Shoulder Rotator Cuff Injury and Rehabilitation.

    Here I will be writing more details about latest protocols for different conditions. Each physical therapist follows the protocols as per they learn from their own experiences. But research studies have established some specific protocols for specific conditions so if one can follow that correctly, will achieve expected result without any fail and extra damage to patient especially traumatic conditions.I have combined the information in such a way that not only physical therapist but everyone can get benefit from my blog. This information will help you take precautions or follow Home exercises. If you  have constant pain while performing these exercises then consult the doctor or physical therapist for further examination.

   Today I am going write about Rotator cuff injury. Shoulder joint is very much unstable joint in our body. Many young athelets are facing multiple problems with their shoulder. One of the most common problem is Rotator cuff injury. It can be misdiagnosed with the impingement syndrom or Periarthritis. And misdiagnosis directly can impact on your treatment & outcome. So Its mandatory to diagnose the problem correctly.

  First you need to understand which muscles are involved in rotator cuff damage. There are 4 muscles  supraspinatus, infraspinatus, subscapularis, teres minor. Any damage to any of the 4 muscles or ligaments which are attached to the shoulder joint called as Rotator cuff injury. Depending on the extent of injury it is divided in four types.

   While providing the treatment to patient always make sure you follow stretching vs strengthening protocol. Both are important equally but both has specific advantages. For the skilled therapy therapist must start stretching exercises at initial stage to prevent ROM restrictions. When RTC injury starts healing process after surgery or even with out surgery, joint is surrounded by inflammatory tissue type cells. The inflammatory tissue cells types contains excess fluid, collegen fibres etc. So in healing process there are chances to develop fibrosis so it is very much essential to start with stretching exercises at very early stage. Mostly therapist concentrate on strengthening exercises after RTC injury and dont focus on stretching exercises. Always take precautions while performing stretching exercises. Dont forget patient has recently damaged his/her RTC muscles/ ligaments. Avoid more than 70 degree flexion and abduction in initial 4 weeks after post op.

  Strengthening exercises should be performed systematically. Each group should be trained individually. Normally therapist strengthens muscles all together  but remember this kind of technique does not give expected results comparing with the exercises are performed individually. For example;
 1) Strengthening exercises Internal Rotators;

       Mostly we only concentrate on shoulder flexors and extensors when it comes to strengthening. We forget to strengthen IR/ ER. Dont forget that your Rotator cuff's action is responsible for not only shoulder stability but also for IR and ER. Subscapularis is responsible for IR. First start with strengthening exercises in supine lying position, then in sitting and later in standing.

2) External Rotator Strengthening; Now concentrate on Teres Minor & Infraspinatus. When you strengthen both IR & ER individually, you reduce the risk of impingement in your shoulder. Shoulder's stability increases. I have posted videos which clearly reflects exercises. If you have constant pain while performing these exercises then consult your Doctor or Physical Therapist for cautious training.

Stretching exercises Of  Rotator Cuff Muscles;

Never forget to do regular stretching exercises of shoulder rotator cuff muscles. Stretching exercises helps to gain end range motion, improve elasticity of muscles and ultimately helps to relieve pain. Always follow stretching exercises before strengthening exercises to avoid risk of injury.I have posted the video about  self stretching exercises specifically to IR/ ER. If you are physical therapist, make sure you teach your patients these exercises as a part of Home Exercises.

If you want to know more in detail then leave a comment here, I will try to assist you.

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