Strengthening is the most important developmental stage of the shoulder after rotator cuff surgery. Given that the four muscles of the rotator cuff (subscapularis, infraspinatus, supraspinatus and teres minor) have become weak, they must be stretched and strengthened through rehabilitation exercise to increase flexibility and obtain a pain-free range of motion.
Isometric Exercises
You may begin isometrics as the first phase of exercise following rotator cuff surgery. Isometrics are performed by isolating each muscle in the shoulder and training the muscle without using weights. The subscapularis is best strengthened by holding the arm out straight in front of the body, then flexing it to a 90-degree angle. To strengthen the supraspinatus, hold the arm out straight in front of the body with your thumb pointed towards the ground. Then, slowly elevate the arm above the body. If this is painful, you should stop immediately because the rotator cuff is under the maximum amount of stress during this motion.
The infraspinatus and the teres minor can be strengthened by doing the same exercise. To perform this exercise, hold the arm out as if you are holding a ski pole right before you plant it. Then rotate the arm from this position out to the side.
It is important to note that, in the beginning, you should do these exercises without weights. Performing these exercises with too much weight can cause an individual to reinjure the surgically-repaired rotator cuff muscles. There are also a number of stretches that can be performed to help strengthen the shoulder, such as pendulum swings, the overhead stretch, the towel stretch and wall climbs.
Resistance Exercises
After you have become comfortable with the isometric exercises, you can progress to resistance or tubing exercises. The tubing is simply a big elastic band that is used to provide resistance for exercise. The first tubing exercise is external rotation. To perform this exercise, connect the tubing to a doorknob or another object that is at waist level. Grasp the tubing with the hand on your injured side, and then rotate the arm out and away from the waist. Keep your elbow bent at a 90-degree angle and the forearm parallel to the ground. Repeat 10 times.
The other tubing exercise is internal rotation. Again, connect the tubing to a doorknob or something at waist level. Grasp the tubing. Be sure to keep your elbow in and forearm parallel to the ground. Rotate the arm inward across the body. Repeat 10 times.
Build up your strength until you are able to do three sets of 10 repetitions for each exercise. As your shoulder muscles become stronger and you become more confident, you can add more resistance by shortening the length of the tubing, which will make the exercises more difficult and more strenuous on the muscles. Dumbbell (hand-held) weights can also be used to strengthen the shoulder. They come in a series of weights, which make it easy to increase the difficulty of an exercise when it becomes too easy.
Tags: rotator cuff, 90-degree angle, connect tubing, connect tubing doorknob, forearm parallel, forearm parallel ground, front body