outcomes and a successful surgery!

I feel good now. I am a smart human being. Can I do things now to help me avoid dealing with any of these issues you speak of?

I am so glad you asked.

Regular shoulder and rotator cuff strengthening exercises and general shoulder mobility drills is a must to keep your shoulders pain free. An effective shoulder warm-up and shoulder activation sequence are key prior to any exercise and activity where you will be using your shoulders overhead.

In 2018, finding shoulder warm ups and rotator cuff exercises is right at your fingertips with online resources (ahem, like this blog) out the wazoo. For those of you without pain I would say this is a great place to start, but for anyone suffering from pain and think you might have rotator cuff involvement, I would encourage you to find a physical therapist to help you establish a customized program specific to you to ensure quick and efficient recovery.

Quick intervention has shown to help decrease pain faster, avoid more complicated tears and allow people to return to the things they love. Pain-free.

Here is a video of a few of my favorite rotator cuff activating drills I incorporate into my week as well as give frequently to patients. Give these a go and see what you think!