A Rotator Cuff Injury is typically a tear to one or more muscles, close to the shoulder joint. Exercising and stretching at the wrong time in the healing process, or in the wrong way, will make your condition worse. Make sure you understand the role of exercises and stretching in healing the Rotator Cuff before starting.
Rotator Cuff Exercise is often recommended for people who have a shoulder injury.
But exercising and stretching the Rotator Cuff at the wrong time can make it much worse.
It's important to understand that most Rotator Cuff injuries are muscle tears.
This needs to be considered when choosing exercise timing, and types of exercise.
It should also be factored in when considering stretching.
Reinjury is the biggest factor in slowing the healing of most people with Rotator Cuff injuries.
Knowing what to avoid can help you heal quickly without setbacks to slow your healing down.
Understanding how exercise and stretching impact the Rotator Cuff anatomy can help you avoid reinjury.
At any moment, as you do a task, your Rotator Cuff muscles are engaged in supporting your shoulder joint.
They provide stability while the shoulder joint lifts objects or moves through the range of motion.
At any point one muscle in the Rotator Cuff group may be contracting more than the others, depending on how the arm is positioned.
This is why you feel that sudden shooting pain when you hit a certain point when moving your arm.
Anyone with a Rotator Cuff injury knows the feeling well.
It's a sudden sharp twinge of pain that tells you that you have moved the wrong way.
That's the moment you activated that one injured muscle, and again, pulled on the tear.
The pain is your body trying to tell you what is going on in the anatomy of your shoulder.
The problem is, when you pull that torn spot on the muscle you are making it worse.
That painful feeling is happening because you pulled apart the fibers that were starting to bond back together in the healing process.
This really slows the healing process down.
That pain is letting you know healing is being undone.
And it might even be an injury getting worse.
This is the key to understanding exercise for Rotator Cuff injury.
If your exercise is triggering that sudden shooting pain, you are making your injury worse.
You want to stay away from that feeling.
But also pay attention to it.
It tells you precisely how you can and cannot move.
The Rotator Cuff Muscles are shaped kind of like a fan.
These are large and strong muscles, that are flared wide at the end where they attach on the upper back.
But they narrow down to a small point on the other end where they attach to the shoulder.
So, you have this large, and very strong muscle, pulling on a small point of attachment to upper arm bone.
Any exercise you do, that pulls on a tear while it is trying to heal, is likely to make it worse.
Exercises, lifting weight, stretching, using resistance bands are all examples of activities that will pull on that tiny point that has a tear in it.
You might be frustrated by the process of healing, but you can heal.
The good news is that your body is trying to heal your Rotator Cuff right now.
The challenge is that you are using it constantly and that constant use comes with frequent re-injury.
Understanding how to avoid re-injury will be key to healing your Rotator Cuff once and for all.
For more in-depth information about how an injury heals click here for our Healing Page.
Keep in mind when sites on the internet suggest specific exercises, they don't know anything about your injury.
Every injury is unique.
They don't know your current range of motion.
They don't know your specific injury and what helps it or heals it.
They are just offering ideas without knowing your particular injury.
The pain is how your body tells you the limit of your healing so far.
What hurts now will not hurt in a couple of weeks as your range changes.
You can carefully discover your new limits as you heal.
But always remember that motions causing the intense shooting pain are actions where you are reinjuring yourself.
It's a signal that healing is being undone.
So avoid that particular motion as much as possible.
This is a very odd but frequently mentioned theme in sites on the web.
For just about any injury, there seems to be a bunch of sites telling you it's from a "muscle imbalance".
They are saying that you have some muscles that are strong, but one is weak, and the weak one got hurt.
That's really crazy, so you can probably disregard the advice of those sites entirely.
Your body develops in a balanced fashion that suits the activity that you normally do.
And even if a muscle imbalance was a possibility, it does not really matter once you are injured.
The process of healing a soft tissue injury, like a muscle tear or tendon strain, is the same, regardless of what caused it.
Your muscle isn't weak, it's injured.
Giving the torn muscle rest to repair the damaged tissue is key.
Trying to exercise or stretch a muscle tear back to health is not a realistic approach.
Exercise for a rotator cuff injury is sometimes put forward as, "You need to move the joint to get blood flow there so it can heal".
Yes, blood flow is important, but not if you injure yourself in the process.
If you have a Rotator Cuff injury, you can reinjure yourself quite easily in two ways.
By using too much weight in an exercise.
Or stretching too far to the point of pain.
The crazy thing is, most exercises that are suggested on the web are often too much and too far.
Absolutely. Gentle motion is good for your injury.
It can help promote blood flow, but it also helps move the lymph system and promotes circulation in interstitial tissue.
Without explaining that in detail, suffice it to say that motion moves your tissue and that is good for your shoulder health.
It's really important to understand that motion does not mean exercise and stretching.
Motion is just motion.
If your shoulder is really sore, just leaning over and dangling your arm so it moves around a bit is enough to get things moving in your lymph system and interstitially.
That's it.
Just motion, not loaded exercise or hard stretching.
The motion alone gets those juices moving in your shoulder.
When you add weight with exercise or strain, you just add stress to the muscles and tendons that can cause the tear to get worse.
When it comes to actual blood flow, yes, adding some load to the muscles, will increase the blood flow more than unloaded movement.
But strenuous exercise is not your only option.
You can stimulate blood flow without endangering the injury with excessive movement.
The BFST is a diathermic device that stimulates blood flow without having to move the injured tissue.
You don't have to use it and you do not need it to heal.
But athletes and others who just don't have time to waste use BFST to stimulate rapid healing.
For more information on Proactive Treatments, you can click this link.
Stretching is a great way to find that point and go past it.
This is the exact recipe for making the injury worse.
Imagine a rope with torn fibers, and only a few fibers holding the rope together.
Would you use that rope pull on a heavy object?
It would likely tear more, or worse, it could completely break.
Yes, lots of sites are recommending specific stretches.
But they do not know the exact nature of your injury.
If you have a little shoulder tightness and no tearing then stretching could be good.
But most people with Rotator Cuff injury know something is very wrong in their shoulder.
They have sudden shooting twinges of pain to remind them when they forget.
You don't need to stretch that kind of problem.
It's not a range of motion issue.
It's a torn muscle or tendon issue.
It's a tear, most likely right where your muscle connects to the tendon in the shoulder joint.
You don't want to be putting that under tension because, right now, it is actively going through the process of bonding itself back together.
When you stretch, you pull it apart.
Which interrupts the healing process.
Exercise at this point is just to stimulate the movement of fluids in the injured area.
You are just keeping things moving and if you already must move for work you probably don't need to do anything.
Unloaded movement is your best choice.
Especially during the early parts of your healing journey.
Your body is removing damaged cells and rebuilding tissues to join the torn muscle back together again.
You have interstitial fluids in your body and in your shoulder.
Interstitial just means it's between other tissues.
These are fluids that seep from one place to another, through tissue outside the reach of the small blood vessels in your body.
This a good thing. It's supposed to happen like that, and it brings nutrients to cells, and helps remove waste products.
This fluid is called lymph and the whole system is your lymphatic system.
When you are healing an injury there is a lot of turnover of broken cells and construction of new cells.
Your body is replenishing and recycling these fluids constantly through your lymphatic system.
Most of us can't stop our daily life, so the movement you are doing each day is often enough.
If you want to do more, simply leaning over and making circles, with your arm hanging, will get things moving.
You are keeping the joint freed up and stimulating the movement of the fluids in the shoulder.
If you don't move at all, it slows the process of exchange or nutrients through your lymphatic system.
But it's a balance.
Some movement is good.
A lot of movement will increase irritation and inflammation in the injury.
And be sure you don't do anything that hurts.
If even the most basic movement hurts, then take more time to rest.
Slowly go back to normal movement over a course of weeks.
You can move to the point where you know the pain usually is.
Really, though, most rotator cuff injuries are very specific in the motion you can't do.
Adjust your motion to be movements that don't move you through the painful spot and you're good.
But don't keep pushing it.
Just pay attention and notice as the pain changes over time and your range of motion increases.
But don't force more range of motion if there is pain.
One thing that holds a lot of people with Rotator Cuff injuries back from healing is that they don't understand how long it will take.
Often people think they can go back to normal when the pain is almost gone.
Yes, the pain can significantly reduce in a few weeks.
That's a great sign.
Remember though, that even though the pain is going away, this is long before the muscle has completely healed.
There is still an ongoing repair process happening in your Rotator Cuff.
Be careful to not overdo it.
What happens is, people think they are better because the pain is gone, and they start doing things they should not do.
They lift something heavy, throw a ball, or just move their arm the wrong way, and all of a sudden, they get that shooting pain again.
It's only then that they realize they were not done healing.
Sometimes this cycle repeats over and over.
This happens because they don't have a time frame in mind for how long it will really take to heal.
A significant Rotator Cuff tear will take 4 to 6 months to fully heal.
You can gradually do more and more as you heal.
But you have to consider the risks.
If you are only 2 months into the healing process, you should not be doing heavy lifting or intense stretching.
Keep track of how long it has been since the initial injury so you can have an idea of where you are in the healing timeline.
Also, realize that any significant reinjury is essentially resetting the clock.
This is why it's so important to avoid reinjury.
This is another reason to use support tape to help reduce the chance of reinjury.
Especially if you are going to be active for work, or any situation where you think there is some risk to your Rotator Cuff.
At first, rest is the most important thing.
Don't exercise too soon.
Save strength building and blood flow exercise for much later in the healing process.
For more in-depth information about how an injury heals click here for our Healing Page.
There is so much information on the web that is just plain wrong when it comes to exercise and stretching for the Rotator Cuff. They may suggest exercises that will cause a tear to become worse. Or they may suggest something that can be helpful but only after you have healed. The most common mistakes are stretching too soon and loaded exercise. Stretching with a muscle tear is not a good idea. Heavy lifting with a muscle tear is bad as well.
That tear will be under continuous tension, through the entire range of motion of an exercise, when you use a resistance band.
This means you will find the weakest point in the tear and put it under direct stress.
These bands are good for building strength, later, once your shoulder has healed.
But not at first when you have damaged tissue that is being put under constant load by the band.
You can use them but wait until you are way into the healing process.
When the pain is masked you are more likely to move right to the point of putting tension on the torn muscle fibers.
This is because your body's natural warning system has been interrupted.
The best choice for Rotator Cuff pain is cold compression.
Cold will reduce pain and swelling very quickly without artificially masking the pain.
Most people with a Rotator Cuff injury will end up using tape.
Pro athletes certainly do. They know it works.
That's why you see them taped up all the time.
It's one of the best ways to protect your shoulder from reinjury.
But many athletic tapes, like KT Tape or Rock Tape, use toxic chemicals in the glue.
As 'Athletic Tape', they are not designed to be worn all day.
They are sporting goods which are unregulated for safety based on the assumption you only use them for a short time, during your sport.
With a torn rotator cuff, you need to have the tape on all day.
It's important to use only high quality medical support tape.
Medical tape is regulated by the FDA with strict restrictions on ingredients and health and safety.
Medical tape is designed to be used all day, every day, and is a much wiser choice if you are using it for your rotator cuff.
Don't buy into generic taping solutons you find online either.
Your injury is unique.
Your taping job needs to target your specific injury.
The proper guidance is to make an X or a T that overlaps right at the point where you feel the pain.
And wear your tape anytime you must be active, or all day long for maximum protection.
Your doctor may prescribe physical therapy for your Rotator Cuff injury.
The positive thing about physical therapy is that you have professional supervision to help guide your exercise choices.
But keep in mind that everything else you have learned about exercise still applies.
Working with a physical therapist does not mean that you should just do anything they suggest without giving it thought.
You have to advocate for yourself.
Communication is key.
Make sure you let them know how an exercise is impacting your body.
If it hurts do not push through the pain.
No matter who encourages you to push harder, never push through the pain of a rotator cuff tear.
It's your body.
Ultimately, you need to listen to the signals that come from your body over anything else.
If you know pushing something harder will likely cause that shooting pain, then stop.
Tell your therapist you need to take a break or try some other exercise.
Any good PT is going to be open to feedback from you.
They can't feel what you feel in your body, so be sure to communicate what you feel.
Sometimes people start PT too soon.
Be sure to consider whether it really makes sense yet.
The first step to healing Rotator Cuff injury is rest.
Remember what is going on in your body.
You have a tear in a muscle in your shoulder.
It is actively trying to bond itself back together.
For the first few weeks rest as much as possible.
Even limiting normal movement can be good for the first week or so.
Movement may be good, but loaded lifting and stretching are not good until way later in the healing process.
The key takeaway is that this is your body.
Everyone else's Rotator Cuff injury is not just like yours.
You have a unique injury in a unique anatomy.
So be careful with one size fits all recommendations about exercise, stretching, surgery, or anything else.
That goes for sites on the web and your doctor.
It's your body.
They advise, but you choose what is best for you.
The biggest factor in healing is rest.
Especially at first.
Then you need to avoid reinjury.
Try to do anything you can to avoid that shooting pain when you move your arm.
Use high quality medical support tape when you must be active.
Use cold compression treatment to reduce pain.
It works amazingly well for pain without blocking the normal communication your body provides.
In time, you will heal.
Remember that it takes longer than you want, and give your body the time it needs.
If you have no time to waste and want to stimulate rapid healing then use BFST.
If your rest, avoid reinjury, and give yourself time to heal, you can be stronger than you were before.
Click here to visit the Recommended Treatments page for more information on BFST, Cold Compression therapy, Taping to protect yourself and other treatments that will really help.
For more in-depth information about how an injury heals click here for our Healing Page.
