Resting inbetween therapy exercises...

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Just wanted to throw this out there. I'm towards the end of my recovery from rotator cuff surgery on my right shoulder - biceps, supraspinatus, labrum. After 9 months I was released from physical therapy and I continued for the last 3 months doing the ROM and strengthening exercises on my own daily. I've almost got full ROM and strength back.

To address the last little bit of stiffness in my shoulder which prevented me from raising my arm to that 170-180 degrees straight up, it was suggested by my therapist to lay down and with my arm stretched out all the way straight behind me and place a 7 pound weight on it to gently force it back down so that the back of the hand eventually touches the table or floor.

I've been doing that and it's a very slow gradual process but it's getting there. The improvements are so small though and I guess it's the breakup of scar tissue and then reformation along lines that will allow that full extension.

One thing I noticed though and that was it actually seems to improve faster if I take a break and do it every other day. Doing it every day seemed to hinder or in fact set me back and make the shoulder stiffer with less ROM than the day before. I don't know the physiology of all this scar tissue breakdown/and reformation, and maybe it's just me. But originally I was told to do this several times a day, maybe for 5 minutes at a time.

I have found that less is more. Anyone else notice similar experiences with their own recovery/rehab?

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    • Posted

      Hi, Sue:

      Really sounds like you're doing well. I mean if you can swim and play tennis that is fantastic.

      I'm not too acquainted with your case. What kind of surgery did you have. Was it one of those complete shoulder replacements?

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  • Posted

    Hi Mike,

    I am 13 months post surgery on a superspinatus tendon (rotator cuff tendon) reattachment. I had a full tendon detachment of about 2CM, which is considered moderate.

    I regained 180 degree ROM above my head without too much difficulty by around the 5th month if I recall correctly. The external rotation of being able to reach the middle of my back with my hand is what took much longer for me to regain.

    The way I regained the ROM above my head was by lying on the bed a couple of times a day and raising my arm above my head with my other hand as far as I could and then pushing the arm with the injured shoulder down towards the bed to 180 degrees. At first I couldn’t do a full 180, but with pain and persistence eventually I got there until eventually I could push the arm down into the bed with some force. And then, little by little, the stiffness went away. Eventually I was able to lie down on the bed, put my arm at 180 degrees above my head without difficulty, then grab hold of the edge of the mattress, and slide my torso down the bed away from where I was holding on in order to create a pulling stretch as if I were hanging vertically from a pull up bar, but without having any of my body weight on the shoulder.

    Another thing that helped me to regain strength to being able to quickly raise my arm to 180 degrees were lateral raises with the therabands. I would step on them with my foot and pull them up laterally until my hand was straight out at my side and level with my shoulder. No need to go higher than shoulder height and cause pain. But just lots of repeated reps with light resistance until you feel a bit of a lactic acid burn. That will restore strength and help progress you towards getting your hand at 180 degrees above your head more quickly too, even though you are only pulling the band up to shoulder height.

    Also, I did most of the physical therapy myself since I was not happy with any of the physical therapists I found, nor the frequent trips to the clinic. I did it all mostly with therabands at different angles, raising 1.5 liter water bottles above my head for a bit of free weight resistance, and the pulling stretches on the bed using my other arm to create force as I mentioned.m. Eventually the atrophied muscles came back.

    The pain is a different issue though. You can expect that to continue in general on and off for a total of 12 months and I agree to back off from everything at times when you are in too much pain. I don’t think forcing things helps. As you said, less can be more. Inflammation is quick to return if you overdo it which then leads to pain. I had times where I stopped everything for 5-10 days and took anti-inflamatories until the excessive pain subsided again. But you do need to maintain a level of consistency of trying to do at least some light movement to strengthen the muscle almost every day if you can, otherwise weakness can return quickly until you get over that hump.

    Anyway, be patient. It sounds like you are already well on track. You just need to do some more types of different exercises to increase strength, ROM, and reduce stiffness.

    I was actually able to get back into the gym and start lifting weights again 6 months post surgery, but even now, after a total of 13 months, I still get pain at times from different movements and activities. It’s the way it goes. I’m thinking it might be like this for another 5-6 months and at this point I am about 95% pain free anyway. And maybe I’ll never be a 100% pain free, but it’s fine. I got my life back already, and then some. I can do all activities and movements again and I am far better off now, and in far less pain than I was pre-surgery and you will be too. 😉

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    • Posted

      Oh, one other thing I forgot to ask you. You mention lifting weights at the gym. Did your doctor give you an restrictions?

      For example my doc said he'd rather I not do pullups, shoulder presses any exercises with weight about shoulder height. He said it wasn't that I wouldn't be able to do them, he said that such exercises can put your tendons at risk. He said that if I am careful, my repairs will last a lifetime.

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  • Posted


    Thanks for sharing all of this! I may try some of those exercises. I met a therapist at my gym he was also offering me advice and tips on exercise using the pulleys at the gym.

    I don't like exercising alone, it's so much easier for me to be at the physical therapy and gym surrounded by people. I guess it's a mental thing. Mind you I do exercise alone, but it seems easier when there are people around to talk to, listen to music, tv, more social I guess. It kind of takes your mind off the repetitiveness and boredom that can suck the life out of you. Mind you this has been going on for 2 years now and 2 shoulder surgeries. The therapist told me that all of my progress is due to my persistence and enthusiasm. I use whatever I can to keep up the enthusiasm and goal towards getting healthier and that includes maybe even showing off my therapy exercises. I love showing other people my exercises and sharing experiences. Some fellow gym patrons even tell me of their own rotator cuff injuries and it's enjoyable sharing experiences. You sound like you be a great person to exercise with!

    "Range of Motion!Range of Motion! Range of Motion!" that's what my head physical therapist told me his mentor taught him. It's all about ROM. So I've been diligently been doing those ROM exercises on my shoulders for the past 2 years. I still do those Rock-a-bye and Peak-a-boo exercises even to this day in public and at the gym. My pulleys hanging from my roof in my study have been used so much that it's beginning to fray. Like you say, it can be a bit painful, and you learn not to push it too far so it becomes something you want to avoid or worse hurts you so much you can't even do them because you hurt so much the next day.

    You like me seem to have learned from this experience and share what you learn. I like that my friend!

    Good to know you!

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  • Posted

    Your welcome and hope my info helps. You are doing well.

    The rule of thumb is no lifting more than 10 pounds of weight above your head for the first 6 months. But your past that point already. And by 4 months there should be a solid tendon reattachment already, so risk if re-tear is already greatly diminished. But if you are concerned, don’t go above 10 pounds on any exercise involving any shoulder movement for now. Then, once you feel comfortable, and no pain with using 10 pounds on any exercise, start increasing weight slowly as long as it doesn’t hurt. And yes, no heavy body weight exercises; meaning no pull ups, push ups, or triceps dips until you feel you have the strength. Play it by ear, listen to your body and start slow. But use some weight. You can’t regain strength and muscle without some resistance.

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  • Posted

    Oh...I wanted to say about the pillows, that I too sleep with a pillow under my arm even now. I got so used to it I do it now even though I don't need to. I also can sleep on both arms it doesn't bother me which as I understand it is a GOOD sign that your shoulders have healed. I can remember that just lifting up my arm to shoulder level and keeping it there was exhausting!

    Also that rule of thumb about 10 pounds overhead, did your surgeon or therapist tell you that? You sound pretty knowledgable are you a therapist? The guy at my gym who is a therapist actually injured his rotator in a bicycle accident. He didn't want surgery and just does the exercises to rehab himself. I guess he felt he knew enough about such injuries to handle it on his own. He said he didn't even have an MRI.

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