ROTATOR CUFF TEAR: SUPRASPINATUS TEAR

Beginning stage exercises:

1. Side Laying Supraspinatus/ Shoulder Abduction
- Have the patient lie on side with unaffected arm propping up the body. With the
affected arm out with palm facing down, raise the arm slightly above same shoulder
side and all the way down slowly.
-3x15
2. Side Laying External Rotation
- Have the patient lie on side with affected arm resting on stomach and a small rolled up
towel under the arm. With a small weight, they should slowly rotate arm upwards and
stop when forearm is just above horizontal level.
-3x10
3. Standing Ts
- Have patient stand with the theraband attached in front. The patients arm should be
flexed forward at shoulder height with straight elbows. While the elbow is straight, the
patient pulls arm back until the arm is by their side.
-3x10
4. W Exercises
- The patient should stand with a double theraband attached in front of them. With the
band in both hands, have the elbows bent at 90 degrees and fixed at their side. The
bands should be pulled outward. Then the arms rotate outward making a W shape. The
elbows should be at their side the whole time.
-3x10
5. Isometric External Rotation Against Wall
-Have patient bend their arm at elbow at 90 degrees. With the patient at sideline with
wall have them push arm out to wall and push against it. The elbow should stay close to
the body the whole time.
-2x30secs
6. Wall Push/ Humeral Head Rotation
-Have patient put both palms and forearms on the wall. It should be placed at a 90
degree angle. The patient should then lift up arm from wall slowly and bring it back
down.
-2x15
7. Supraspinatus Static Release
-With the patients back against a wall, place a ball between them and the wall where
the supraspinatus is located. Have them lean their head sideways on the same side as
the ball.
-2x45 sec
8. Straight Elbow Push up
-Have patient in a push up like position, only with knees on ground. Make sure to have
elbows locked the whole time. Then the patient should do a pushup with their scapula
pushing into the back.
-2x15
9. Walking the Arm up the Wall
-With Patient being sideline to wall, put hand on wall and slowly raise arm walk the
wall till the arm is fully up. Lean slightly and hold stretch.
-3x20 sec
10. Behind the Back Towel Stretch
-Have the patient hold a towel in the affected side and raise overhead so the towel
hangs behind them. Then, with the other hand behind the back slowly pull the towel
down giving a stretch.
-3x30 sec

Intermediate Stage Exercises:
1. Prone Row With External Rotation
- Have patient lie on table on their stomach with affected arm dangling over. The hand
should be rotated so the thumb is facing towards the body. Have them do a rowing
motion with the elbow at same level as the shoulder and no further. Then they should
rotate the arm upwards until the forearm is almost parallel with the body. Then slowly
reverse those steps to starting position.
-3x10
2. Dynamic Hug with Theraband
- With the theraband behind the patient at shoulder height, the patient will grip both
ends of the band with the tubing on the outside of their shoulders. They will slowly pull
the band forward and slightly downward. This creates a in a hugging motion.
-3x15
3. Dumbbell Lateral Raises
-Have patient stand with dumbbells resting at sides. The patient slowly raises the
dumbbells out from sides till they are level with shoulders and slowly bring them back
down. (Almost like a flying motion)
-3x10
4. Empty Can/ full can Elevations
- Have Patient stand with small weights in hands. The hands should be rotated 45
degrees out to the side with the thumb down or facing up. The patient slowly raises the
arms at 45 degree angle approximately of way above head.
-3x10
5. Prone Horizontal Abduction with Weight
- Have patient lie on stomach with arm hanging over side of table. Have them grasp a
small dumbbell weight with thumb facing forward. They should slowly raise arm
straight out to the side and then stop when arm is level to the body, going no further
than that.
-3x10
6. Face Pull with Band
-Have theraband split so that the patient holds one end in each hand. The theraband
should be about shoulder level with the patient. With the patient facing the wall and
back straight, they should perform a row so that the elbows and arms are parallel to the
floor and it stops just before they reach their face. This should be done in a slow motion.
-3x10
7. Proprioceptive Shoulder Stabilization
-Have the patient hold their full arm out to the side and then in front of them for two
different ways of doing this. Have them grip their hand into a fist and another person
should lightly tap the hand in different directions so that the patient has to keep the
arm in the same spot the whole time. If it moves they have to return it to the starting
position.
-3x20 sec
8. Small Foam Roller Stabilization
-Have patient on knees and hands with a small foam roller on lower back. One arm at a
time, fully extend the arm out in front of them slowly and bring it back to starting
position, while balancing the foam roller and not letting drop.
-3x20
9. Side Shoulder Raises on Ground
- Have the patient lie in a side plank position. With the affected arm in front, push on
ground so that the body slightly raises and return back to the ground. They should only
use their arms/shoulders to push them up.
-3x15
10. Across Body Shoulder Abduction with Rotation of Forearm
-The patient should be facing sideways to wall with the affected arm on side farthest
from wall. With a theraband attached to the wall about arm length height the affected
arm will grasp the end of the band. The wrist and arm should be straight. The arm
should be across the body and the shoulder blades retracted. The arm will abduct to
about 70 degrees and the thumb will rotate to outward facing position.
-3x10
Advanced Stage Exercises:
1. Seated Machine Row
-Perform a row on the machine by pull back. Make sure that the back is straight and the
seat is adjusted to fit the patients comfort.
-3x10
2. Cable Pull Downs (Front of Body)
-Have the patient face the cable machine, with the affected arm holding the handle for
the cable. The patient will do flexion and extension of the shoulder, with palm facing
down and the elbow not bent. This should be done in a slow motion.
-3x10
3. Cable Punches
- The theraband should be at waist level and the patient facing away from it. The patient
should stand with one leg ahead of the other. Depending on the side that is injured the
other leg should be out. With the hand grasping the theraband, the patient begins at
waist level and bends the elbow at a 90 degree angle, with elbow remaining near their
side. Thy slowly punch forward, slightly raising the arm in a forward, upward motion.
The hand should reach about neck level with the arm almost straight. Patient should not
bend at the waist and remain in an upright position.
-3x10
4. Shoulder Press/ Military Press (Dumbbells or Machine)
- Have the patient stand with a dumbbell in each hand. Have them bend their elbows
and raise their upper arms to shoulder height so the dumbbells are at head level. The
patient then pushes the dumbbells up and in until the ends of the dumbbells touch
lightly, directly overhead. Then they slowly lower the dumbbells back to about head
level. The patient should have their back straight.
-3x10
5. DynaDisk Balancing for Shoulders
- Have the patient in a pushup position. However, both hands should be on a dynadisk.
Keep elbows straight and the patient must try to balance.
-3x45 sec
6. Plank on Exercise Ball
-Have patient in a plank position with their feet on the floor and their forearms on the
exercise ball in the form of a V. The patient should hole themselves up while balancing
on the ball during the process.
-3x30 sec
7. Inclined Pushups
-Have patient in pushup position with feet on bench or elevated object and hands on
floor. Have the patient do a pushup in this position going as far down as possible.
-3x15
8. Lateral Moving Pushups
-Have the patient in a pushup position. Make sure they go down into the pushup with
the elbows at 90 degree angle and come back up. Then they will bring their hand next to
the other and then push the other hand out so that they are moving over and can do
another pushup.
-about 5 lengths
9. Ball throwing/Catching
-With a weighted ball, throw it at the patient in different directions. The patient must
catch it with both hands. To make it harder, the patient can stand on one leg.
-3x20
10. Side Plank with Arm raises
-The patient lies on their side with the arm underneath bent at the elbow to support the
body. (So the forearm is supporting)With that arm and their core, they raise their whole
body off the ground except for the forearm and outside of foot. With the other hand it
should be raised straight up and held.
-3x30 sec
Return to Play Exercises:
Make it sport specific (volleyball)
Continue advanced exercises
Crossfit 30 minutes
1. Medicine ball throws
2. Squats
3. Box jumps
4. Biking/treadmill
5. Vertical jumps
Limit practices full practices
1. Setting drills- 15/30 minutes
2. Blocking drills-15/30 minutes
3. Severing drills- 15/30 minutes
4. Diving/dig drills- 15/30 minutes
5. Spiking/hitting 15/30 minutes
6. Flexibility- 10 minutes
Home Exercise Program:
1. Back of Shoulder Stretch
-have patient bring affected arm across body in an almost horizontal position. With the
other hand, pull the arm closer to chest to give a stretch.
-3x30 sec
2. Door Frame Rotator Cuff Stretch
- Have patient stand in front of doorframe. They should bend elbow at 90-degree angle
and place palm against doorframe. Then they will lean forward to feel a stretch.
-3x30 sec
3. Forward Lean/ Hands on Hip Stretch
-Have patient put hands on their hips with the thumbs facing forward. Have them slowly
lean over and relax the shoulders so the arms can hang in that position.
-3x30 sec
4. Shoulder Shrug
-Slowly elevate the shoulders and slowly bring them back down.
-2x15
5. Prone Arm Hangs/ Pendulums
-Have patient lay on table on stomach. With affected arm dangling off the edge, have
them hang there and swing their arm slowly in different directions or in a rotational
movement.
-2 x25