Rotator Cuff Injuries and Post-Rehab Protocols

Muscles Involved  

Before we dive into the protocols let’s first discuss the muscles involved. The muscles that attach to the glenohumeral joint are the: 

• Infraspinatus 

• Supraspinatus 

• Teres minor 

• Subscapularis 

Each has a role in securing the head of the humerus into the joint.  

As we age, these muscles start to become more avascular limiting the amount of blood supply. This causes these muscles to become unstable and weak resulting in muscle imbalances. These imbalances usually start with an impingement which is the precursor to rotator cuff tearing. 

Post-Rehab Protocols for Torn Rotator Cuff 

The rotator cuff has two layers. The superficial and deep layers. The severity of the injury varies, but this is a common injury. Tears that involve only the superficial layer are called “partial thickness” and those that involve both are called “full-thickness” tears. Many clients at the gym have had rotator cuff injuries. 

Rotator Cuff Tears 

Rotator cuff tears are also classified by the size of the tear. The larger the tear the greater the time for rehab and return of function.

•  - 1 cm = Small tear 

•    1-3 cm = Medium tear 

•    3-5 cm =large tear 

Partial tears are more painful due to the higher density of free nerve endings in the superficial layer. Knowing what layer and type classification can truly help gauge what you will be capable of doing in the gym.  

Training Goals for Rotator Cuff Tears  

Improve rotator cuff strength 

The main goal with your workouts will be to improve rotator cuff strength. Knowing your limitations and Range of motion are key to preventing re-injury risk. Internal and external rotation of the humerus directly affects the rotator cuff.   

If you completed physical therapy, you may be familiar with some basic exercises for rotator cuff tears. You should continue these exercises throughout your post rehab program. I would not recommend changing the exercise until you are able to do overhead exercises again.  

Improve posterior shoulder girdle strength 

The second goal is to improve posterior shoulder girdle strength.  Five muscles are considered the shoulder girdle. All trapezius, levator, pec major and minor, rhomboids and serratus.  

There is no one exercise for these muscles however; just like the rotator cuff muscles, knowing what ROM you should train in and your strength limitations are key to a successful exercise program. People make the mistake of thinking they can lift the same amount of weight as you did before only to reinjure themselves.

Overhead exercises should be avoided until shoulder girdle is strengthened and the arm can be raised past 90 degrees in abduction and flexion .Working with a trainer familiar with these muscle groups to create a custom plan for you is key. I’ll work with you to find out the right exercises for you and your post-injury rehab.  

Post-Rehab Criteria 

Please understand that a Post-Rehab program does not take the place of physical therapy. A physical therapist will provide his or her own exercises and techniques to get you to function again.  

A proper post-rehabilitation and conditioning program serves the purpose of getting the individual as close as possible back to pre-injury functionality. If you are considering doing your own post-rehab program, I would highly recommend at least meeting with a medical exercise specialist or post-rehab & conditioning specialist to help identify your limitations as to not reinjure yourself during the process. 

These are the criteria for starting a post-rehab program for rotator cuff tear: 

• Discharge from physical therapy 

• Have medical clearance for exercise  

• Have a pain scale of 4 or less 

• Have most if not all range of motion (ROM) restored 

These are considered red flags and you should consult with your medical provider before considering a post-rehabilitation program is any of these exist.  

About M.A.T. Trainer Maurice Harden 

Maurice Harden is a ten-year military veteran who was also trained under the new Army Physical Fitness Program. He is the first and only MAT® specialist in the Tampa Bay area who graduated from the Master’s Degree program focused on muscle activation techniques®.  

Want to learn more about how I help with rotator cuff tears, give me a call to set up a medical fitness training consultation.