Shoulder Rotator cuff tear help video Advanced rehabilitation exercises

This is an instructional video to correctly demonstrate how to manage a Shoulder Rotator cuff tear with Advanced Rehabilitation exercises.

The content in this video is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.

Step by Step

  1. The Rotator cuff is a group of muscles surrounding the shoulder joint.
  2. They are Supraspinatus, Infraspinatus, Subscapularis and Teres Minor.
  3. The Rotator cuff basically aids movement of the shoulder joint by keeping the shoulder joint tight in the socket. It also controls translation, which is basically keeping it in the centre of the socket.
  4. It is also very important with sensorimotor control & proprioception.
  5. So a Rotator cuff tear is a tear in the tendon of one of these muscles, most commonly affected is Supraspinatus.
  6. Now you should have followed the previous video for your early and Intermediate rehabilitation and only when you are performing these exercises well with no pain then you are ready to advance to advanced rehabilitation
  7. Again it is important that before you follow this video that you have a firm diagnosis of a rotator cuff tear and have read the disclaimer for this video.
  8. All the exercises should be pain free during after and the next day
  9. The aim is to increase the resistance gradually for strength and advance the repetitions gradually for endurance.
  10. Basically strength should be achieving fatigue between 6-10 reps and performing 4 sets with several minutes rest between the sets.
  11. For endurance you should be fatiguing at above 15-25 reps for 4 sets but with no more than 30 secs between sets.
  12. You should aim to work each session 2 to 3 times per week
  13. The first level advanced strengthening exercise is
  14. Through range looped exercise band flexion with a step up
  15. Tie the exercise band together to make a loop which is hip width apart when it is tied and the slack is taken up.
  16. Next with your elbows tucked in by your sides, put your hands into the looped band so that it is around your wrists.
  17. Keep the palms of your hands facing each other at all times and push slightly outwards at the hands, not the elbows.
  18. You should be pivoting on your elbow.
  19. Now elevate your arms up till they are pointing to the ceiling and bring them back down to your sides. Throughout you need to keep the outward pressure at your hands and not your elbows.
  20. Once this becomes easier and you are ready to advance then the next exercise advancement is
  21. Horizontal abduction with lateral rotation:
  22. Keeping the arm horizontal from the shoulder to the wrist, move it from front to back with the thumb pointing up with exercise band resistance or a weight
  23. The next level is
  24. Prone Y arm lifts
  25. Lie face down, take your arms out to the side to 120 degrees, keeping them above the horizontal plane of your shoulder.
  26. Make sure that your thumbs are pointing up to the ceiling to ensure that your shoulders are in external rotation.
  27. It is important that your shoulder blades aren’t winging and that your shoulders aren’t shrugged up towards your ears.
  28. Once you reach that point, hold this position for 10 seconds and repeat for 3 sets in total.
  29. You can do them one at a time or both arms together.
  30. Other alternatives are using cable pulleys, making it possible to do this exercise in standing.
  31. Alongside the strengthening you need to perform an advanced stability exercise.
  32. This is Shoulder stabilisation in 4 point kneeling with a Swiss ball
  33. Kneeling with two hands on a ball, maintaining straight elbows and good posture.
  34. Gently lean forwards, backwards and side to side.
  35. Perform 10 repetitions for each side in each direction and repeat for 3 sets in total.
  36. To make it harder advance onto one hand only if you are ready for this advancement.
  37. Once you have progressed through these advanced exercises you will need to move onto sport specific strengthening and stability exercises, which unfortunately I can’t show you in this video as these will vary depending on the sport.

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Online Physiotherapy

Put simply this is Physio done via either telephone or video over the internet. Skype and facetime are examples of this.

Contrary to popular belief online physiotherapy can be very effective and it can help the same injuries that face to face physio can help. I have helped many people with injuries such as disc prolapses, tennis elbow, neck pain and much more).