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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Tag: rotator cuff exercise

For all those following along with my journey, I have moved just past the 8 week post-op mark. I am pleased to report that I continue to see small steady improvements with my mobility during day-to-day activities as long as I am moving below shoulder height. I continue to have periodic and general low-level soreness at times (intermittent) but no marked pain unless really pushing my motion with stretching.

MD Follow-up

I recently saw the surgeon between weeks 6 and 7. He examined the shoulder and determined everything seemed to be progressing fine. I explained to him that I felt my passive range of motion (particularly flexion) felt limited by a pinching pain along the front of the shoulder in PT and at home. I also just felt that the shoulder was more stiff than I had hoped it would be at this point. He recommended giving me a steroid injection to help with inflammation and mobility. He assured me it would in no way compromise the repair.

See the article abstract below regarding early AROM after surgery:

https://pubmed.ncbi.nlm.nih.gov/31084488/

This was my first experience with cortisone. Patients have always told me 1 of 3 things:

  1. It’s magic and now all the pain is gone
  2. It hurts more initially but eventually after a few days they noticed some relief
  3. It did NOT help at all

The response for me was more in line with answer #2. The posterior shoulder was very sore within 2-3 hours after the injection, and the shoulder felt very heavy the rest of the day (motion actually seemed worse). In 24-36 hours, that pain and heaviness subsided, and I would say I could move the shoulder somewhat better in 72 hours. Since the injection, I have not had the pinching pain, and the motion seems to be getting better gradually. With that said, I still have some discomfort at times and a long way to go to recover all my motion as expected at this phase of the rehab process.


Continue reading…

I passed a major milestone last Thursday as I hit the 6 week post-op mark. I have been transitioning out of the sling since week four (at home) while continuing to use the sling out in public. I officially quit using it last week. Things have been progressing, but two words really define the recovery so far: slow and incremental.

Being patient is no easy task when I am so used to working in the clinic, lifting weights and playing sports with my boys. Sleeping has still been a bit of a challenge as the shoulder aches after a few hours in one position, but I am now sleeping in my bed for 6-7 hours with only 2 disturbances per night. My mobility with dressing, shaving, showering and getting dressed is steadily improving. With respect to pain, it is absent at rest. However, it still strikes when I move the wrong way or happen to lift the arm against gravity due to weakness and stiffness.

Rehab

I have been going twice per week, but missed last week due to a summer vacation. I was diligent with my exercises 2x/day while away. Prior to leaving, my latest passive range of motion was equal to 117 degrees of flexion and 38 degrees of external rotation at 5 weeks post-op. As far as guidelines for the next 2-4 weeks, the goals are to restore ROM, resolve pain and begin light strengthening with rehab activities such as:

  • Begin active assistive range of motion (AAROM) progressing to active range of motion (AROM)
  • Continue with deltoid and rotator cuff isometric strengthening
  • Begin light scapular strengthening – retraction (light rows), protraction (serratus anterior work), scapular depression and gentle ball stabilization work in a dependent position
  • AAROM exercises with a dowel rod or cane (external rotation, extension, scaption, flexion, horizontal adduction/abduction)
  • Joint mobilization, continued passive stretching to restore full range of motion and addition of shoulder pulley in this phase
  • Light biceps and triceps strengthening (elbow at side)
  • Scar massage

One important note: I have found the continued use of ice helpful in reducing daily soreness and discomfort following my home program. As such, I would highly recommend its daily use this late into the rehab.


Continue reading…

I recently featured this exercise in my online column for PFP Magazine. This is a great arm care exercise that should be part of every overhead athlete’s routine, especially my throwers. I like to use these types of exercises to prepare the shoulder for higher level lifts as well as serve as staples of an in-season or off-season arm care program.

Click here to read the full column.

There are several things that contribute to shoulder impingement and rotator cuff pain.  Perhaps one of the biggest issues that impacts overhead athletes, Crossfit enthusiasts and the avid weight lifter is limited shoulder mobility.  Poor flexibility in the pecs, lats, posterior shoulder as well as limited thoracic spine extension and rotation all contribute to suboptimal movement.

Poor mobility can place the scapula in biomechanically flawed positions, increase glenohumeral internal rotation and restrict shoulder movement at end range creating compensatory movement and pain.  The video below is a snippet from my upcoming webinar on rotator cuff dysfunction and nonoperative treatment.

This webinar will be great for strength coaches, exercise enthusiasts, Crossfit athletes/coaches, athletic trainers and physical therapists. If you want to attend the webinar or catch the on-demand version, simply visit www.alliedhealthed.com.  In addition, you may find my DVD on rotator cuff training very helpful in overcoming shoulder pain and staying pain free in the gym.

ultimate-rotator-cuff-dvd-set_3dicon

Click here to see a brief video overview of the DVD or visit my site at www.BrianSchiff.com for more info.  Use the code Holiday15 at checkout from today until December 25 to save $10 off the retail price.

Have a great Thanksgiving and enjoy your time with family and friends!

Research along with years of observation has taught me that the brain is inherently looking for the most efficient way (aka least effort) to execute movement in life.  In addition, it HATES pain just like you and I so it does everything possible to avoid it including ordering the body to perform dysfunctional movement patterns.

After a painful episode, the brain often needs reminded that the body can go back to the proper movement patterns once the pain is gone.  However, it often holds that painful memory and may by default lean toward a faulty movement pattern.  This protective mode then ends up perpetuating a faulty movement pattern that is no longer necessary nor efficient.  Over time, dysfunctional movement patterns can create further stress or harm to other segments in the kinetic chain.

So, I am always seeking ways to stimulate the body to work properly and exercises that facilitate proper neuromuscular patterning are instrumental in my rehab and training.  I wanted to share two exercises that I like to utilize in my rehab and training for the shoulder.  In particular, I like to employ closed chain activity to stimulate the serratus anterior as well as the other scapular stabilizers.

Below are two exercises I wrote about in my “Functionally Fit” column for PFP magazine.  The first exercise shows quadruped rocking.  Shirley Sahrmann mentions this in her work, Diagnosis and Treatment of Movement Impairment Syndromes.  I began using it after reading her book, and I agree that it works very well for scapular dysfunction.  Below is the start and finish position for the quadruped version as well as my own advanced tripod version of the exercise.

For a complete explanation of the exercise and its application, click here to read the column.

As a follow-up to this exercise, I included an unstable progression I like to employ using the BOSU trainer.  I call this the unstable tripod scapular clock.  It can be done on the knees or up on the toes.  I have included a quick video on this below. Again, I like this exercise for scapular work as well as core stability training.

Click here to read my PFP column on this exercise for the full description, application and regressions. The real beauty of this last exercise is the “big bang for your buck” attributes since it hits shoulder, core and hip stability all at once for those able to work at that level.  I hope it works as well for you as it has for me!