All Posts tagged exercises for shoulder

Rotator cuff tears and shoulder pain

February 15, 2011 (San Diego, California) — A physical therapy program can effectively treat most patients who present with atraumatic full-thickness rotator cuff tears and shoulder pain, without the need for surgery, researchers announced at the American Academy of Orthopaedic Surgeons (AAOS) 2011 Annual Meeting.

“Our non-operative program is successful in over 90% of patients and the effect seems to last at least 2 years,” John E. Kuhn, MD, associate professor and chief of shoulder surgery at Vanderbilt University Medical Center in Nashville, Tennessee, and director of the Multicenter Orthopedic Outcomes Network (MOON) Shoulder Group, said.

In the United States, at least 10% of persons over age 60 years, or nearly 6 million people, will develop a rotator cuff tear.

Prospective Cohort Study

The study included 396 patients age 18 to 100 years who had atraumatic full-thickness tears documented by magnetic resonance imaging and no other abnormality. The primary symptom was pain in most patients.

Patients were assigned to a physical therapy program that included daily postural exercises, active-assisted motion, active training of scapula muscles, and active range of motion, along with anterior and posterior shoulder stretching. They also performed thrice-weekly rotator cuff and scapula exercises. The program has been shown to be effective in patients with impingement syndrome.

Study participants also did manual mobilization exercises with assistance from a therapist.

Patients returned at 6 and 12 weeks. At this point they could decide that 1) treatment was successful and they needed no formal follow-up, 2) they had improved but would like to continue therapy with scheduled reassessment in 6 weeks, or 3) nonoperative treatment had failed and they would undergo arthroscopic rotator cuff repair.

Patients were contacted by telephone at 1 and 2 years to determine whether they had undergone surgery since their last visit.

Improvements on Multiple Outcome Measures

Six-week data indicate that fewer than 10% of patients had decided to undergo surgery.

Of patients in whom follow-up data were available for at least 2 years, only 2% had opted for surgery.

The analysis also revealed that patients who decided to undergo surgery generally made their decision within 6 to 12 weeks of starting physical therapy. In addition, patients did most of their physical therapy at home and usually made only 1 weekly visit to the physical therapist.

Finally, Dr. Kuhn emphasized that the physical therapy program alleviated pain without “doing anything to the tear.” The finding suggests that pain may be a less suitable indication for rotator cuff repair than is weakness or loss of function.

American Academy of Orthopaedic Surgeons (AAOS) 2011 Annual Meeting; Abstract #319. Presented February 15, 2011.

 

These findings are typical of what I find in my rehab practice. Those clients that do the exercises improve.

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Bad Tennis Shoulder Exercises Using Theraband

Thera-Band Tubing Exercises for Tennis: These exercises are designed to help improve strength and prevent injury.

Perform these exercises with a resistance that allows you to complete 15-20 repetitions to fatigue; start with one set and progress to 2 sets of 20. Increase to the next color resistance level when these exercises become easy.

Thera-Band Tubing with Door Anchor
Pull webbing of Door Anchor through clasp to create 2 loops at end opposite of disk. Slide one   handle of the tubing up through one loop and then down through the second loop of the Door Anchor. Pull and tighten the Door Anchor loops down securely on the tubing to fix length as needed.
  Thera-Band Tubing Forearm Pronation
Secure the middle of the tubing under one foot. Grasp the handle with your wrist facing upward and forearm resting on your thigh. Slowly rotate your forearm so your palm faces downward. Hold and slowly return.
  Thera-Band Tubing Forearm Supination
Secure the middle of the tubing under one foot. Grasp the handle with your wrist facing down and forearm resting on your thigh. Slowly rotate your forearm so your wrist faces upward. Hold and slowly return.
  Thera-Band Tubing Wrist Extension
Secure the middle of the tubing under one foot. Grasp the handle with your wrist facing downward and forearm resting on your thigh. Slowly extend your wrist upward. Hold and slowly return.
  Thera-Band Tubing Wrist Flexion
Secure the middle of the tubing under one foot. Grasp the handle with your wrist facing upward and forearm resting on your thigh. Slowly bend your wrist upward. Hold and slowly return.
  Thera-Band Tubing Reverse Fly
Hold one handle in each hand, and grasp tubing about a shoulder-width apart. Extend your arms at shoulder level and keep your elbows straight, stretching the tubing. Hold and slowly return. Keep your head and trunk upright.
  Thera-Band Tubing Lat Pull Down
Secure the middle of the tubing to a door or sturdy object above shoulder level. Grasp the handles at shoulder-level and pull backwards, bending your elbows. Bring your hands to your shoulders. Hold and slowly return. Keep your head and trunk upright.
  Thera-Band Tubing Shoulder Dynamic Hug
Grasp both handles and wrap the tubing around your upper back. Bend your elbows and slightly abduct your shoulders. Bring the handles together, and cross over the other forearm. Keep your wrist straight and elbows slightly bent. Hold and slowly return.
  Thera-Band Tubing Bent-over Row
Stand on the middle of the tubing. Slightly stagger your step and lean forward at your hips. Don’t arch your back. Grasp both ends of the tubing with your elbows extended at your side. Pull one end of the tubing upward, bending your elbow. Hold and slowly return. Brace your abdominals and don’t rotate your trunk.
  Thera-Band Tubing Shoulder External Rotation
Securely attach the middle of the tubing to a door or sturdy object. Place a rolled-up towel under your arm. Bend your elbow at your side and bring your forearm in front of your body. Grasp handle and pull outward, keeping your elbow by your side, and forearm parallel to the ground. Hold and slowly return. Keep your wrist straight.
  Thera-Band Tubing Shoulder Scaption
Grasp both handles and stand on the middle of the tubing. Lift your arm out to your side and slightly forward (about 30 degrees from your body). Keep your elbow straight and palm facing forward. Lift to shoulder level, hold and slowly return.
  Thera-Band Tubing Elbow Extension
Stand on the middle of the tubing. Extend your shoulder and grasp handle with your elbow bent behind you. Straighten your elbow, keeping your shoulder extended. Hold and slowly return.
  Thera-Band Tubing Elbow Flexion
Stand on the middle of the tubing. Grasp the handles with your palms facing upward. Bend your elbows upward, keeping your elbows by your side and your wrist straight. Hold and slowly return.
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