If you love working out or gardening, you understand how serious shoulder injuries can be. Rotator cuff tears are one example of such injuries. They commonly cause shoulder pain, affecting millions of individuals each year. Seeking proper treatment can help you recover, feel better, and prevent minor injuries from worsening. For many patients, physical therapy could be all needed to treat a damaged rotator cuff.

At Suarez Physical Therapy, we can help you regain mobility and muscle strength after an injury. Our physical therapists can restore your shoulder’s natural range of motion using therapeutic techniques such as exercise, heat, ice, massage, and specialized treatment. Our physical therapy professionals in Las Vegas offer treatment customized to each patient's needs.

An Overview Of Rotator Cuff Tears

A rotator cuff consists of four muscles and tendons connecting the upper arm bone, the humerus, to the shoulder blade. Its primary function is to maintain stability in the shoulder joint.

The rotator cuff can become inflamed or irritated due to:

  1. Repetitive arm motions.

  2. Heavy lifting.

  3. Trauma such as a fall.

Rotator cuff tears occur when muscles or tendons are injured. This can lead to tissue disruption or damage. Depending on the severity of the tear, these injuries may be classified as either partial-thickness tears or full-thickness tears.

  • A full-thickness tear affects the rotator cuff tendon or muscle, running from the top to the bottom of the muscle

  • A partial-thickness tear affects a section of the rotator cuff muscles or tendons but does not extend all the way through

Rotator cuff tears commonly result from prolonged shoulder overuse or a traumatic incident. These conditions are often classified as acute or chronic:

  • An acute rotator cuff tear occurs suddenly, usually as a result of trauma, such as a fall or moving heavy objects

  • Chronic rotator cuff injuries develop over a significantly longer period. These tears result from repetitive arm movements above shoulder level, such as participating in overhead sports such as tennis, baseball, golf, basketball, or swimming, or performing repetitive tasks at work

Patients with chronic rotator cuff injuries usually have a history of rotator cuff tendon inflammation. This inflammation causes shoulder pain during movement, known as shoulder impingement syndrome.

A rotator cuff tear can develop due to:

  • Continuous wear and tear or degeneration of tendon tissues

  • Injuries to the shoulder's biceps tendon

  • Labral tears affecting the cartilage ring at the shoulder joint

A physical therapist can help you manage the issues related to rotator cuff tears.

Symptoms of Rotator Cuff Tears

Patients suffering from rotator cuff tears may experience the following symptoms:

  • Pain in the upper shoulders or along the forearms

  • Shoulder weakness

  • Loss of shoulder mobility

  • A feeling of heaviness or weakness in your arm

  • Being unable to raise your arm and reach up or behind your back

  • Limited mobility and pain that prevents you from engaging in routine tasks

Diagnosing a Rotator Cuff Tear

A physical therapist can carry out a thorough assessment to determine the exact cause of your shoulder pain. This involves gathering information about your symptoms, evaluating your arm’s range of motion, checking for signs of weakness, and conducting tests that can reveal rotator cuff tears.

For example, a physiotherapist can ask you to raise your arm, move it to one side, or instruct you to resist a certain force at various elevation angles. Sometimes, these test results indicate the need to refer patients to an orthopedic specialist or another expert for diagnostic imaging procedures such as MRI, ultrasound imaging, or CT scans.

How a Physical Therapist Can Help With Rotator Cuff Tears

Once diagnosed with a rotator cuff tear, you will consult a physical therapist and orthopedist. They can determine whether you should undergo surgery or attempt to recover without it.

If surgery is not required, your physiotherapist will work with you to regain muscle strength, coordination, and range of motion. This allows you to resume normal activities. In some cases, they can modify your workout routine to reduce stress on the shoulder region. If you opt for surgery, a physical therapist can assist you before and after the procedure.

Regardless of the treatment you receive—physical therapy alone or surgery followed by physical therapy—early intervention can help you recover quickly and avoid any lasting effects.

For Acute Injuries

If rotator cuff tears are suspected after trauma, consult a physiotherapist or any other medical practitioner to rule out any severe limb or life-threatening problems. Once a serious injury has been ruled out, your physical therapist can help you manage your pain and plan the best course of therapy.

For Chronic Injuries

Physical therapists can help you manage the signs and symptoms of chronic rotator cuff injuries and improve your shoulder function. They can also teach unique shoulder movement patterns to patients with large rotator cuff tears that cannot be fully repaired. However, if conservative treatments and physical therapy do not restore your function, surgical intervention may be necessary.

The Role of Physical Therapy Before and After Surgery

Surgery to restore shoulder function may be required if a patient's health condition is serious. Physical therapy will play an important role in your recovery. A repaired rotator cuff is prone to reinjury after shoulder surgery. Working with a physiotherapist is essential for restoring full functionality to the affected arm.

After the surgery, you must wear a sling to protect your arm and shoulder while you heal. During this stage of recovery, your physical therapist can offer treatments to:

  • Alleviate pain.

  • Gradually restore movement.

Once you remove the sling, your physiotherapist will guide you through a comprehensive rehabilitation program. Your physical therapist can create a treatment plan based on the evaluation results and your specific goals. They will guide you through your post-surgical rehabilitation, which includes everything from gentle range-of-motion and strengthening exercises to sport-specific activities.

The treatment plan can incorporate various workouts that:

  • Strengthen the rotator cuff and other tendons.

  • Support the shoulder joints.

Your recovery period will vary based on the surgical method and overall health. However, you may be unable to resume heavy lifting, sports, and other demanding activities for four months after surgery. Also, full recovery might take nine months to one year.

After surgery, you risk reinjuring your shoulder. It is essential to follow the postoperative recommendations given by your physiotherapist and surgeon. Your recovery will typically be divided into four stages:

Stage 1 (Maximum Protection)

The first few weeks following surgery are known as the first stage of treatment. This is when the shoulder is most vulnerable to re-injury. During this phase, you will wear a sling on your arm. You will likely need help or alternative ways of completing daily activities like dressing and showering.

In addition to teaching you strengthening workouts and gentle range-of-motion exercises, your physical therapist can also use manipulative or manual therapy, a hands-on approach to treating patients. This mostly includes muscle manipulation, kneading, or joint manipulation and mobilization. They will also guide you on pain management, including electrical stimulation and cold compression techniques.

Stage 2 (Mild Protection)

This phase aims to restore shoulder mobility. You will use the sling less often, and the strengthening and range-of-motion exercises will become more complex. These workouts will also strengthen the rotator cuff and core muscles, which support the shoulder blade and trunk.

Although you will not be doing much heavy lifting, you should be able to continue using your arm for everyday tasks. During this stage, your physical therapist may use special manual mobilization techniques to help you regain your range of motion.

Stage 3 (Resuming Routine Tasks)

At this stage, your physical therapist will aim to restore strength and joint awareness to match your other shoulder. You should be able to use your arm fully for everyday tasks at this stage. However, you cannot carry out physically demanding activities like sports. Your physical therapist will increase the resistance in your exercises by having you use heavier weights or more challenging movement patterns. Your physiotherapist may also introduce a modified weightlifting or gym-based program at this stage.

Stage 4 (Returning to Work or Sports)

This phase aims to facilitate your reintegration into work, sports, and other advanced activities. Your physical therapist will provide precise instructions on activity-specific exercises tailored to your needs. Some athletes may be asked to participate in throwing and catching drills as part of their training regimen.

For others, it may involve exercises that include lifting heavier objects onto shelves or receiving guidance on correct body alignment for activities such as:

  • Raking.

  • Shoveling.

  • Performing household chores.

Can Exercise Help Fix a Rotator Cuff Tear?

Once the pain and swelling in your arms have reduced, you can start exercising to help heal and prevent loss of motion and frozen shoulders. After an injury, you can apply the RICE method, that is:

  • Rest.

  • Ice.

  • Compression.

  • Elevation.

These measures work together to relieve pain and swelling.

You can also perform specific exercises using a resistance band or light dumbbells. These include the following:

Doorway Stretch

Spread your arms to the sides while standing in an open doorway to help warm up your muscles. Lean forward through the doorway until you feel a light stretch. Hold the sides of the doorway with both hands at or below shoulder level.

Keep your back straight as you lean and shift your weight onto your toes. You should feel a stretch in the front of your shoulders. Be careful not to overstretch. Hold this position for 15 to 30 seconds and repeat thrice daily.

Side-Lying External Rotation

Place your feet shoulder-width apart and bend your knees slightly. Keep your back straight and lean forward slightly at the waist. Hold a light dumbbell in each hand and extend your arms away from your body, avoiding locked elbows. As you do this, squeeze your shoulder blades together. Do not raise your arms above shoulder level. Return to the starting position and complete three sets of ten repetitions.

High to Low Row Exercises

Connect your resistance band to a sturdy object at shoulder height or higher. Make sure it is secure enough to withstand pulling without detaching. Kneel on one knee, raising the knee opposite your injured arm. Align your knee and body in a straight line.

Put your other hand on the raised knee. Hold the band firmly and stretch your arm out, then bring your elbow closer to your body. Keep your spine straight as you pull and squeeze your shoulder blades together and down. Do not twist or move with your arm. Return to the starting position and complete three sets of ten repetitions.

Lawnmower Pull

Place your feet about shoulder-width apart. Put one end of the resistance band under the foot opposite your injured arm. The band should go diagonally across your body. Hold the other end with your injured arm. Bend slightly at the waist so the hand holding the band is parallel to the opposite knee. Keep your free hand on your hip and maintain a slight knee bend.

Stand up straight and pull your elbow across your body to your outer ribs as if you were slowly starting a lawn mower. Keep your shoulders relaxed as you stand, and squeeze the shoulder blades together. Do three sets of ten repetitions.

Can Rotator Cuff Tears Be Prevented?

If you consult a physical therapist when you experience shoulder pain or discomfort, they can help prevent your rotator cuff tear from worsening or even from occurring. If you already have a shoulder problem, they could recommend that you stop performing activities that could aggravate your condition and cause a rotator cuff tear.

A physiotherapist can help you strengthen your rotator cuff muscles, teach you how to avoid harmful positions, and guide you on when to resume your normal activities. Physical therapists recommend the following steps to maintain shoulder health and prevent rotator cuff tears.

  • Avoid repeatedly holding your arms overhead, as this could strain your shoulders. If your work requires performing these movements, consult a physical therapist about safer arm positions and techniques.

  • Include exercises that strengthen your rotator cuff and shoulder blades in your regular exercise routine. The rotator cuff’s strength is as important as that of any other muscle group. General strength training exercises can help maintain shoulder health and prevent rotator cuff injuries.

  • Maintain good posture. Research shows that moving your head and shoulders forward can alter the position of your shoulder blades, potentially causing shoulder impingement syndrome.

  • Avoid lying on your shoulder or sleeping on your side with your arm stretched out over your head. These positions can cause damage to your rotator cuffs and may aggravate your pain.

  • Avoid smoking at all costs. It can reduce blood flow to the rotator cuff.

  • As soon as you start to feel unwell, you should see a physical therapist.

What Type of Physical Therapist Should I See?

Physical therapists have the knowledge and training to treat patients suffering from rotator cuff tears. However, you should consider the following factors:

  • A physiotherapist specializing in helping patients with muscle, joint, or ligament problems. Some physical therapists focus primarily on orthopedics as their main area of expertise.

  • Board-certified physical therapists or those who have completed a fellowship or residency in orthopedic physiotherapy may be better equipped to help you with your condition. Their advanced knowledge, experience, and skills qualify them to address your needs.

  • Search for physical therapists in your area with specific clinical expertise using Find a PT, an online tool created by the American Physical Therapy Association. This tool can help you find physical therapists with various credentials and specializations.

When searching for a physical therapist, consider these general factors:

  • Ask family, friends, or other healthcare professionals for recommendations.

  • When calling a physical therapy office to schedule an appointment, ask how many times the therapists have helped patients with labral tears before.

  • Be prepared to provide a detailed description of your symptoms and explain what exacerbates them.

Are There Other Safer Exercises For Someone Who Has a Rotator Cuff Tear?

You can perform more exercises to help you heal faster and prevent further damage. These include:

  • Trapezius and rhomboid muscles using Self-Myofascial Release (SMR).

  • Perform SMR on your back using a tennis ball against the shoulder.

  • Small and large pectoralis SMR using a tennis ball.

  • Stretch your whole body.

  • Chest stretch using a static foam.

When Should You Start Physical Therapy for a Rotator Cuff Tear?

Passive motion exercises can typically begin as early as possible after a rotator cuff injury under a physical therapist’s guidance. Even with a small rotator cuff tear, physical therapy can start the day after your injury. However, depending on the severity of your injury and your usual activity level, your physiotherapist could advise you to rest for a week or two after the incident.

Find a Las Vegas Physical Therapist Near Me

Pain in the shoulders and surrounding tissues can indicate rotator cuff inflammation. You may develop rotator cuff tears if you frequently overuse your shoulders and arms. Delaying treatment can worsen the situation, resulting in more severe pain and loss of range of motion. An experienced physical therapist can help you determine the problem and how to treat it.

At Suarez Physical Therapy, we have the knowledge and skills to diagnose your problem and develop a tailored treatment plan. Call us at 702-368-6778 now for a shoulder examination, ensuring you receive prompt, effective care.