Rotator Cuff Exercise Alternatives

GauchoMark

Well, as I approach the big 4-0, it seems as if I have some frayed tendons in my rotator cuff on my left side. Fortunately/Unfortunately, they are not sugical yet, but cause me quite a bit of pain on some exercises that I have had to quit doing. I'm not new to lifting, so I've tried a lo of different things, but I really haven't found a suitable replacement for my shoulders and upper pecs. The problem is that during a rep, if I move incorrectly, the ball moves in the joint and it is excruciating - many times it causes me to buckle or come close to it. I never go past 180 degrees on the movement, at least not intentionally! This helps, but isn't the answer.

I used to do incline barbell & dumbbell bench, shoulder presses, etc.

Now I can do lateral raises for the shoulders, but the upper pecs are tough. Incline fly's feel OK most of the time so that is my current go-to, but sometimes that irritates it too.

Those of you with rotator cuff issues - any suggestions?

mbaker566

i would suggest doing what your physical therapist suggests

GauchoMark

I'm past physical therapy stages. My shoulder is strengthened to the point that it doesn't hurt to move it now, which was the goal of physical therapy. Now, it only hurts during exercise, which is also bad. However, the tendons have inline tears which will not heal, but it isn't so bad yet that it justifies surgery.

The PT and doctor could care less if my pecs and delts are awesome! They just want me to be able to move around routinely, which I can, so thier job is done for now!

slideaway1

I have never had rotator cuff issues, but have heard it's pretty common with lifters so I have tried to pre-empt it. I'm just waiting for it to get me. Because I'm aware that it's a common injury I just YouTube'd Rotator Cuff warm ups and do them religiously before lifting. I think just making sure the shoulder is warm, stretched and has a good blood flow to it real helps beforehand. As well as the warm up, I go really light on shoulder press for 20 reps or so before slowly increasing into my four working sets. I find after the heavy shoulder press the lateral raises are then pretty straightforward and the muscles feel warm/flexible/pain free etc.

GauchoMark

Yeah, the main thing the doc told me was to be sure a do a proper warm up to get the joint "lubed up" (his term) and on any type of press your upper arm should never go past 180 degrees. So, all those guys dropping the bar (or bouncing it) to their chest during a bench press are over-extending their shoulder. Now that I have the injury, I can really tell when I go too far down!

mbaker566

i would think they would want you to be healthy as I worked with my team till I was able to do what I needed to get back to my aerial work. but nevermind then

tomatoey

Don't let yourself get to the point where surgery is the only option!

I think you should find a new PT who treats athletes and knows how to get them into playing condition.

Meantime, if you're going to keep lifting, I think continue to let pain be your guide for range of motion and weight (and reps). But stop before you would expect pain to come - don't go right up to the edge of it. And give yourself plenty of recovery time, more than you think you need.

My real thought is to play it as safe as possible in the absence of guidance, and maybe adjust your expectations until you have real help

For me, it took months of doing nothing (except for swings to prevent frozen shoulder) for my rotator cuff tendinopathy to improve. Sometimes, absolute rest is the best thing

(Then I twigged it back into being, just by doing housework. More rest )

This site has good info
http://www.tendinosis.org/index.shtml

From that site:

"Rest

By the time you feel pain from tendinosis, your injury has been gradually building for many weeks. Remember that tendons heal slowly. You will probably need to wait several months before a reasonable amount of repair has occurred, so have patience with this slow healing process.

You'll need to avoid activities that cause pain, which can be a problem when some of those activities involve your work. Whenever possible, try to get the injurious aspects of your job done some other way (such as voice recognition software instead of keyboard typing), or try to change your job while you heal. Check with your doctor and physical therapist for specific suggestions and guidance.

Although you need to rest the injured body part(s), keep doing the normal daily activities that don't cause you pain. You need to prevent atrophy and stiffness from disuse. Your doctor might want you to wait a few weeks before starting exercises, but when you are ready your physical therapist can create a gradual strengthening program for you. Loading from the proper exercises can help to stimulate healing." (so you need help with that last bit)

Packerjohn

6 shoulder operations in the last 5 years here including rotator cuff repair. 59 YO and 35+ years of a desk job with keyboarding is rough on the shoulders.

Exercises I do now are rows, inverted rows assisted pull ups, face pulls. Lots of back work to help overcome all the effects of office work. Also landmine presses, pushups on a Swiss ball or using a suspension trainer. I've found chest presses (one arm at time) using an inverted kettlebell are good, helps build stability around the shoulder. Also, try your dumbbell presses using a neutral (palms parallel to your body) grip.

I've found several strength and conditioning guys over the years that have a lot of articles/videos out there on prehab/rehab/working around shoulder issues. A PT I worked with (who actually taught continuing education to other PTs mentioned he followed these guys and read their stuff.

Check out the articles on these guy's sites or Google them and shoulder, you'll get a ton of information

Ecic Cressey (works with a number of pro baseball players, considered "the shoulder guy"
http://www.ericcressey.com/

Mike Robertson lots of functional training to build strength and avoid injury
http://robertsontrainingsystems.com/

Dean Somerset, like Robertson
http://deansomerset.com/

I also bought a thing called the Rotator to help stretch my shoulders, seemed to help
http://therotater.com/wp/

The company that sells the Rotator has shoulder articles from a number of people linked to their website. Also you can sign up for a free newsletter they send out every week or 2 that has 10 links to various shoulder exercises/issues.

Finally poor thoracic spine mobility can result in shoulder issues, a couple good articles on this with a bunch of links
http://www.marksdailyapple.com/the-importance-of-thoracic-spine-mobility/#axzz3fIS5HVxG
http://www.marksdailyapple.com/how-to-improve-thoracic-spine-mobility/#axzz3fIS5HVxG

Best of luck.

Packerjohn

Adding something else. Poor breathing can impact shoulder pain. This article explains and gives some things to work on.

http://jtsstrength.com/articles/2014/05/01/the-scapula-and-thoracic-spine-a-classic-love-story-to-improve-your-overhead-position/

GauchoMark

thanks. that is a lot of info to process!

tomatoey

Some good guidance and prehab suggestions (exercises, stretches, how to approach an exercise session) from here too:

http://www.uptodate.com/contents/rotator-cuff-tendinitis-and-tear-beyond-the-basics?view=print#H15

Return to activities — After surgical repair, most people require 6 months of rehabilitation before strength and shoulder function return to normal. Post-surgical rehabilitation is necessary and use of the shoulder must be limited. Immediately after surgery, you will be allowed to use the affected arm with your elbow at your side for eating, using the keyboard, using the telephone, and driving. Above-the-shoulder activities are not usually allowed for three months after surgery.

Sporting activities can be gradually restarted, including golfing at four months, light weight lifting at four months, swimming at five months, and throwing and tennis playing at five to six months.
...
So maybe it's an idea to work on some of the more piddly sounding strength and stretching things before getting into the weights? I don't know.
...

Rotator cuff strength and function exercises — Restoring rotator cuff strength and coordination exercises help to restore functional use of the arm and to prevent future injury. You can begin performing such exercises as long as they can be done without pain. Consult with your provider or physical therapist to determine when to begin strengthening exercises.

As pain improves, the level of difficulty of these exercises should be increased. Increased difficulty is necessary to improve shoulder strength and control to a degree that reduces the risk of re-injury. Mild soreness is expected with these exercises, although pain should not continue for more than 24 hours. Sharp or severe pain during or after exercising may indicate a flare of the underlying problem; stop these exercises for a few days if this occurs.

Preparing for strengthening exercises — Before performing strength exercises, we suggest that the emphasis of therapy be on restoring maximal mobility of the shoulder. Stretch the injured shoulder with the pendulum stretch or wand exercises, which are described above (see 'Pendulum stretch' above).

....

Do not perform ANY exercise below if you experience acute discomfort or pain in the shoulder. Strengthening exercises should not cause ANY sharp or severe pain while they are performed.

***

So I guess let pain be your guide

Good luck