Jesse Owens

Professor Fabian Rayne

KIN 1470
March 26th, 2014

Health History and Assessment

The client I chose to look at had an arthroscopic rotator cuff repair November 28th, 2013. The
assessment stated that the client had no recent health issues. The client works as a handyman.
Assessment
-

March 2008 pain in shoulder gradually getting worse.

Sharp and throbbing pain affecting entire left shoulder joint.
Tingling sensation in finger tips.
Pain is rated 5-7/10 at rest and 9-10/10 at worst.

Clients Current Rehabilitation Plan

Exercise
Neck Stretches

Reps
10-20

Weight
None

Elbow flexion and

extension

10-20

None for first 3 weeks

Wrist motions

10-20

None for first 3 weeks

Cervical retraction

10-20

none

Scapula Retraction

10-20 and hold each

contraction for 5sec

None for first 3 weeks

Description
-start with chin
tucked.
- Move head forward
and back to starting
position, turn your
head side to side, and
tilt your head side to
side.
-In a seated position
flex and extended the
elbow.
-support forearm on a
table.
-Flex and Extend your
wrist and adduct and
abduct your wrist.
-Place fingers on chin
and push drawing
head back.
-In standing position
with elbows at you
side, gently pull your

Closed Chain
Pendulums

10-20

none

shoulder blades down

and then squeeze
them together.
-Standing leaning
over with one arm on
a hard surface with
back straight. Rotate
your arm on a swiss
ball counter clockwise
and clockwise. Allow
the arm doing the
motion to be relaxed
lightly resting on the
ball.

Current Program Analysis

The current program design is to help speed up the recovery of a rotator cuff repair surgery for
the first month post-surgery. The current program is very basic with basic movement because
after the surgery the client will have very little movement at the shoulder joint. It is important to
regain movement in the shoulder joint through stretches and minor movements before
strengthening the muscle. One thing that I would change about this program is to make the
repetition range smaller. For the more simple movement such as wrist flexion and extension I
would have the client perform 15-20 repetitions and for more taxing movements like the closed
chain pendulums 10-15 repetitions. Also for the very first few weeks I would only make the
subject perform a maximum of 10 repetitions until they felt the movements a little easy. An
exercise that I would add to this program would be a posture exercise at the beginning so the
client is use to putting their shoulder in the proper position and avoiding bad habits especially
right after a surgery.

Longer term program

Weeks 4-8 (weeks 6-8 increase sets to 2)
Exercise Name
Table SlideAbduction in
scapular plane

Repetitions
10-15, hold each
for 5seconds

Sets
1

Weight
None

Table slideforward flexion

10-15, hold each

for 5seconds

none

Table slideexternal and

internal rotation

10-15, hold each

for 5seconds

none

Low row while

standing

10-15, hold each

for 5seconds

None

Description
-Sit with your
side facing a
table.
- Place arm on
towel on table at
45degrees.
- Slowly lean to
the side allowing
arm to slide on
the table.
-Sit facing a
table
- Place arms on
towel on table
- Slowly lean
forward allowing
arm to slide
forward.
-Place bothe
forearms on a
table with a
towel
underneath.
- While holding a
stick internally
and externally
rotate both arms
while
maintaining
small area
between elbow
and side of the
body.
-Stand in front of
table facing away

Arm abduction
against wall

10-15, hold each

for 5seconds

none

External rotation
against wall

10-15, hold each

for 5seconds

none

Neck Stretches

10-15, hold for

5seconds

none

from it.
- Place both
palms against the
table and push
against it.
-Stand beside a
wall with arm at
90degrees
against the wall
and attempt to
abduct arm.
-Stand beside a
wall with arm
against it at
90degrees and
attempt to
externally rotate
arm.
-start with chin
tucked.
- Move head
forward and back
to starting
position, turn
your head side to
side, and tilt your
head side to side.

Weeks 8-12 (increase weight throughout weeks as needed)

Exercise Name
Forward
shoulder raises

Repetitions
10-15

Sets
2

Weight
5lbs (increase
weight as
needed)

Lateral raises

10-15

5lbs (increase
weight as
needed)

Description
-Hold weight in
hand.
- With a straight
arm lift arm in
front of the body.
-Hold weight in
hands.
- With a straight
arm lift arms
away from body.

External rotation

10-15

Internal rotations

10-15

Thoracic Stretch

10, hold each rep

for 10seconds

Sleeper Stretch

10, hold each rep

for 10seconds

Use rubber bands -Keep arm bent

at 90degrees at
the elbow with a
few inches away
from the body
and rotate the
forearm away
from the body
while
maintaining the
space between
the elbow and
body.
Use rubber bands -Keep arm bent
at 90degrees at
the elbow with a
few inches away
from the body
and rotate the
forearm across
the body while
maintaining the
space between
the elbow and
body.
none
-Lie on back
with a rolled
towel between
your shoulder
blades.
- Push should
down into the
floor.
none
-Lie on your side
with elbow bent
at 90degrees.
- Use other arm
to rotate other
arm down
towards the
ground.

Week 12-16+ (increase weight throughout weeks as needed and weeks 14+ sets 3-4)
Exercise Name
Repetitions
T raises on bench 10-15

Sets
2

Weight
5lbs (increase
weight as
needed)

Y raises on
bench

10-15

5lbs (increase
weight as
needed)

Internal Rotation

10-15

5lbs (increase
weight as
needed)

External rotation

10-15

5lbs (increase
weight as
needed)

Description
-Lie on a bench
chest first.
- With straight
arms lift arms
laterally making
a T shape.
-Lie on a bench
chest first.
- With straight
arms above head
lift arms making
a Y shape.
-Keep arm bent
at 90degrees at
the elbow with a
few inches away
from the body
and rotate the
forearm across
the body while
maintaining the
space between
the elbow and
body.
-Keep arm bent
at 90degrees at
the elbow with a
few inches away
from the body
and rotate the
forearm away
from the body
while
maintaining the
space between

Pointer

10

None

Shoulder StepUps

10

None

the elbow and

body.
-On hands and
knees.
- Elevate
opposite arm and
leg.
-Start in a pushup position next
to a step.
- place one hand
on a step and
step up with arm.

Rehabilitation Process for a rotator cuff muscle can be very tedious. It is important to slowly
introduce movement to the client and slowly increase the load and work at which the client
performs at (Van der Meijden et al, 2012). In my program I incorporated this by continuing off
of the low volume and no weight exercises for a few weeks and slowly increasing the sets up
from 1-2 after 6weeks of exercising. Studies have shown that at the beginning of rehabilitating a
rotator cuff injury that they want to limit the electromyography activation at the beginning and
slowly increase so I slowly increased the exercises that involve more muscle movement and
volume (Van der Meijden et al, 2012). It has been shown that when rehabilitating a rotator cuff
injury that you introduce cervical, shoulder, and elbow movements into the program which is
why I added some of the exercises I did (Van der Meijden et al, 2012). At the beginning of the
rehabilitation it is important to avoid movements that may re-aggravate the injury like external
rotation, internal rotation, abduction, and flexion so I slowly eased these exercises by introducing
the isometric movements in after 4 weeks of light exercises with minimal movement allowing

the tissue to strengthen (Van der Meijden et al, 2012). Since it is important to slowly increase the
electromyography into the rehabilitation program I chose more difficult exercises for the last 2
months with weights (Van der Meijden et al, 2012).
Summary
The client I used for this assignment had an arthroscopic surgery performed to their rotator cuff
muscle. Going off of the first 4 weeks of rehabilitation that the physiotherapist designed I made
a longer term exercise plan that the client could use to eventually get their shoulder back to
normal or as good as it can be. To improve and not re-aggravate the injury it is important to
introduce small movements at the beginning with no or minimal weight to the harder movements
with resistance. It is important for the client to increase their weights as they go when the
exercises being performed become too easy. In the end an exercise program such as this would
be a correct approach to rehabilitating the client from their surgery.

References
Van der Meijden, O., Westgard, P., Chandler, Z., Gaskill, T., & Millett, P. (2012).
REHABILITATION AFTER ARTHROSCOPIC ROTATOR CUFF REPAIR: CURRENT
CONCEPTS REVIEW AND EVIDENCE-BASED GUIDELINES. International Journal of
Sports Physical Therapy, 7. Retrieved March 20, 2014, from
http://www.ncbi.nlm.nih.gov/pmc/articles/P