Published 12:00 am Wednesday, December 2, 2009

Q. I am trying to prevent rotator cuff surgery. Can you give me some exercises to strengthen/ help my shoulder?
A. First, let’s look at the anatomy of the rotator cuff. Some people don’t realize that the rotator muscles are actually four muscles: Subscapularis, Supraspina-tus, Infra-spinatus and the Teres Minor.
(The way I remember them is SITS.)
Many people suffer rotator cuff tears. Some have no symptoms. Some may have weakness and/or atrophy.
An MRI would be able to show tears.
The first steps of rotator cuff treatment include:
n Physical therapy. It’s the most important step in the treatment of a rotator cuff injury.
n Anti-inflammatory medications. Medications are very helpful controlling the symptoms of a tear.
n Cortisone injections. They can be extremely helpful at limiting the acute inflammation so you can start your therapy and exercises
So now let’s get into the exercises.
Internal rotation: With your knees bent, lie on a firm surface. Bend that arm to a right angle (90 degrees). Rest your elbow on the floor. Keeping the elbow next to your side, lower the forearm toward the floor, away from the body (keep the 90 degree angle). Slowly return your forearm to your side. Repeat 10 to 15 times using a light weight. Do both sides even if the other side does not have any problems.
External rotation: Depend-ing on the severity of your injury, you might only be able to do this exercise on your injured side due to the fact that you are lying on your side. Lie on your uninjured side with a pillow supporting your head. Place a small rolled up towel under the elbow which is on top. Bend that arm to a right angle (again 90 degrees) resting the forearm on your stomach. Keeping the elbow against the towel, slowly lift a small weight until your forearm is slightly higher than your elbow. Return to starting position. Repeat 10 to 15 times
“Rear” d-bell raises: In a standing position, start with your right arm between the front and the side of your body, thumb down. For balance you might have to raise the left arm slightly to the front. Raise your right arm about 45 degrees to the back. Do not lift beyond the point of pain. Slowly lower your arm (make sure you are not swinging your arm). Repeat the exercise about 10-15 times. Change sides.
Hopefully, this will get you going.
Before you start these exercises make sure your doctor/physical therapist is aware of your doing them. Good luck!
And, if you have to have surgery, it will not be the end of the world. We have some great shoulder doctors here in Salisbury who have already helped lots of our members.
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Ester Hoeber is associate executive director of the J.F. Hurley Family YMCA. Contact her with health and fitness questions at 704-636-0111 or ehoeben@rowan ymca.com.