Rotator cuff repair: exercises

It is useful to use painkillers or icepacks to reduce pain before you exercise. It is normal for you to feel aching, mild discomfort or stretching sensations when you do these exercises. Intense or long-lasting pain of more than half an hour should not occur. If reducing the level of your exercise does not improve these symptoms, please discuss the problem with your physiotherapist.

Do short and frequent sessions, for example five to ten minutes, four times a day, rather than one long session.

Gradually increase the number of repetitions you do under the guidance of your physiotherapist. 

Phase 1 - exercise from operation to six weeks afterwards

1. Neck exercises

In a standing or sitting position, turn your head to one side. Repeat five times.

  1. Turn your head to the one side and repeat five times
  2. Turn your head to the other side and repeat five times
  3. Tilt your head to the right, right ear to right shoulder, repeat five times
  4. Tilt your head to the left, left ear to left shoulder, repeat five times.

2. Elbow exercises

These can be performed in a standing or lying position.

  1. Straighten and then bend your elbow. Repeat five times.
  2. Try to work towards achieving full flexion and extension of your elbow joint.

3. Scapular setting exercises

  1. Gently flatten your shoulder blade on your rib cage as if moving your shoulder blade to your back pocket
  2. Maintain a neutral spinal posture
  3. Avoid slumping 

Optimal posture

 

Avoid poor posture

 

Assisted flexion in lying to shoulder height only

  1. Elbow supported on a pillow
  2. Thumb up grip on walking stick
  3. Use unaffected arm to push involved arm into flexion just to shoulder level (initially you will comfortable to 30 or 40º but aim for 90º, shoulder level, by five to six weeks)
  4. Do not hitch the shoulder.

Flexion

External rotation 

  1. Elbow supported on a pillow
  2. Thumb up grip on walking stick
  3. Elbows bent to 90º and held at side of body
  4. Push involved arm outward using the stick just until it is in alignment with the shoulder. Do not over push this movement in the first two weeks or it could place strain over the shoulder rotator cuff repair. If it feels comfortable you can slowly increase the range.

 

Phase 2 - exercises from five weeks to 12 weeks after your operation

1. Shoulder flexion in standing

  • Assisted elevation through flexion in lying on your back or standing. Grip walking stick handle with the arm to be exercised.
  • Use the opposite arm to push the involved arm into elevation moving at 90º to the plane of the body. By  five to six weeks you should be able to reach shoulder level and you can gradually increase your range as pain allows.

2. Shoulder external rotation in standing

  • Grip walking stick handle with the arm to be exercised
  • Upwardly rotate shoulder blade
  • Elbow bent to 90º and held comfortably at your side
  • Push involved arm outward using the stick
  • Keep shoulder blade still.

Remember to avoid excessive hitching of the shoulder

3. Static medial rotation muscle contraction

Using a wall

  • Upwardly rotate shoulder blade
  • Elbow bent to 90º and held comfortably by side, palm placed against wall
  • Gently push into the wall
  • Work at 30% maximal voluntary contraction or at 3/10 effort.

You can perform the same exercise using a stick

  • Upwardly rotate shoulder blade
  • Thumb-up grip on walking stick
  • Elbow bent to 90º and held comfortably by side
  • Gently push involved arm in while resisting with unaffected arm. There should be no arm movement.
  • Work at 30% maximal voluntary contraction or at 3/10 effort
  • Repeat each exercise ten times and hold for ten seconds, building up to 30 repetitions.

4. Static external rotation muscle contraction

  • Upwardly rotate shoulder blade
  • Elbow bent to 90º and held comfortably by side, back of hand placed against wall
  • Gently push out into the wall
  • Work at 30% maximal voluntary contraction or at 3/10 effort
  • Repeat each exercise ten times and hold for ten seconds, building up to 30 repetitions.

Using a wall

You can perform the same exercise using a stick 

Phase 3 exercises - ten weeks to three months

Your strength and mobility will slowly increase with time and the more challenging exercises your physiotherapist will select for you. Improvements in your shoulder strength will continue for 12 to 18 months.

1. External rotation in 30 – 60º flexion

  • Upwardly rotate shoulder blade
  • Thumb up grip on walking stick
  • Keep elbows bent to 90º and elevate shoulders to 30 to 60º forward flexion
  • Gently pull out involved arm while resisting with unaffected arm. There should be no arm movement.
  • Work at 30% maximal voluntary contraction or at 3/10 effort
  • This exercise can also be repeated using a light resistance yellow tubing or band.

2. The above exercise can be repeated at 90 degrees flexion and above

 

Further information

If you are unsure of who to contact or you have an appointment query, contact Mr Hand’s secretary on 023 8120 5212 between 9am and 4pm, or Mr Cole's secretary on 023 8120 5087.

If your wound changes in appearance, weeps fluid or pus or looks infected, or you feel unwell with a high temperature, contact your GP urgently and ask your GP to inform the shoulder unit.

If you have a query about your exercises or movements, please contact the physiotherapy department at UHS on 023 8120 6459.

If you have a query about your outpatient appointment please contact 023 8120 6218.