Swimex Professional Blog

This infographic is part of the SwimEx Hydrotherapy Exercises for Common Injuries series. This is exercise and treatment plan is for Rotator Cuff Repair.

rotator cuff repair

 

 

HYDROTHERAPY EXERCISES FOR ROTATOR CUFF REPAIR

It is highly recommended to protect all surgical incisions from infection. Cover any incision that is open or still has a scab with Tegoderm to help prevent infection when in the pool.

STAGE 1: 0-6 WEEKS POST-OP

Stage Goals

  • Maintain integrity of repair
  • Do not overstress healing tissue
  • Gradual increase ROM
  1. Pendulums: Shoulder  placed underwater and let the arm relax and hang. Shoulder traction may be progressed using a weight and/or laminar flow
  2.  Walkaways: Place hand on bar, stair, or top of pool and slowly walk backwards allowing the shoulder to stretch into shoulder flexion. This exercise can be used for shoulder scaption and abduction stretching as well.
  3. Active assistive range of motion, includes: flexion, abduction, external and internal rotation: Use a stick or non-injured/surgical arm to gently move and stretch the injured/surgical arm.
  4. Active range of motion, includes: flexion abduction, external rotation and internal rotation: Active motion should be started at 30 deg/sec (NOT BEFORE 3 WEEKS)
  5. Scapular retraction: Stand upright and pinch shoulder blades together. This can be performed with elbows straight or extended.

STAGE 2: 6-12 WEEKS POST-OP

Stage Goals:

  • Maintain integrity of repair
  • Do not overstress healing tissue
  • Gradual increase ROM to full
  • Re-establish dynamic shoulder stability
  • Re-establish scapulohumeral rhythm

The exercises listed below can be progressed by increasing speed, moving against water current, resistive bands, and/or adding a weight or tool that will increase the arms resistance through water, for example Hydrotones.

  1. Standing external rotation
  2. Standing scaption
  3. Standing rhythmic stabilization facing current
  4. Standing horizontal T: Stand in pool and place thumbs facing up toward the surface of the water with elbows extended. Bring the arms back into a “T” position with pinching the shoulder blades together.
  5. Prone scaption or “Y’s”: Use a flotation device or pool noodle to help with floating in the prone position. Start with elbow extended and raise the arm with the thumb pointing toward the surface of the water into a “Y” position with pinching the shoulder blade.
  6. Push up “plus” against wall, current, or as the picture below is shown: Start in a push up position with hands against the wall. Perform scapular protraction and retraction while keeping the elbows extended.  The picture below is a high level of difficulty progression.

STAGE 3: 12-18 WEEKS POST-OP

Stage Goals:

  • Progress rotator cuff strengthening and scapular stability
  • Progress functional training

Progress exercises from stage 2 with more speed, current, bands, weight, etc.  Make sure that there are no ROM and strength impairments by then of this stage. 

  1. Flexion diagonals or PNF motions
  2. Standing 90/90’s (90° flexion and 90° abduction with internal rotation and/or external rotation)

STAGE 3: 18-26 WEEKS POST-OP

Stage Goals:

  • Begin light and slow sports specific movements

These exercises can be progressed by increasing speed, moving against current, resistive bands, and/or adding a weight or tool that will increase resistance.

  1. Baseball Swing- perform concentric and eccentrically
  2. Throwing motion with footwork (crow hop, pitching windup, etc.)
  3. Tennis swing, golf swing, lacrosse swing, etc.

After this stage patient or client should transition out of the pool.

Always consult a medical health care professional before performing any of the following interventions.

Whether you’re new to hydrotherapy or use this tool frequently, SwimEx is the go-to source. Check out our resource center with hydrotherapy videos, tools, and tips.  Or, here’s another example of how hydrotherapy can effectively treat injuries.

Chicago Cubs Hydrotherapy