29 Feb Physical Therapy after Rotatory Cuff Injury
What Is A Rotatory Cuff?
The rotator cuff is a group of muscles and their subsequent tendons that are extremely important for shoulder motion and strength. Having an injury to one or more of these muscles can be extremely impactful on an individual’s life.
Understanding the anatomy of the shoulder and rotator cuff is important. The rotator cuff is comprised of four muscles and their tendons.
They are as follows:
- supraspinatus muscle
- infraspinatus muscle
- teres minor muscle
- subscapularis muscle
All of these muscles perform or assist in various movements of the shoulder and upper arm. There are many different ways these muscles and tendons can be injured.
For example, lifting heavy objects, pushing or pulling items, reaching for and carrying items, and accident falls can cause injury to these muscles or tendons.
How Do Rotary Cuff Injuries Occur?
Sometimes, the injuries to the rotator cuff muscles can occur over time in your job.
There are other times when the injury is a more acute or rapid insult.
Common symptoms for a rotator cuff injury can include but are not limited to swelling, pain, loss of motion, stiffness, and weakness throughout the affected arm.
Determining the extent of injury to the rotator cuff is essential to the correct application of a rehab program.
A sprain or strain to the muscles or tendons usually responds well to a conservative approach in the rehab setting.
Occasionally a tear to the tendons can also be helped with a conservative approach. Significant tearing with severe mechanical symptoms may require surgery.
In either occasion, conservative care or post-operative care, The Injury Care Center can and will assist with recovery of these impairments.
How To Treat A Rotary Cuff?
Normally, a rehabilitation program at one of our facilities will begin with an evaluation by one of our expert physicians. Once a plan of care has been established, including any pain managements and prescription for rehab, you may be evaluated by one of our experienced and caring rehab professionals.
Pending the status of your injury, whether you have had surgery or not, we will come together to decide what plan of action will work best for you. Whether or not you have had surgery, we will normally begin a rehab program with palliative modalities. What this may mean would be an application of heat or ice, TENS, and ultrasound to start out with.
These tools are used to decrease pain and stiffness so that we can begin a program of stretching and strengthening. Once your symptoms are decreased, we will begin light range of motion exercises. These are used to ensure your arm is moving the way it was prior to your injury.
Overhead motion is important to everyday life, especially if you require it for returning to work. Obtaining the motion is important, however, it would not mean much if we did not also incorporate strengthening into the program. This will be important to make sure your injury does not reoccur, and you have ample strength to return to your prior level of function.
Strengthening may consist of theraband use, machine use, and functional training. Each progression in your program will depend on your symptoms and your presentation to the rehab professional. If your work injury was severe enough to require a surgery to the rotator cuff, your rehab program will be different pending the extent of the surgical intervention.
You may be required to wear a sling after your surgery and rest for about six weeks before starting any rehab program. This is normal. Once you are able to begin a rehab program, we will bring you in for a physical therapy evaluation. You may be only able to perform passive range of motion at the evaluation.
If that is the case, we will need to move your arm for you to assess your available range of motion. In addition to assessing your passive range of motion, we will also be looking at your incisions and how they have healed and any swelling/bruising accompanying the post-surgical site.
Again, modalities may be applied once you begin a rehab program to relieve pain and stiffness. After being in a sling for several weeks, it is very common to have the stiffness throughout the shoulder and neck region. Patient’s will then be provided with some passive stretching techniques.
Your rehab provider will instruct you in the proper form and performance of these stretches to ensure you are not increasing any stress on the repaired site. As you progress in the rehab program, you will most likely have regular check ins with the physician at the Injury Care Center as well as your surgeon.
The surgeon may clear you for more exercises as your injury heals. The rehab experts at our facilities are well educated in the techniques appropriate for you and your recovery. As we progress to strengthening, we will target your rotator cuff and shoulder muscles to improve your overall function.
Importantly, we will begin a work reintegration program when you are both cleared by the surgeon and physician and ready pending re-evaluations by your rehab provider. A work reintegration program will be essential when attempting to return to work as we will be able to assess your capability to perform work related duties in a controlled environment.
The Injury Care Center Can Treat You
AT each of our facilities, we are equipped with various tools to assist in this progression. These tools include, but are not limited to, biofeedback and a work training station. Biofeedback will be used to ensure you are performing these lifting techniques with proper form and do not re-injury yourself.
As you progress in your work integration program, we will work together to plan a return to work when you are healed and in no danger of re-injury. We look forward to assisting you in each and every step of the recovery process!