Heat if needed before strengthening. No other modalities necessary. **Please do not use the UBE (upper extremity bicycle).
Use an isotube for all rotator cuff exercises. Start with one set of 10-12 repetitions of each exercise per day. Young athletes may do up to 3 sets per day. Others should stay at one set per day (two max). If you increase the resistance, which is often not necessary, please return to 1 set of 10-12 repetitions and then work up from there. Please perform the strengthening exercises every day.
Avoid pain. If pain occurs, modify by: decreasing the resistance, decreasing the number of repetitions, or restricting the exercises to the pain-free range of motion. Exercise through the fullest pain-free arc of motion. Use a slow, smooth motion.
Once symptoms resolve, it is important to maintain strength by performing the exercises 3 days per week for 3 months.
Rotator Cuff Strengthening Exercises
1) Internal Rotation, 2) External Rotation, 3) Forward Flexion, 4) Abduction, 5) Extension, 6) Diagonal PNF; from opposite hip with thumb down, to elevated position with thumb up: Like pulling a sword from a scabbard on the contralateral hip and raising it over your head.
1. Internal Rotation
2. External Rotation
3. Forward Flexion
Diagonal Proprioceptive Neuromuscular Facilitation
Scapulothoracic Strengthening Exercises
Use an isotube. Form is very important for these exercises. Each exercise should be performed in 4 discrete motions to strengthen the shoulder blade (scapulothoracic) muscles. Otherwise, the body tends to “cheat” and use arm muscles to perform these motions, preventing strengthening of the scapulothoracic muscles that we are trying to focus on.
3) Push up plus
4) Press-up plus from a chair with arms