This information is for patients who have been referred for physiotherapy because of an injury to the shoulder known as a rotator cuff tear. It will support the advice from your physiotherapist.
About a rotator cuff tear
The rotator cuff is made up of the muscles and tendons that hold the shoulder in place. It allows you to lift your arm and reach up.
A rotator cuff tear is a large tear of these tendons. This can be caused by:
natural ageing
wear and tear
trauma, such as a fall.
Once the rotator cuff has torn, the tendons do not heal. However, strengthening a large muscle in the shoulder, called the deltoid, can help get the movement back.
How to reduce pain and swelling
Following a rotator cuff tear, your shoulder may be swollen and painful.
Medicines such as ibuprofen or paracetamol should help. You can buy these without a prescription.
You can also use an ice pack or bag of frozen peas. Put this on your shoulder for 15 minutes every few hours. Wrap the ice or bag of peas in a damp tea towel or cloth to protect your skin from an ice burn.
Reducing or stopping smoking will also help recovery.
If these do not help, speak to your GP or pharmacist for more advice.
Exercises
These exercises aim to make the deltoid muscle stronger.
Your physiotherapist will show you these exercises.
They need to be done 2 to 3 times a day for 3 to 6 months.
To make the exercises easier, you will start them lying on your back (exercise 2), so that you are not having to work against gravity. This helps to stop you shrugging, or ‘hitching’, your shoulder up when trying to lift your arm. Try to avoid ‘hitching’ as much as you can.
Your physiotherapist will talk to you about how you are getting on and change the exercises as you get stronger.
Exercise 1 – Arm swing
This is a warm-up exercise.
Lean forward on a table or the back of a chair, supporting yourself with your ‘good arm’. Let your injured arm hang down in a relaxed position.
Gently swing your arm forwards and backwards like a pendulum. (Top row of pictures).
You can also swing your arm across your body (bottom row of pictures).
Repeat 2 to 3 times for one minute.
Exercise 2 – Lying flat and lifting your arm
Lie on your back with your injured arm on a rolled towel. Try to lift your arm straight up without support.
If you can do this go straight to exercise 3.
If you can’t, use your non-injured arm to help lift the injured arm up.
Keep the arm up with the elbow straight for as long as possible, without helping it.
Bring the arm back down to your side with the help of the other arm.
As your arm gets stronger, you will be able to raise and lower the arm with less support.
You should be able to get into this position and return your arm back to your side comfortably before moving onto exercise 3.
Exercise 3 – Lying flat and flexing your shoulder
Lie on your back with your injured arm on a rolled towel.
Slowly reach your arm up to the ceiling.
Slowly move your arm forward and backwards. Start with small movements that do not hurt.
As you get stronger, make these arcs bigger, but only if it doesn’t hurt.
Keep going until your arm gets too tired to continue, or up to 5 minutes non-stop.
Exercise 4 – Lying flat and flexing your shoulder with weights
Repeat exercise 3, but this time hold a 500ml bottle of water or small weight.
Start with a small movement. As you get stronger, and if it doesn’t hurt, make these arcs bigger.
Keep going until your arm gets too tired to continue, or up to 5 minutes non-stop.
Exercise 5 – Sitting up slightly and flexing shoulder (without/with weight)
Lie down on a bed or sofa, propped up on cushions.
Slowly move your arm forward and backwards. Start with small movements that do not hurt.
As you get stronger, make these arcs bigger, but only if it doesn’t hurt.
Keep going until your arm gets too tired to continue or up to 5 minutes non-stop.
Exercise 6 – Standing exercise using an elastic band
The physiotherapist will give you a stretchy elastic ‘resistance’ band. Tie a knot at one end of the band.
Put the knotted end of the band over the top of a door, and close the door.
Reach up to the band as far as you can with your injured arm. You may need to help your arm with the uninjured arm.
Hold the band and pull down towards the floor, against the resistance.
Slowly let the band take your arm back to the starting position, but control the movement back up.
Repeat this until your arm gets tired, or for 5 minutes non-stop.
There are different coloured bands for different levels of exercise. Your physiotherapist will decide which one is right for you.
Exercise 7 – Sliding a duster up and down
Stand facing a wall
Hold a duster under your hand and slowly slide your arm upwards as far as you can go, and then back down again.
Repeat this until your arm gets tired, or for 5 minutes non-stop.
If you are struggling to get your injured arm to slide the duster up and down; you can use the uninjured arm as support.
