[Alec Belman]

I’m getting differing advice on when (how far out from injury) to start PT/Strength exercises after a rotator cuff strain (no tear). Should I be working through mild pain during the exercises and when should I generally expect to see reduction in pain.
Thanks, this forum is so useful

Topic

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on September 15, 2019 at 9:06 am #28473

Alec,
Great question really. After an initial injury, range of motion and tissue mobility can be started as tolerated. We always try to avoid the negative consequences of immobilization. As the injured tissue calms down from the initial stages of inflammation, you can start having some greater success loading the tissue. You want the tissue to adapt to the load, not react to the load. Some discomfort is fine, but be truthful about how the tissue responded to the exercise. If I’m pretty sore the next day, or had a significant increase in pain after the exercise, I probably did too much. You will have better success not initially focusing on the specific muscle which can easily be overloaded, but training the large functional movements of press/pull/horizontal/vertical/diagoanal with strict form and light resistance.
Cheers,
Pete

[djcrusoe0929]

djcrusoe0929 on September 15, 2019 at 9:17 am #28475

Alec,

In general you can get into PT/strengthening after a strain pretty quickly.

When I see clients one of the first I’m focusing on is symptom modification, by exploring to see if certain movements or exercises help reduce pain. If there are exercises that we can find that reduce pain right after you can expect to see about a 50% improvement in 3 wks and being at about 85-90% by 8 weeks.

As for how much pain to be working through I normally take to clients about a “stop light”

Green (good to go) -feel good while you are doing it and continues to feel good after

Yellow (caution) – feel a slight increase in pain during and maybe for a little while after but settles back to baseline/doesn’t make you worse the next day

Red (stop) – significant pain during and flares symptoms after

Isometric exercises awesome for the early stages of strains because they tend to be well tolerated and can help reduce pain

[djcrusoe0929]

djcrusoe0929 on September 15, 2019 at 9:32 am #28476

Green light and yellow light exercises are good!

forgot to put that little piece in there

Good luck!