Rotator Cuff Recovery

A snowHead

Hello Snowheads,

After 18 weeks on snow I picked up my first injury annoyingly indoors up at MK 3 weeks ago. Fell onto an outstretched arm and had pain straight away, a+e reckoned a grade 2 ac joint injury and the doctor at the fracture clinic thinks it's rotator cuff injury. Been referred for physio for the time being to see how it goes. Have any of you got any experience recovering with this type of injury conservatively?

A snowHead

My very non medical advice would be to keep it moving as much as you feel you can. I fractured the humeral head and tore my rotator cuff last December. It resulted in a frozen shoulder and i still have limited mobility with it.

I did manage to ski last season with the help of a couple of steroid injections.... but we warned, they hurt like hell!

Well, the person's real but it's just a made up name, see?

@mooreski,
I suppose it depends on just how the rotator cuff is damaged. I have Slap tears in both shoulders as a result of climbing. I could not face the surgery normally associated with repairing this. I am old.

Good physio exercises got me back to climbing. I learned from shoulder 1 where my following my GP advice of rest, I suffered severe muscle wastage. Shoulder 2 and I was straight into physio. Gradual increase in range of movement of the joint, followed by increasing theraband exercises produced a pretty good outcome.

My shoulders sound like a bowl of rice crispies, but so long as I am gradual in my approach to strength and mobility improvements things remain manageable. I still can't get beyond 8 pull ups/chins without breaking down though!

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@mooreski, Go and see a good physio, even if it's private and costly. I did similar a few years ago, suffered for a couple of months, then went to a great physio, about 3 sessions, huge improvement, and probably another month later no issues.

Anyway, snowHeads is much more fun if you do.

Thanks for all your advice so far @RichClark, @HammondR, @srobbo.

The extent of the tear is all but unknown, doc has said try for physio and if that is no good further tests (assuming mri/ultrasound). I’ll be looking up some physio first thing in that case, NHS wait is a bit longer than I had imagined. I couldn’t do chin ups before so I’m not too fussed...

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When I had a Rotator Cuff injury, which wasn't very serious, I did specific exercises like:

- External shoulder rotation

http://youtube.com/v/tijDtTzNdu8

- Internal rotation

http://youtube.com/v/HgRgAioWb2E

Upright rotation

http://youtube.com/v/jQ4TKUEVDoc

Check out other rotator cuff exercises and stretches as well.

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@mooreski, one word of caution. If you are nails, disregard this post.

Having a shoulder scan isn't like knees and such like. Because the shoulder is such a complex joint, huge amounts of discomfort/searing pain must be inflicted on the patient. A gigantic needle is stuck right into the joint and some fluid is injected in which makes the scan result clearer.

In spite of being 100% unreconstructed Northern, I am not having that again.

After all it is free

@mooreski, before I start, I am not a physio or doctor or anything like that. It will probably take about 3 months to get from your GP, through triage and to an actual physio. Don’t wait this long to start using your arm, or it will seize up. Try and keep it moving, lifting small things, whatever you can manage.

@HammondR, that does not sound like fun Shocked

Hello @mooreski, snowHead

There are 3 key steps to rotater cuff recovery:

1. Stretching
2. Stretching
3. Stretching

These are my top 3 stretches - worked for me... (same geezer as above but I much prefer cable machines for these types of things)

http://youtube.com/v/I1DtikA6KGw

http://youtube.com/v/N4b4KIPUpeo

http://youtube.com/v/T_WCU7wjn4Y

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Just to add to what @red 27, said....I found Trigger Point/Myofascial Release with a tennis ball, also helped. A bit of Googling will point you in the right direction. If in doubt a good physical therapist who uses it, will show you.

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@mooreski, I've had both and the symptoms are very different. I'm surprised you have got two conflicting diagnoses. An AC joint sprain is primarily a skeletal injury (ligament) whilst a rotator cuff injury is muscular (tendon).

Therefore if it's AC, you will have no loss of strength in the joint but it will click/pop/grind in certain (most) movement planes and may well be excruciatingly painful if you do the 'wrong thing'. You almost certainly will not be able to lie on it without pain.

A rotator cuff injury (if not completely torn) will ache but will not grind or click. Moving your arm will feel specifically weak in one plane of movement but fine in other planes depending on which rotator is damaged. If it's completely torn you will have no more than a few inches of movement and it needs surgery.

An AC joint responds well to stretching (which reduces the strain on the ligament) followed by a gradual increase in load bearing exercises. Be careful not to aggravate the weakest plane of movement.

A rotator cuff needs to be rested initially (2 weeks) to be sure that you don't tear it completely followed by isometric exercises and then a fairly rapid increase in load bearing exercises. After 3-4 weeks you should work it to fatigue 2-3 times a day.

I would expect to fix a rotator cuff completely in 6 weeks but a Grade 2-3 AC joint is 6-12 weeks depending on the severity.

Disclaimer: Not qualified to offer advice except through experience. 34 dislocations and 3 reconstructions.

snow reports

@red 27, 2 out of the 3 videos you've posted are not stretches, they're load bearing strength training. They're also specific external rotator exercises for the infraspinatus. That's fine if that's the rotator cuff part that's injured but no use at all if the injury is to the supraspinatus or subscapularis.

I'm not trying to be clever, just making the point that for a rotator cuff injury, the exercise must address the specific movement weakness - internal, external or lateral.

For rehab, it's best to do a series of reps that address all three planes of movement as it will soon become clear which is the weak point. Same as anywhere else on the body, shoulder injuries are often caused/aggravated by an imbalance between the muscles. Focus on the weak point and when all three planes have similar strength levels, the rehab is finished.

i"m a postman and after 30 years of carrying a sack on one shoulder it finally succombed to a rotator cuff injury, royal mail sent me to a very good physiopherapist, in fact he looks after a very well known golfer, and all he gave me was a popped balloon and showed me a few stretching exercises with it, after the six week course was up he was quite happy to send me back to work, although this happened 8 years ago i have recently been diagnosed with osteoarthritus in the same shoulder joint.

You know it makes sense.

Thanks for the videos @old Fartbag and @red 27 I'll certainty give them a go once I've seen the physio! @HammonR maybe I won't request a scan in that case 😂

@scarlet Pretty much spot on with your estimate 12 weeks from injury day is my first physio but in the meantime will be going through work and if not private! Can't wait that long till I'm active again! A popped ballon @composter glad to see they've not gone to high tech.

Not the best to get to conflicting opinions @raceplate although the doc thinks the AC joint was a old injury which I never noticed about! Although I'm sure the bump on ,y shoulder wasn't quite as large before...

Otherwise you'll just go on seeing the one name:

Moorski I can only reiterate the advice to get some physio asap. On March 16th I fell skiing and dislocated my shoulder. To cut a long story short it was diagnosed and put back within a couple of hours without too much pain. I was recommended to see an orthopaedic surgeon on my return to the uk. Went to my GP immediately (mistake should have gone to A&E), 3 weeks to get appointment at hospital, 6weeks to get MRI, (not a painful process) eventually saw Consultant on 6th June which was nearly 12 weeks later. In all of this time i lost nearly all range of movement and strength in my shoulder. Consultant wanted RoM back before any operation so arranged physio. Three weeks later I got NHS physio appointment!!!
I didn’t wait and arranged private physio through my insurance and wish i had done it straight away. It took another 12 weeks to regain 95% RoM. The physio excercises were painful but she said “its good pain” and I agree. Even now when my shoulder hurts I do some strengthening exercises and the pain eases. I’m still waiting for surgery to repair the shoulder.
As an aside. When I fell off my bike three years ago into the other shoulder it took 18 months to recover pain free without help.

A snowHead

@mooreski, I suspect that the popped balloon was actually a theraband - they're worth having, start with red and then work up to green.

I had to work though these initially, because of the fracture there was very little that I can do.

A snowHead

@kevinraine, Fairly similar story. I was knocked over in Les Arcs and fairly quickly x rayed and the shoulder put back in. The doctor in Les Arcs reccomended that I see a surgeon in Grenoble because he suspected the rotor cuff rupture. I delayed and saw my GP when I got back home. He referred me immediately to the local hospital and I got an appointment in a couple of days and booked in for surgery a week later to reattach the 2 torn tendons. Apparently it was classed as trauma so went straight to the top of the queue; no doubt pushing a couple hip replacements further back. Physio started 6 weeks later with a weekly visit to the local hospital. The next 6 months were incredibly painfull but now the shoulder has full range of movement and back completely normal.

When I went through a similar procedure a couple years later for a grade IV AC seperation on the other shoulder the surgeon couldn't restrain his laughter when he saw the screws fromthe rotor cuff repair while trying to compare shoulders. This time they waited 6 months to see what function was recoverd without operating. In the end the operation was less painful that the rotator cuff repair and though it still doesn't feel "right" I have full range of movement and strength.

The physios at the hospital were good and I just followed their instructions.

Well, the person's real but it's just a made up name, see?

I've had a slap repair on one shoulder and a rotator cuff on the other. You can do all the stretching you like and its important you do but your body wont release the shoulder fully and properly until its ready. Don't rush any recovery because no matter how tight your shoulder feels after surgery if you stretch like your physio tells you it'll come back to near perfect. Patience is a virtue with shoulders!

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Thanks for all the info! As a bit of an update the DR's have diagnosed a non-tender prominence to the ac joint and weakness of supraspinatus and subscapularis in the rotator cuff. Pretty much full range of motion and just working on building up strength. Back skiing and maybe racing soon (I'll try and stay upright next time Very Happy

).

Anyway, snowHeads is much more fun if you do.

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@mooreski,

Sorry to hear of your injury.

How certain are you that the diagnosis is correct?

Did you see a shoulder specialist, a junior doctor or did they scan you?

Cuff tears may take months to settle. So you want to be sure they are correct. Did they scan you ( ultrasound or possibly mri)
A lot of time ( and money) can be wasted on a treatment if the diagnosis is incorrect.

Jonathan Bell

Then you can post your own questions or snow reports...

Damaged my left rotator cuff in March this year. Partial tear as I could pass the drop test. Some physio but mostly gentle exercise and lots of swimming.

November and I am about 90 % recovered. Full movement but still some pain.

70 year old living full time on a boat.

After all it is free

Resistance band training can help a lot with this! I got some good bands from http://e-physio.co.uk/ really helped me with my injury rehab

Fell forward last January and hurt both shoulders tho left was worse. Carried on skiing for the week, thinking it was just bruising. Back in UK shoulders have not got better, in fact got stiffer. Can't move arms out to sides without pain. Have now been referred for an ultrasound in case I've torn something. In the meantime have been given very useful link to shoulder exercises. I can do some of them but not the overhead ones at all. Thought these exercises might be useful if anyone else has a similar problem?
https://www.versusarthritis.org/about-arthritis/exercising-with-arthritis/exercises-for-healthy-joints/exercises-for-the-shoulders/

Read some of the previous comments and think keeping mobile with gentle stretching in the meantime is a good idea.

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Eek. I have 3 kids. All that pain but you do get handed a little bundle of joy afterwards. Is there joy after rotator cuff injuries?

snow reports

I had a rotator cuff problem after a fall on the slopes a few years ago and it took months to get even a modicum of better ...the only excercises that helped me was a 1 then 2 K weight and just keep on doing gentle testing arm raises with it nasty injury

Update: econsult with gp who phoned me after 2 days. Gp requested urgent ultrasound. Appointment letter arrived one week later. Appt date is 28 march. Was supposed to be skiing again 27 march. Nervous of booking private physio without knowing what the damage is.

You know it makes sense.

Otherwise you'll just go on seeing the one name:

I got wiped out six weeks ago by an out of control French bloke about three stone heavier than me. I was airborne and landed on my right shoulder. My physio said that he thought that I had dodged a bullet as nothing was broken.

I believe that professional diagnosis and rehab is essential. Injuries can vary. It may not just be the rotator cuff which many people assume is the only problem. I also had a stiff neck and a bruised chest. It was uncomfortable to cough for the first two weeks. It is still not fully recovered, mind you I am 75. I have exercises specific to my requirements.

I also heard of a lady who did not seek professional advice and ended up with a frozen shoulder.

Please seek professional advice.

A snowHead

Just thought I would add to this conversation. I have been watching Jeff Cavaliere (Athlean X) videos on youtube since 2014. He is considered to be one of the best PT's going. He ruptured his rotator cuff losing a bet throwing a baseball when he was the head physio for the New York Mets. Long story short - if you search "athlean x rotator cuff" on youtube you will find heaps of useful info. He also has a ton of other useful vids on training through injury. Smile

A snowHead

Well, the person's real but it's just a made up name, see?

Darn.... Never fun. Did mine in early 2001. Caused me issues for years and didn't really come good until i started strength training about 6-7 years ago.

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It has long fascinated me that so many injured snowheads come onto this site to ask advice from a load of well-meaning non-medics.
I bet GottaCatchEmAll's surgeon, if he was any good, told him from the start that the only thing that would work was surgery.

For shoulder injuries, you must make sure the team you are consulting are Shoulder Specialists, not some general orthopaedic surgeon.
Better still, check they are part of a Shoulder Surgery Group.
Could be NHS, such as https://www.rnoh.nhs.uk/services/shoulder-and-elbow-unit
Or if impatient and insured, you could try https://www.kingedwardvii.co.uk/services/specialist-shoulder-unit
(Other private units are available )

Then after your operation (if needed), you need to follow the excercise regime to the letter, however much it hurts (and it will).

Anyway, snowHeads is much more fun if you do.

Even if you don't have a specific Rotator Cuff problem - it makes sense to strengthen the area, to help protect against injury. It's a series of exercises that are often neglected in a weight training routine.

Even a relatively minor injury takes ages to come around....and then IME leaves you more susceptible to reinjury.

Help!!

Rotator Cuff Recovery

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