Rehabilitation and Treatment

Treatment of inflammation of the rotator cuff begins with an accurate diagnosis to rule out a tear of the cuff, followed by an active care program of Active Release Technqiue and/or Sound Assisted Soft Tissue Mobilization and Rehab.  These treatment protocols have been found to be twice as effective as physical therapy programs involving range of motion and passive modalities such as ultrasound. 

Stretching of the shoulder rotator cuff muscles is easily performed both as treatment for inflammation and as a warm up before activity. Specific stretches are targeted to the desired activity. For example, for skiing, with a ski pole held firmly with one hand at the basket and one hand on the handle, with the arms held out straight, bring the pole from the waist to above the head, repeating the motion slowly to the limits of the range of motion. With the arms above the head, lean the ski pole as far as possible to the left and then to the right. This motion should be repeated with the arms in front of the body, both held out straight and in the flexed position. Many other shoulder stretches are available and most are helpful as long as sharp pain is avoided.  The following is our stretching protocol demonstrated to our patients.  Remember, do not do any that cause pain.   Rotator Cuff Stretches

Strengthening of the shoulder rotator cuff muscles is best performed by isolating each muscle group and selectively training that muscle. Rehab starts with strengthening the muscles around the shoulder blade.   This gives the rotator cuff a strong foundation to work off of.  The patient is then progressed to rehab of the rotator cuff muscles.  Please look at the following two links for our protocols:

Rotator Cuff Strengthening

Scapular Stabilization

The logic behind stretching and strengthening the inflamed rotator cuff in order to speed healing and functional performance is as follows: the inflamed tissue is characterized by increased fluid between the cells, increased numbers of new blood vessels and inflammatory type cells. As a result of this inflammatory reaction, new collagen tissue is laid down in an effort by the body to heal the injured tissue. If the shoulder is immobilized during this time, the new collagen is laid down in a disorganized fashion, creating scar. The goal of gentle stretching, strengthening and anti-inflammatory medication, is to stimulate the cells to lay down collagen along the lines of stress, forming normal strong tendons. The combination of a good warm up, gentle stretching, strengthening below the limits of pain, icing after working out and anti-inflammatory medication has been consistently shown to speed recovery time in the strongest possible fashion.

Prevention and Treatment

Shoulder injuries can be diminished by careful warmup, stretching, and strengthening of the shoulder muscles. The exercises described above for treatment of the injured shoulder are superb for a general conditioning program. When shoulder injury symptoms begin, early evaluation and treatment can prevent mild inflammation from becoming full blown rotator cuff impingement, or worse, a tear of the rotator cuff. A program of twenty minutes a day of shoulder stretches and muscle strengthening exercises is recommended to increase performance and decrease injuries. As “chance favors the prepared mind”, so does injury haunt the unprepared athlete.

Summary

The rotator cuff muscles are susceptible to injury from falls. The injuries are usually treatable with stretching, strengthening, and anti-inflammatory medication with full return to sports expected. Careful differentiation between inflammation and tearing of the rotator cuff is mandatory. If the cuff is torn, early arthroscopic or open repair is often helpful. Preventive conditioning exercises can diminish the frequency of these injuries.

Information about how Dr. Dingsor treats can be found on About the Doctor page or if you need further information call 605-882-2304.