Rotator Cuff Injury

Last year I strained my rotator cuff and spent 8 weeks in physical therapy rehabing it. I now have a similar pain in my other shoulder, though the pain is less severe and occurs after a greater range of motion.

Instead of spending a ton of $$$ in physical therapy (even after my health insurance coverage) are there any suggestions for how to rehab at home (exercises, stretches, supplements, etc)? Of course I still remember the exercises the physical therapist gave me.

Thanks.

What muscle did you injure?

How did you do it?

What range of motion/strength test are you failing?

this is just me… but i was wrecking my shoulders every year… always from the barbell OH press and hammerstrength OH press. i quit doing these and started re-building my shoulders (very slowly) using nothing but a modified arnold dumbbell press. palms forward at the top, and palms facing my body at the bottom - which was the only way to stop the stabbling pain. one year later, no pain. dumbbell presses are the secret i swear! that, and low weights. sorry, man. good luck.

oh, and drop the weights on benches and biceps, too.

I second the DB press idea. Only difference is, at the suggestion of 1 of the T-Nation contributors (I forget who) I just do them with my palms facing each other throughout. No twisting, as in an Arnold press, no facing forward (or backward) ever, just keep them parallel. It actually hits the delts really well – I think better than if you rotate them during the movement, which I feel takes some of the tension off the delts – and doesn’t bother my shoulder joints much at all.

Not sure how I hurt it (at least can’t remember a single event). I was in the process of getting back into lifting after a lengthy time off when it happened. I have pain when I lift my arm above shoulder level (such as putting on/taking off a shirt, military press, etc).

[quote]tsisung wrote:
Not sure how I hurt it (at least can’t remember a single event). I was in the process of getting back into lifting after a lengthy time off when it happened. I have pain when I lift my arm above shoulder level (such as putting on/taking off a shirt, military press, etc).
[/quote]

Sounds like you have impingement. The worst thing you could do right now is any overhead pressing motions, also bench and incline probably bother you. For weight training, eliminate any overhead pressing for the time being and change the incline and bench to DB with neutral grip (palms facing each other). This position allows an increase in subacromial space that is lost with a barbell. Concentrate on rowing motions motions and you could also try pulldown motions with a close, supinated grip which helps to open the subacromial space.

What you would want to concentrate on is stretching your pectoral group and your shoulder external rotators (teres minor and infraspinatus) which when tight cause an anterior shift of the glenohumeral joint which decreases subacromial joint space causing impingement and ultimately rotator cuff tear/surgery if left unaddressed.

The pectoral group is easily stretched in a door way with 3 positions…

  1. forearms flush with door frame, elbows at 90 degrees, 90 degrees under arm
  2. straight arms/elbows reaching toward corners of doorframe
  3. straight arms/elbows reaching overhead to top of door frame (unless this position bothers you)…repeat each for 30 seconds numerous times throughout the day.

To stretch the external rotators you could use NEER functional IR stretch which involves using a towel/belt/rope over your good shoulder and putting the involved arm behind the back and pulling up with the opposite arm/towel. Be sure to maintain scapular retraction so that the shoulders don’t wing resulting in a loss of the stretch.

Also you could use a side-lying sleeper postion stretch (if you can tolerate lying on the shoulder). This position is preferable due to the stabilization of the scapula against a hard surface which transfers the stretch to exactly where you want it. http://www.epicenterperformance.com/uploads/documents/PurePower-Shoulder.pdf#search=‘sleeper%20stretch’

some other good stretches to perform here also

Another contributing factor to impingement is posture, make sure you are sitting up properly without your shoulders rounded forward or head forward. This improper posture causes muscular contractures that result in anterior translation of the humeral head resulting in decreased subacromial space causing impingement.

As far as strengthening of the cuff is concerned, concentrate on external rotation movements (outlined in several articles on T-Nation). Including sidelying external rotation with light weight and TheraBand standing external rotation (you probably did this previously in PT). Also, concentrate on proper strengthening of the posterior musculature/scapular retractors.

"The pectoral group is easily stretched in a door way with 3 positions…

  1. forearms flush with door frame, elbows at 90 degrees, 90 degrees under arm
  2. straight arms/elbows reaching toward corners of doorframe
  3. straight arms/elbows reaching overhead to top of door frame (unless this position bothers you)…repeat each for 30 seconds numerous times throughout the day."

I like this advice

[quote]firemedichcfr14 wrote:
"The pectoral group is easily stretched in a door way with 3 positions…

  1. forearms flush with door frame, elbows at 90 degrees, 90 degrees under arm
  2. straight arms/elbows reaching toward corners of doorframe
  3. straight arms/elbows reaching overhead to top of door frame (unless this position bothers you)…repeat each for 30 seconds numerous times throughout the day."

I like this advice [/quote]

Really? Respectfully, I disagree with much of what he wrote.

I tore my supraspinatus, and already having a strong background in sport medicine, decided I must become my own expert.

I utilized OHP as one of my primary rehab tools, as was mentioned by others on a recent thread.

Working the external rotators is mandatory; I use bands but found light weights the best at first.

His symptoms sound like mine were; I have no impingment.

This is all POINTLESS however. He has no information to work with and therefore no plan to fix things. He needs to talk to a GOOD doctor with half a brain and go through the proper tests (such as the impingement test given in a recent article here and the Appley’s Scratch test.)

As for those doorway stretches, I think they are of little use, and don’t hit the pec minor, which is often the tighter chest muscle. There are stretches done laying on an exercise ball which improved my posture far more.

An massage therapist can determine if scar tissue exists and improve it. Without scar tissue being adressed the problem will reappear.

My 2cents.

[quote]ScienceGuy wrote:
firemedichcfr14 wrote:
"The pectoral group is easily stretched in a door way with 3 positions…

  1. forearms flush with door frame, elbows at 90 degrees, 90 degrees under arm
  2. straight arms/elbows reaching toward corners of doorframe
  3. straight arms/elbows reaching overhead to top of door frame (unless this position bothers you)…repeat each for 30 seconds numerous times throughout the day."

I like this advice

Really? Respectfully, I disagree with much of what he wrote.

I tore my supraspinatus, and already having a strong background in sport medicine, decided I must become my own expert.

I utilized OHP as one of my primary rehab tools, as was mentioned by others on a recent thread.

Working the external rotators is mandatory; I use bands but found light weights the best at first.

His symptoms sound like mine were; I have no impingment.

This is all POINTLESS however. He has no information to work with and therefore no plan to fix things. He needs to talk to a GOOD doctor with half a brain and go through the proper tests (such as the impingement test given in a recent article here and the Appley’s Scratch test.)

As for those doorway stretches, I think they are of little use, and don’t hit the pec minor, which is often the tighter chest muscle. There are stretches done laying on an exercise ball which improved my posture far more.

An massage therapist can determine if scar tissue exists and improve it. Without scar tissue being adressed the problem will reappear.

My 2cents.[/quote]

What is your strong background in sports medicine? Did you have surgery? How did you tear your supraspinatus? How was it diagnosed?

Lying on an exercise ball? Doesn’t that look a lot like standing in a doorway minus the thoracic extension achieved with ball?

You have become an expert? He point blank says that overhead lifting causes him pain, so you want him to do more? That should be a good idea.

The pec minor…yeah that is what is so tight that pulls most people’s shoulders forward. It couldn’t possibly be because of the large pec major pulling the shoulders forward from entirely too much anterior based strength training.

I can honestly say I am happy there are so many “experts” out there to keep a steady supply of injuries coming through the door.

[quote]ScienceGuy wrote:
firemedichcfr14 wrote:
"The pectoral group is easily stretched in a door way with 3 positions…

  1. forearms flush with door frame, elbows at 90 degrees, 90 degrees under arm
  2. straight arms/elbows reaching toward corners of doorframe
  3. straight arms/elbows reaching overhead to top of door frame (unless this position bothers you)…repeat each for 30 seconds numerous times throughout the day."

I like this advice

Really? Respectfully, I disagree with much of what he wrote.

I tore my supraspinatus, and already having a strong background in sport medicine, decided I must become my own expert.

I utilized OHP as one of my primary rehab tools, as was mentioned by others on a recent thread.

Working the external rotators is mandatory; I use bands but found light weights the best at first.

His symptoms sound like mine were; I have no impingment.

This is all POINTLESS however. He has no information to work with and therefore no plan to fix things. He needs to talk to a GOOD doctor with half a brain and go through the proper tests (such as the impingement test given in a recent article here and the Appley’s Scratch test.)

As for those doorway stretches, I think they are of little use, and don’t hit the pec minor, which is often the tighter chest muscle. There are stretches done laying on an exercise ball which improved my posture far more.

An massage therapist can determine if scar tissue exists and improve it. Without scar tissue being adressed the problem will reappear.

My 2cents.[/quote]

Medical expert guess how the supraspinatus is most commonly torn…from impingement upon the AC joint, commonly referred to as impingement. Either from a prolonged fraying or a sudden injury (FOOSH- fall on outstretched hand).

I appreciate the responses. I plan on doing PT exercises such as those I did last year and some more that 74 added (many are the same as previously prescribed in PT last year).

I’ve added a glucosamine supplement as well but not sure if that will help this issue.

I’m trying to avoid visiting a doctor as my company switched from a HMO plan to a HSA plan. Since the HSA plan is so new I have little funds in it for medical care until they have time to build up.