Browsing Tag

shoulder pain

Shoulder pain

Rotator Cuff Rehab: Strengthening exercises

June 13, 2017 • By

Rotator cuff injuries are one of the most common injuries and one of the most feared, but they don’t need to be. With the right rotator cuff rehab exercises, your shoulder can be pain-free and strong again in no time.

There is a huge amount of research coming through that is showing that we have become far too reliant on surgery which often comes with its own risks and can lead to scar tissue and frozen shoulder. Current best practice recommends about 12 weeks of conservative rehab before looking into surgery if not improving. Recent studies have shown:

  • Subacromial impingement and bursitis: Exercise is as effective as surgery AND reduces the need for surgery in 80%
  • Rotator Cuff partial tear: Exercise is as effective as surgery
  • Full Thickness Rotator cuff tears: Exercise reduces the need for surgery by 75%

Rotator cuff rehab physio

That’s some fairly awesome stats from multiple studies and shows that with the right rehab exercises, there is a good chance your shoulder pain will resolve without the risk of surgery, so let’s get into it!

 

Following on from our stage 1 post on early Rotator Cuff Rehab, this is all you need to know to lay a strong base for your shoulder stabilizers.

Stage 2 Rotator Cuff Rehab: Building strength

This stage starts when you can lift your arm up in front of you over shoulder height at least. If you can’t do that, step back to stage 1 or consult your health professional

1. External rotations

  • Lie on your side with your elbow at 90° and holding a small weight – starting with about .5kg can be a good start
  • Then lift the weight, rotating with your shoulder as shown – making sure your elbow stays touching your side the entire time and then lower down
  • Repeat for 3 sets of 10 and increase or decrease weight as needed to fatigue the muscle without pain

Rotator cuff rehab external rotationRotator cuff rehab external rotation

 

2. Overhead rotational press

  • Always start with your knuckles forward and in front of your shoulder and then press up while rotating so that your knuckles are backwards
  • Do 3 sets of 12, starting with a weight that is pain-free (such as a can of beans) and build up from there

Overhead rotational pressOverhead rotational press

3. Lawn mowers

  • Start with your hand in front of your opposite pocket. Leading with your elbow, bring your arm across your body and up to the opposite corner as shown.
  • Start with a weight that is pain-free such as .5kg and build up from there with, performing 3 sets of 12 with an aim of the shoulder being fatigued at the end.

Disco dancer shoulder rehab exerciseDisco dancer shoulder rehab exercise

4. One arm push-up

  • Place your hand on the wall at chest/nipple height. Do a push-up to the wall, keeping back straight and shoulders level.
  • Only go as far as you can control and adjust the distance of your feet from the wall so that it is challenging but not painful.
  • Do 3 sets of 10

One arm push-up shoulder exercise

Tip: If the exercise is sore to do, try and use something lighter (or move closer to the wall for #4) and if you can’t do it without pain, don’t do that one for a couple of weeks – just start with the exercises that you can do. Remember rotator cuff rehab typically takes around 12 weeks on average so patience is key

Get into routine of doing the exercises 5 days a week, combined with other exercise such as walking or biking regularly


Shoulder pain

Rotator Cuff Tear Exercises: Heal Strong and Fast

June 8, 2017 • By

A Rotator cuff tear is one of the most feared injuries but shouldn’t be. Here’s what you need to know about rotator cuff tears to get them stronger, faster.

Just how common are they?

A rotator cuff tear is present in over 20% of the population, but don’t let that number fool you because not 1 in 5 of us actually have painful rotator cuffs. This is because, just like you can and probably do have joint degeneration in your knee that gives you no pain at all, you can have rotator cuff tears that are pain-free (asymptomatic).

So the real number you should be interested in is the number of symptomatic tears; 35% of rotator cuff tears on radiology are symptomatic, which is still very common!(1)

Rotator cuff tearWhat is the rotator cuff?

Put simply, it is a group of muscles which come from the front, back and top of your shoulder-blade and wraps around that ball and socket of your shoulder. Their job is to coordinate between themselves to help keep the ball positioned nicely in the socket while you move your arm.

Rotator cuff tears often happen in the tendon, close to the shoulder joint.

Does a rotator cuff tear need surgery?

Really, it is case by case but most rotator cuff injuries do not need surgery.

As a good guideline, with all rotator cuff tears, it is best to trial 12 weeks of conservative rehab and if that has not much improved the injury, then you look at seeing the surgeon.

A recent study actually showed that there was no difference between surgery and active physiotherapy at 1-year follow-up(2)

Physio Rehab exercises for a rotator cuff tear needs to cover three things:

  • Regaining range of motion and muscle activation
  • Improving strength
  • Regaining full control and function

We are going to cover these stages in three posts and here is Stage 1, which starts after 3-4 days of rest, or more if needed:

Stage 1: Regaining range and muscle activation

1. Pendular circles

2. Regular movement

Using a broomstick or a pulley, this is a great active-assisted exercise for regaining movement and stopping the shoulder stiffening up.

Hold onto the end of the stick with your injured side and help lift it up with the other hand.

Repeat this 20 times 5 times per day without pushing into pain.

Active assisted shoulder flexion Active assisted shoulder flexion

 

isometric rotator cuff strengthening exercise3. Rotator cuff activation

These exercises activate the rotator cuff in a safe way by doing gentle wall pushes. It is essential to load the rotator cuff in a safe way and gently to encourage strong healing and minimizes scar tissue formation.

  1. External rotation
  2. Abduction

 

Read for Stage 2 rotator cuff rehab? Follow this link to the next post in the series.


Back pain, Health, Hip pain

The Best Glute Stretch

August 25, 2015 • By

This is the stretch my patients rave about the most and about the only stretch they keep doing once injury free – because it makes you feel so much better – and gets results! So give this glute stretch a shot, it can really work wonders.

The great thing is that the title is not an exaggeration.

First of all I will show you the glute stretch and a video to make sure you are doing it right and then I’ll fill you in on why it is so good for your hips, knees shoulders and especially your low back.

 

The Best Glute Stretch:

What you’re stretching:

  • the best glute stretchYour glutes, hamstrings and other hip rotators. All of these muscles at the back of your hips get stretched out here to unload the pull on your low back and hips. This also increases the mobility of your hip joint by increasing the rotation – which is essential for something as simple as walking, but also for sports such as golf where hip rotation is crucial.

 

  • Lat stretchYour latissimus dorsi is stretched out when you bring your arm across your body as shown in the video. When tight the lats can pull your shoulder down and forward, so great to stretch out!

 

Try and do this stretch daily and make it part of your routine as it can work wonders, but as with other exercises, it isn’t a quick fix!

 


Health, Shoulder pain, Upper limb

Shoulder dislocations – Don’t brush it off – Prevent Re-injury Now

September 2, 2014 • By

Have you had a shoulder dislocation physioshoulder dislocation playing contact sport? If you are young and want to keep playing sport – you are at massive risk of re-injury.

There is growing evidence that if a young athlete dislocates his shoulder and plays a physically demanding contact sport – They should have surgery. This is because the shoulder becomes unstable following this and the chances of further dislocations are incredibly high.

In a study by Slaa et al, it was found that:

  • Over-all recurrence rate of 24%
  • There is a huge 64% recurrence rate in patients under 20 years of age

Also a literature review found an average recurrence rate of 67%, with much less chance of re-injury if the patient is older than 40 years of age.

The most important findings in these studies are that you have very high chance of sustaining further dislocations if you are an athlete (82% – simonet and Cofield) and/or are a young person.

 

shoulder labral tearA large part of this is because damage has occurred to the labrum – This is the tissue that helps make the shoulder socket larger and suck the ball of the shoulder joint in. If the labrum is torn (which it often is in shoulder dislocation) this causes a break in the negative pressure in the joint – it has lost the suction – meaning it is easier to “pop out” again.

 

Thedislocated shoulder, do you need surgery? shoulder joint has a tiny socket to start with!

Think of shoulder joint like a golf ball sitting on a tee – The ball of the shoulder is much larger than the socket (the tee), so to make the socket larger, the labrum comes off the socket to add more stability.

 

So if you have dislocated your shoulder, are young and/or want to continue playing a contact sport…

  • Go have your shoulder assessed by your Physio
  • Get referred to an orthopedic specialist if they deem it necessary
  • Rehab your shoulder well and get your rotator cuff as strong and stable as you can.

Do it right the first time.

 

Yours in good in health,

Shaun

 


Mobility

Is Your Shoulder Mobility good enough? Quick Test

June 23, 2014 • By

shoulder mobility, get full shoulder rangeSwimmers, wight-lifters, cross fitters and more – you need full overhead shoulder range to prevent injury and perform well  – but how do you know if your shoulder mobility is up to scratch?

Do this easy test to see whet your overhead shoulder mobility is like!

All you need to do is lie on a bench, bed or table with your owns straight out in front (why it is often known as the superman test).

 

Combined extension test for swimmers shoulder rangeAction: Keeping your head down the entire time, raise both arms up as high as you can.

Now, you will need either a camera or someone else watching as you wont be able to see.

Pass or Fail?

For optimal range your arms need to be at least horizontal – See the photo above, the long red line is the horizon line and the other is the arm line. In this example, this is roughly negative 20 degrees of overhead range. This is a fail!

 

How to improve this?

 

What now? Get out there, find a helper and test yourself – this is very important range that, if below par is a real risk factor for injury, not just for your shoulder, but your neck and back.

 

You might also enjoy: