There are tendons in the shoulder (rotator cuff) which elevate your arm away from the body. When there is a massive tear of the tendons it can be difficult to lift the arm away from the body.
There is a large muscle (anterior deltoid) which we aim to train, this can compensate for the loss of these tendons. This muscle helps to lift the arm when the rotator cuff is torn.
The majority of these exercises start with you lying on your back. The reason for doing this is to reduce the work against gravity. It will take a long time to feel the benefits of the exercises and we would recommend a minimum of 3 months of the programme.
Pendular exercises can be done as a warm up
Bend over supporting yourself with your good arm, moving initially in circles and then forwards and backwards and finally side to side. Each motion should be done 20 times, repeating 4 sets.
Lie down flat on your back, bend the elbow of your affected arm then raise your arm so it is pointing towards the ceiling If you cannot manage this use the stronger arm to assist if necessary.
Hold the arm in this upright position with its own strength. Then slowly move the arm keeping your elbow straight to both sides of the upright position as shown in the diagram. Keep the movement smooth and continuous for 5 minutes. Start with a small arc of movement until you find it gets easier to perform.
As you get more confident increase the distance, your aim is to get your arm to go onto your thigh and up above your head touching the bed behind you.
Once you have completed stage 2, progress to stage 3.
As you get more confident in controlling your shoulder movement, a light weight (less than 1 kg) can be held in the affected hand.
Once you are able to control the shoulder lying down with a weight in your hand you can move onto the next stage.
This is done sitting up in ‘half way’ position, placing some pillows underneath your upper body can help. Start without weight and when you are able to do this you can progress to doing this with some added weight as before in stage 3.
Finally when this has been completed try the same sequence standing, initially without weight then adding light weight as able.
We would expect to see improvements in 3 months of starting the treatment.