How To Heal A Rotator Cuff Tear Without Surgery

hey guys dr christie ennis physical therapist certified strength and conditioning specialist and nutritionist and today we're going to go over how to heal your rotator cuff injury or tear without surgery now obviously this doesn't hold true for everybody not everybody could get away without having surgery so yes i know you've probably talked to a bunch of people that have had rotator cuff surgery and i'm not saying that that won't absolutely have to happen but i certainly treated a ton of patients that were told they were going to have to have surgery and then didn't even need to with some other treatment so always try something a little more conservative before you go right to the surgery route and then i have those patients always tell my patients if it doesn't work really haven't lost that much and then go ahead and you can try a different route if you need to for that so for today we're going to go over the stuff that you can do at home on your own to help heal these tears now you've got four rotator cuff muscles so you can obviously have a tear in any one of those the most common one is right up here and so it doesn't mean like i said that you can't have other muscles so a lot of times pain is in the front where it attaches on top or even underneath here again just where some of those muscles are so pay attention to those little areas that might be uncomfortable now step one you probably already know this but just in case you don't is ice right if you've just had an injury there's going to be some sort of trauma typically or not even trauma but you just caught got that pain there's usually a little bit of inflammation in there so putting ice on it several times a day 20 minutes or so at a time is where you want to start that's number one number two what i see as one of the biggest issues for people is actually sleeping and it's super hard to control what you do in your sleep so i'm going to show you some different things with some pillows so if you are let's just say my injuries on my left side if you're a back sleeper you can take a pillow prop it right underneath that arm and you may have to play around a little bit with how high that pillow is but this is a good place to start with that shoulder resting so you're helping to support it now if you're a side sleeper and you don't fortunately sleep on the side that's painful i'm just going to go the other way so i can keep on that left side you still actually want to have pretend i have pillows under my head not my feet but you still want to have a pillow here to help support that shoulder so it doesn't flop over okay now the worst case scenario is if you are a side liar and you lie on that side okay again hard to control what we do in our sleep but we can try to help cradle it a little so if you have your pillows here and then we have another pillow here so my hip is almost going on that pillow and you may need to prop it up a little bit more now i'm at least putting less pressure on that shoulder it's a little bit supported off the ground with those pillows so one of those three methods will hopefully work for you okay all right so we've got ice we've got pillows and then i'm going to stand up this one is called the pendulum and all it's doing is helping to take pressure off of that area so you can kind of lean over right on a chair or counter you're letting that arm dangle don't hold it you're letting it dangle and then you're adding a little circle sometimes you just need to start with back and forth but you should do this exercise and go ah yes that feels so good and that's how all of these should be you want to make sure that you're avoiding pain as you're doing these things okay so that is that that one you can do anytime during the day when your shoulder is bothering you now typically what happens is that you also start to get some scar tissue build up so i'm going to grab the derma edge we're going to remember i said that three out of those four actually attach right here so we're going to work on all of those muscles around that area okay and usually it feels really good to kind of get into the front of that arm get a little bit of blood flow going to get some of that healing going you can even get through the back of the arm a little bit there but usually kind of the top up here and here tend to feel the best and you'll notice it'll feel bumpy because you just had an injury there so it's getting kind of blah okay that's the technical term again all right now the other kind of big issue that happens is that we start to lose range of motion right so to help ease that along i can tell you to just raise your arm that's not going to work so well those muscles are cranky and aggravated so we want to do some active assisted range of motion and the one that i tend to find works the best for people is if you can get a rolling pin or a foam roller and i'm going to sit down you can do this at the you know the dining room table the kitchen table the counter but putting those arms on there and then very slowly you're not applying a lot of pressure but very slowly kind of rolling forward with it you want to stop before you get to a point of pain right so it's just nice and gentle and you should notice even that you might be able to go a little bit further as you start to move out i always go with forward first you can then go almost at a little bit of an angle but i'm going to tell you right now that straight out to the side is really not going to feel good so don't even try that so start with the forward and then you can go ahead like i said a little bit of an angle if that hurts though back off all right go back to your pendulums right from there i'm actually going to come i'm using all the equipment in my room right now i feel like but we're going to do a little bit of a self mobilization so again this is my sore arm i'm going to press down into this bar so you can do this again on a counter just move this chair out of the way i'm going to take my other hand and place it right over so press down take the other hand over and then i'm going to kind of scoot down or you can even try to scoot back you can play around and see which feels comfortable again no pain so if you do this and you go ow please stop just stick with the beginning stuff that we talked about but a lot of times people go oh my gosh yeah this really feels good so you just hold for a couple seconds and come up so you're doing repetitions of this okay about 10 or so ish we'll use ish here all right moving on if it's tolerable what i tend to find is an isometric contraction can help spare the muscle and the pain but get blood flow going to help heal and one of the most common ones to do that's going to help is keep that elbow in at your side take that opposite hand to the outside of the arm so my left hand is going to push out my right hand is going to push in neither one is actually going to move that's why it's isometric and you have control 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