Rehabilitation of Rotator Cuff Impingement Disorders

Posted On: June 7, 2020

Does your upper arm hurt when you raise your hand over head? Does it pinch and sting when you move your shoulder in certain directions? Is it difficult to sleep on your side due to shoulder and arm pain? If you have any of these symptoms you may very well have a rotator cuff impingement syndrome.

To confirm this diagnosis, you should be examined by a specialist trained in the management of musculoskeletal problems like a chiropractor, physical therapist or an orthopedic surgeon.

Addressing this problem is important because when rotator cuff impingement syndromes are caught early, the condition will often resolve with therapy. If left unchecked, however, the tendons of the rotator cuff may tear to a point where therapy won’t help.

There are basically two types of rotator cuff impingement syndrome: primary and  secondary. This article will discuss rehabilitation for primary rotator cuff syndrome.

For starters, patients must manage the pain and inflammation. Pain is managed by avoiding painful positions. Things like overhead reaching and reaching across the body have to be avoided. Patients can not sleep on the involved side. When sleeping on the other side they should hug a pillow that stops the arm from falling across the body.

Like many musculoskeletal conditions, paying attention to one’s posture will help limit the pain.

Inflammation can be controlled by icing over the point of the shoulder. Put a towel between the ice and your skin; then cycle ten minutes on and ten minutes off for thirty to sixty minutes.

Training the rotator cuff muscles with exercise tubing or light free weight is essential. Here are two of the exercises we perform for these problems in the clinic. The first is external rotation which trains the back side of the rotator cuff. A light resistance tubing is used. The elbow is kept at the side with a small towel folded up and held under it. The elbow is bent to ninety degrees in front of the patient. The hand is then brought out diagramed against the resistance of the tube.

The opposite movement is worked with a medium resistance tubing similar to the above except the hand is pulled into the body. Each exercise is to be done with 10 repetitions for 2-3 sets.

This is just a start. There are other exercises that need to be done. Rotator cuff training, however, should be done under the supervision of a professional like a physical therapist or a chiropractor, at least until the patient masters the form.

One of the most effective therapies we use at North Shore Spinal and Sports Rehabilitation is transverse friction massage. This is a deep focus massage to the irritated tendon that helps stimulate proper healing in that tendon.

The proper rehabilitation of rotator cuff impingement syndrome typically takes three to four months. The end result in most cases is termination of pain and a return to full function.

If you or a loved one are experiencing upper arm pain when you move your shoulder, or have been diagnosed with a rotator cuff problem, you should see a professional versed in the rehabilitation of these problems. The sooner you do, the faster you will move towards recovery.

Stay well.

Dr. J

I would like to thank the people at Perfect Fit Health for allowing me to use the diagrams. Their free app, Perfect Fit 360, has been an invaluable resource for our patients.

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