Rotator Cuff

Healing your shoulder Naturally: 12 Common Questions About how you can Naturally Heal Your Rotator Cuff

By Dr. Eric Koehler
Physical Therapist

1. What exactly is the Rotator cuff and why is it such a big deal?

Discussions about the rotator cuff never seem to bring about good news. We hear scary news about how a friend or a family member has had one. Shoulder Injuries, most often mentioned as tears seem really common and troublesome. Sports athletes, workers, middle-aged adults and seniors all have been noted to have issues with the rotator cuff.Discussions around the rotator cuff often focuses on long standing pain, weakness, and often surgery.

Before any discussion of how to heal your rotator cuff naturally we need to have an understanding of what the rotator cuff is.

The rotator cuff is simply a series of four muscles that are deep in the shoulder joint. They are known as the SITS muscles.These muscles are deep in the joint of the shoulder joint.

These muscles are the SITS muscles. SITS is an acronym for

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

Don’t worry there won’t be a test on the names!

These muscles all start on the shoulder blade (Scapula) and wrap around the upper arm bone (humerus). The muscles have their tendons (the connective tissue that connects muscles to bones) wrap around the shoulder joint to form the protective covering of the ball and socket joint of the shoulder (known as the Glenohumeral joint).

So what is the role of these muscles? These muscles are muscles that keep the ball and socket joint of your shoulder aligned together as you move your arm in different positions. They are not ordinarily very strong muscles, but they need to be strong enough and stay active while you go about your activity. When you reach, lift, and stretch your arm to position your hand these muscles are always working for you. They don’t get any recognition for all the good work they do. It’s kinda like the stage hands and sound people who take care of music or theater performances….when they work well you don’t even know they are there. BUT, when they don’t work properly things can go wrong and they get noticed right away!

    2. So what can go wrong with the rotator cuff and why does it seem like such a common problem?

    We are learning more and more about the types of things that go wrong with the rotator cuff. We are also learning that the medical tests that are used very often aren’t as precise in locating the problems of the rotator cuff as we once thought.

    First, there are several things (actually more than a dozen) that can go wrong that cause problems in the rotator cuff muscles. (the four most common causes of shoulder and rotator cuff pain are listed first and bolded).

    1. Stiffness of the rotator cuff causing painfully limited motion and strain on many of the muscles around the shoulder.
    2. The tendons of the Rotator cuff muscles can become weakened making the muscles less effective at helping to move the arm and do all the home activities, work and sport activities we want. (This is known at tendinopathy.)
    3. The nerves around the rotator cuff can become irritable and cause pain when there isn’t actually any significant muscle damage. 
    4. The rotator cuff muscles can become weakened either by loss of natural strength, being out of shape, or related to partially or completely torn tissue.
    5. (You will notice that there are three other major causes of rotator cuff and shoulder related pain that have NOTHING TO DO WITH TEARS OF THE ROTATOR CUFF!)

    6. The muscles of the rotator cuff can become tightened due to poor posture or limited use.
    7. The muscles of the rotator cuff can be WAY too flexible. This is more common in younger persons (teens and 20s) and in ladies more than guys.
    8. The rotator cuff muscles can become a bit slow to respond when they need to while you are going about your life and moving your arm, thus making the ball and socket joint not align properly.
    9. The rotator cuff muscles can become inflamed and cause irritation in the shoulder region.
    10. Arthritis, and inflammation associated with arthritis, can cause irritation and pain in the rotator cuff.
    11. The rotator cuff muscles can become just plain old weak from lack of conditioning and activity.
    12. The rotator cuff muscles can become irritated because the supporting muscles of the shoulder blade, spine or chest aren’t properly working to support healthy movement.
    13. Irritation from the neck spinal nerves can cause the rotator cuff muscles to be painful, weak, and sore.
    14. A frozen shoulder can occur in the rotator cuff. This is when the rotator cuff tendons and joint get “glued together” and flexibility is severely limited.

    A big mistake that is made is assuming that that weakness and pain in the shoulder MUST be ONLY be caused by a “torn” rotator cuff muscle. That is a mistake for two big reasons:

    First, if one believes that all they have wrong with their shoulder is a torn rotator cuff they will seek out the wrong Treatments and likely be worse off because of it. This tendency to blame all shoulder troubles on a torn rotator cuff ignores the other dozen or more things that can go wrong!Labeling all shoulder problems as caused by rotator cuff tears will also cause excess worry and fear. (When was the last time you heard disastrous stories of painful torn rotator cuff muscles?) Often this worry and fear makes the pain worse AND makes people fearful of seeking help.

    Second, getting treatment for a “Torn rotator cuff” may keep you from getting to the real reason YOU are having trouble. You see there are FOUR MAJOR reasons why you might have shoulder and rotator cuff pain.Getting treatment for shoulder pain based on a rotator cuff without knowing the real cause may cause you unnecessary misery, wasted time and money, and possibly unnecessary surgery. All of these only keep you from the activities you want to get back to and actually make your recovery longer. (It often takes 9-12 months to recover from a shoulder surgery. Who would want to go through surgery and the long painful recovery without knowing that all non-surgical approaches have been considered BEFORE QUICKY scheduling surgery!)

    Surgery isn’t a guarantee you will get back to your previous level, or improve at all with your function. In fact there are many orthopedic surgeons who think that the improvement from many shoulder surgeries is actually from the PHYSICAL THERAPY PRESSCRIBED EXERCISES THAT ARE DONE for up to six months AFTER THE SHOULDER SURGERY!

    Don’t get me wrong, it would be nice if you knew your shoulder pain, weakness limitations where only are caused by “a rotator cuff tear”.That is a nice simple explanation and simple (but painful and costly surgical solution!) But if you get the wrong type of care for your shoulder believing it is only due to a rotator cuff tear you will likely spend a lot of time and money on solutions that don’t get you feeling better and back to your family, work and your active lifestyle!

    And the bottom line as to why rotator cuff tears are so common may be that medical professionals are likely concluding that only the rotator cuff muscle damage is the cause of all shoulder problems.

    3. Don’t I need X rays or MRI to “Really know what is going on?”

    We hear this question all the time and we love to answer it.

    Yes, there are times when it is Essential and you must get an MRI or an X ray to find the cause of your problem!!!

    At the Physical Achievement Center we are specially trained to make sure you get an MRI or X ray recommendation ONLY WHEN IT IS NECESSARY! We use specific questions and tests on EVERYONE who comes to us for help. We also have special follow up tests we use on everyone to determine you definitely need and MRI. IF there are any concerns for worrisome findings we always ask for further testing. 

    In the end, VERY FEW people need these tests!And, when you get an MRI when you don’t really need one it only causes trouble. Unnecessary MRIs lead to excess worry, fear, and likely lead to needless and costly: injections, surgery, and with the possible horrible side effects from long-term medications (think of the dangers of some medications we hear about in the news-opioid medication and risks with NSAIDS with our heart. Liver and kidney damage are also common side effects of medications.

    You see the modern MRI and XRAYS are awesome at seeing every small detail inside your body. The problem is NO ONE has perfect insides!

    In other words these tests often telling us there are big problems inside our body when the body is really NORMAL. This can become a big problem when it comes to treating YOUR rotator cuff and shoulder problem. 

    Shoulder experts all around the world agree that MRI and X rays, when done for the wrong reasons, are actually causing more people to have NEEDLESS surgeries, pain, and disability. There are dozens of studies that prove that young athletes, adults, seniors, and middle aged athletes WHO DON’T HAVE ANY WEAKNESS, PAIN, OR SHOULDER PROBLEMS have MRI findings that show they have rotator cuff tears! 

    WOW! So what does that mean?

    What is means is all shoulder problems don’t come from torn rotator cuffs AND just because a test shows you have a rotator cuff problem DOESN’T MEAN your problem is CAUSED by the rotator cuff.One Large scale study concluded that rotator cuff thinning of the muscles and tears are as natural as we age as thinning and greying of hair and a natural part of aging…NOT A DISEASE THAT NEEDS SURGERY IN EVERY INSTANCE!

    The good news, especially if you are seeking natural ways to heal your pain and get back to the life you enjoy, is that the experts at Physical Achievement Center have effective treatments for YOU that don’t rely on medications, injections or surgeries-even when nothing else has worked!

    4. Will I get better with shoulder and rotator cuff issues?

    When you feel the nagging effects of shoulder pain it feels like it will NEVER get better! The pain, tightness, inability to reach and lift, restless nights, and missing out on life (family, home, work, sport) takes it’s toll- both physically AND mentally.

    Good news though…Nearly everyone we work with has gotten better with their shoulder and rotator cuff injury. This is especially true if they follow through with ALL three phases of healing:

    These three phases are:

    1. Pain relief and inflammation control
    2. Restore full flexibility and strength of the rotator cuff and all shoulder muscles
    3. Train the body to get back to all of your activities at home, work, and sport/exercise

    In fact, it is extremely rare for someone not to see significant benefits. If someone doesn’t see predictable improvements we will be sure to have them get the follow up care they need for continued improvement.

    The biggest key to whether or not you will get better is if you are willing to be coached through a course of natural healing with the proper combination of hands on healing AND specific exercise prescription tailored to YOUR needs! And, I wish I could tell you this could happen in a week or two, but it may take 6-12 weeks depending upon the severity of your condition, how long you have had problems and how much you stick to the specific plan outline by the rotator cuff experts at Physical Achievement Center.

    5. What Exercises are good for Rotator Cuff related problems?

    First off, specific exercise training is one of the two proven approaches to heal your rotator cuff naturally. But here is the problem.

    It just took 0.45 seconds for GOOGLE to find precisely 842,000 (yes, I mean exactly 842,000!) selections for rotator cuff exercises when I did a search today. Wow!!! Modern technology is impressive indeed!

    Wow, wait!!!!!

    Now, which ones to start with?????

    This reminds me of how to fix my car. I will confess that I am not very good at mechanical stuff, like fixing cars. When I was in my 20s I bough one of the best Sears Craftsman tool sets I could afford with over 132 tools. I thought I was going to be able to fix anything. I was all jazzed about this and started to do a complete tune up on my 1982 Buick Park Avenue.

    To save myself the embarrassment, Let’s just say it didn’t end well! AFTER, I had gas spraying out of the gas line I realized I used the wrong force on the wrong part with the wrong tool. ……..it wasn’t at the time, but now it is a funny story! 

    I ended up calling my expert mechanic friend to save the day….. and we both had a good laugh!

    You see, my 132-piece Craftsman tool set could have been a 2,032 part tool kit, but I didn’t know the proper tool for the proper part with the proper force to make the tune up an easy process.

    The same can go for exercises to solve lower back troubles. There are so many exercises that you hear that are good for rotator cuff and sciatica-in fact, I just found over three quarters of a million of them with my quick internet search!

    The thing is each exercise MAY be helpful. (Just like all the tools I used for the tune up were perfectly good tools.) An exercise needs to be carefully selected at the right time, in the right direction, on the right part, with the right force, and changed/updated as time goes on to get any real progress toward healing!

    There are some general exercises that may be beneficial, but first you gotta know the causes for your back pain and sciatica, or else you may be doing one of three things:

    1. The wrong exercise may delay healing or make it worse.
    2. The wrong exercise may be not be causing any harm, but may be a waste of time. 
    3. The exercise may be helpful at correct stage of healing but stop being helpful at the next stage of heeling.

    My advice is simply this in regards to exercise with rotator cuff and shoulder pain: start easy and slowly progress both flexibility training and strength training.If your shoulder strength and pain isn’t getting better week by week and your aren’t getting closer to the pain relief and activities you need to……. you have to do what I did with my car … get help from a professional.

    6. What can I do about rotator cuff and shoulder by myself to help?

    Some straightforward questions we are asked about include the following:

    Complete rest? Rarely, if ever. Stay reasonably up and active as you can. Frequent short, rests may be helpful (think minutes, not hours), but inactivity for long periods of time will likely make it worse. The damage that occurs on muscles, bones and joint with the shoulder being totally inactive takes a LONG time to recover from (if you recover at all!)….. and delay healing response.

    In over 25 years seeing people recover form rotator cuff and shoulder pain I have NEVER had anyone successfully rest their pain, weakness, and stiffness away!

    What about over the counter medications and heat rubs?

    Heat rubs may be quite helpful to ease the pain somewhat, but won’t get you anywhere near full recovery. On the bright side, heat rubs won’t likely cause the shoulder problems to get worse. 

    Anti-inflammatory over the counter pills can be helpful for some people but carry some serious risks for everyone if used long term, and for some folks even short term. (Recent medical studies have verified this as well!) If you decide to use them use, use them sparingly and only as a way to get to other lasting approaches to your rotator cuff related shoulder problems.Remember, No one has rotator cuff related shoulder Pain and weakness because they didn’t have enough “Natural IBUPROFEN” in their body!

    Heat or ice? Most people love heat and shy away from ice. Staying away from Ice may be a mistake. As I discussed above most of the time there may be inflamed nerves involved in rotator cuff related shoulder problems. Ice calms inflammation down while heat may make it worse. If you are unsure of which to use, use ICE. If you don’t like ice try it for at least five times (be sure you use a layer or two of cotton between you and the ice pack or ice) for 15-20 minutes every hour up to 8 times daily. 

    7. What exercise and activity can I do with rotator cuff related Shoulder pain?

    There are three main things you can consider if you are going to do it yourself (DIY) for recovering from rotator cuff related shoulder pain.

    First, do no harm. Don’t start any big time new training or exercises that is a dramatic increase in activity from your normal routine. Keep activities you attempt at or bellow a level of 3-4/10 pain level.

    Second, consider a reasonable activity and rest cycle. If you have a big project to do, like shoveling or raking the lawn, or working in the garden break up the project in smaller chunks and rest often to give the tissue and nerves a break from the stress of the activity.

    Third, Prepare for more ambitious activities weeks, or months in advance by SLOWLY building up the tissues with flexibility and strength exercises in gradual, controlled way.

    We find that this last one is the most difficult because many people have a hard time knowing what activities and exercise are right for their problem and level of healing. That is where the advice of an expert can come in handy and is invaluable.

    8. What can professionals do to help me with Rotator Cuff and shoulder problems?

    Simply put three things:

    “First Do No Harm!

    You think that would be a no brainer, but unfortunately some health professionals do harm. They do this by going too quickly to unnecessary prescriptions, injections, MRIs, X rays, and endless treatment plans that don’t help you reach your goals. A true rotator cuff and shoulder pain expert who has your best interest in mind will avoid these common traps so you don’t get the wrong treatment.

    Incorrect treatment will keep you from getting back to your favorite activities, may make your pain worse, may cause very harmful side effects, and can increase your sense of fear. Fear and lack of correct treatment can immobilize you into doing nothing at all to get relief. ALL OF THESE ARE TERRIBILE consequences of treatment that aren’t proven or from outdated recommendations.

    Second, they should spend A LOT of time finding out about YOU, and can never ask too many good questions.

    No two shoulder problems are the same. Yeah, I know your friend, co-worker, aunt, and next-door neighbor all tell you they had the “same thing.” By the same thing they mean they had pain and difficulty that kept them from doing the activities they enjoyed. A rotator cuff and shoulder pain expert should listen carefully to “YOUR STORY” and hear about what is bothering you. They should ask you when you have the problems: pain worse with reaching this way or that way; pain worse with lifting or reaching-and in which directions; pain at rest verses only with moving; and so forth. They should understand clearly by listening for (in YOUR words) what your major concern is. And most importantly, the rotator cuff and shoulder expert should know day one what YOUR goals are. It is in this way that the Rotator cuff and shoulder pain expert can get valuable information on knowing not only what is causing your problems, but more importantly, what is the solution to getting you back into the activities you desire.

    Third, they should outline a program where you are improving week by week towards your goals AND eventually to a point where you need only occasional assistance!

    Rotator cuff and shoulder experts should usually use some hands on techniques and approaches at first.Starting very soon in the process of treatment. That is the key to successful treatment. The experts at Physical Achievement Center know which hands on techniques to use on the right areas of the shoulder and spine! 

    A Rotator cuff and shoulder expert should be teaching you how to use your posture, activity, rest, exercises, etc. to guide you towards greater levels of pain control, muscle strength, activity, and self care.

    Ultimately they should be a TEACHER of how YOU can take care of yourself. IF THEY DON’T TEACH YOU HOW TO CARE FOR YOURSELF YOU NEED ANOTHER Rotator cuff and shoulder EXPERT TO HELP YOU!You won’t be rude to change….you will only be rude to yourself if you don’t!

    MOST IMPORTANTLY, YOUR ROTATOR CUFF and SHOULDER PAIN EXPERT SHOULDN’T TALK ABOUT SURGERY BEFORE THE NON-SURGICAL APPROACHES ARE USED CORRECTLY FIRST! Why would anyone want to have un-necessary surgery when there is successful non-surgical help readily available?

    9. How can I get a find the best professional to help me with Rotator cuff and shoulder problems?

    Many professions tell you they can fix rotator cuff and shoulder pain with one approach OR they simply refer to a surgeon. Early in my career I used to do that. I used the standard rehab approaches at the time. When the approach failed I would simply chalk it up to “MUST BE A TORN ROTATOR CUFF” and refer to an orthopedist for consideration of surgery. 

    That was a big mistake!Back then we didn’t know any better. HOWEVER now properly educated medical professional know better! 

    They know better because MAJOR STUDIES AND PATIENT EXPERIENCE HAS PROVEN THAT FOR PEOPLE WHO WANT TO HEAL THEIR SHOULDER NATURALLY THEY CAN DO IT SUCCESSFULLY WITHOUT SURGERY!!!!!

    The research proving non-surgical healing occurs without surgery ISN’T RESEARCH COMING FROM PHYSICAL THERAPIST. It is coming from the BEST ORTHOPEDIC SURGEONS publishing studies in the BEST BONE AND JOINT MEDICAL JOURNALS!!!!!

    You see in a major study done in 2013 Dr. Kuhn showed that 75% of patients who have severe tears of the rotator cuff DIDN’T need shoulder surgery to Get better!! THAT IS AWESOME NEWS because up until that point even Physical Therapists mistakenly believed that sever tears ALWAYS requires surgery. Surgeons and Physical Therapists didn’t know until the major studies came out that surgery isn’t the only option for major muscle damage in the rotator cuff.

    What is even better news about the study that Dr. Kuhn published is that the only difference between those who recovered form exercise and hands on therapy compared to surgery WAS THE PATIENTS WISH TO HAVE SURGERY IN THE FIRST PLACE got surgery while those who preferred non-surgical approaches got better with hand on therapy and exercises!

    You read that right!

    Folks who wanted surgery decided to have surgery long BEFORE THE NON-Surgery approach was even tried. That right was given to folks in the study to ensure that people who believed they needed surgery wouldn’t feel like they got shortchanged. If you feel like you won’t be short changed by NOT having surgery then you will likely get better if you decide to use natural healing AND FOLLOW THROUGH WITH IT…just like the people in Dr. Kuhn’s Study!!!

    Here is a simple test to see if your medical professional you are working with is looking at ALL Non-surgical options to help you heal in shorter periods of time (and with less cost!):

    ASK THREE IMPORTANT QUESTIONS and then carefully listen to the response:

    First, would you recommend I FULLY use hand on healing and exercise BEFORE ORDERING TESTS LIKE AN MRI?

    Second, are you aware of the latest research that shows even for complete tears of the rotator cuff non-surgical care helps at least 75% of people recover naturally without surgery?

    Third, why shouldn’t we fully use hands on treatments in combination with progressive flexibility & Strengthening guided by a Physical Therapist first to make sure this problem can be handled without the cost and time from work and life with surgery?

    If the medical professional you are working with hasn’t fully explained why your problem can’t be considered for non-surgical care, is rushing you toward MRI and surgery talk you may want to get a second opinion! That second opinion may make the difference between having surgery not knowing about other options. The second opinion may also more fully explain why you are having problems and what are ALL the ways to fix it.

    If your rotator cuff and shoulder pain expert isn’t considering all the natural healing methods that are science proven approaches they likely to keep you improving week by week to get you back to your active lifestyle doing such as:

    1. Caring for and playing with children, and grandchildren
    2. Shopping trips, Gardening, golfing with friends, and exercise
    3. Exercising with friends, yoga class, pickle ball, and dancing.
    4. Taking care of the inside and outside house holdchores- shoveling, raking, mowing the lawn, etc.

    10. What does successful treatment look like for Rotator cuff and shoulder related pain?

    Successful treatment starts with a rotator cuff and shoulder and sciatica expert finding out about you with a thorough interview. This interview should be relaxed and be done with asking questions to find out about how your problem: started, reacts during daily activities, has changed over time, responded to different types of help, etc. The interview should be done so you can tell your whole story.

    The next part of the process is a detailed and skilled physical exam. That part can sound worry some. This part of the process isn’t typically painful and includes only a few necessary tests and measures if done properly. When the interview is done by a rotator cuff and shoulder expert thoroughly the expert can plan the testing to only use the necessary measures and tests in order to keep you as comfortable as possible while they gather data for the next steps.

    The next part of the process is the explanation of the findings and outlining which of the many very helpful approaches will be used. You will be educated on your treatment options thoroughly in an unhurried way. We invite you to ask whatever questions you have about your condition and what the course of treatment looks like.

    Once you are completely confortable with understanding everything you are ready to start treatment in order to get feeling better right away. Expert treatment typically includes a special mix of these possible things done in the right portion AND ESPECIALLY In the right order:

    The Experts at Physical Achievement Center will guide you through all three phases of the healing process.

    Phase One: focus on getting rid of the inflammation, and stiffness

    Phase Two: focus on getting normal movement back and full strength of your shoulder and upper body.

    Phase Three: Get back to previous activities YOU want to at home, work, athletic activity/sport and travel.

    11. How long will it take to get better with Rotator cuff and shoulder Problems?

    A: It depends…it depends on YOU. 

    In general, it takes to 4 to 8 weeks to go through the first 2 phases of healing (controlled pain, all movement and strength back to normal).

    It may take another 1 to 4 months to get back to all activities you want to do…depending on how active you are.This is the third phase of healing.

    Here are 10 variables that determine how fast someone can heal:

    • Overall health habits.Healthy people heal faster.Younger people heal faster.
    • Other health issues such as diabetes, heart disease, high blood pressure, tobacco use, alcohol abuse and body weight all influence healing rates…and make the time to heal longer.
    • Diet.People who consume more nutrients in their calories (Dr. Joel Fuhrman calls this “Nutrarian”) heal faster than those who primarily eat processed foods.
    • Rest levels.Our bodies need sleep and rest to rebuild.A lack of sleep slows healing time.
    • Stress levels.People who have high levels of stress heal more slowly.
    • Sedentary lifestyle.People who sit all day for work or to watch TV heal more slowly.
    • People who follow advice and instruction from top-level healthcare professionals heal more quickly than those who do not follow-through with care.
    • People who are highly aware of their daily postures and habits heal more quickly…because they can adjust habits such as daily movements, sitting positions, and sleep positions more quickly.
    • Readers heal more quickly.People with higher attention spans are more likely to be self-educated on a topic and more likely to follow-through with successful treatment.
    • People who think there’s hope tend to be more persistent and won’t let anything stop them.Steven Covey calls this “Begin with the end in mind.” Moving away from difficulties and towards results requires a mental “Will do” attitude. This mindset will help you to follow through on all actions that you need to get better with your lower back pain and sciatica .

    BONUS MATERIAL!!!!

    Five bonus questions answered about Rotator cuff related problems!

    1. DO I need a full gym or expensive exercise equipment to recover form rotator cuff related shoulder problems?

    The simple answer is no!You will likely benefit form simple items that are already around your house.

    Things like bungee cords, exercise cords you already have around, 1-2# food containers, light hand held weights, or simple empty plastic milk bottles filled with water may be all that is needed for strengthening exercises.

    Flexibility exercises may be done with simple canes, a yardstick, wooden dowel, or an inexpensive overhead pulley device you can build yourself or purchase from the Physical Therapy clinic, local medical store or Amazon.com

    The Rotator cuff and shoulder experts at Physical Achievement Center rarely advise expensive equipment as low technology usually is more than enough IF YOU HAVE THE RIGHT EXERCISE, FOR THE RIGHT AREA, AT THE RIGHT TIME, AND ADJUSTED OVER TIME TO ENSURE YOU CONTINUE TO IMPROVE. That is the professional job is to see that you keep improving week by week!

    2. What are the top exercises for stiffness related rotator cuff problems

    Gradual flexibility exercises such as table slides, overhead pulley, cane overhead stretch often get one’s stiff painful shoulder moving again. DON’T try to get all the flexibility back in one or two exercises sessions. It may take several exercises a day AND done over several weeks to build up the flexibility. Don’t get discouraged.

    You can call our office to have us mail the copies of the basic flexibility exercises to you at 920-230-2747. We are glad to help you get on the right track! 

    IF you are motivated you can stick with it! Nearly everyone who keeps at it gets better. If not you may need some expert guidance with the exercises or combination of hands on treatment with specific exercises tailored to you!

    3. What are the top exercises for weakened tendons of the rotator cuff?

    There are two basic type of exercise training you can do. Both are helpful and either may be tried.

    First, you can use bungee cords or specific bands (start with yellow or green and work your way up to blue colors!). Simple holding onto the band with the band secured around a door knob you can pull your hand away from the door so you hand goes toward you belly button or stand the opposite direction and reach your hand away from your body. Start with 10 reps both ways making one set. Build the number of sets to 3 adding one set every week.

    The second is to use more of pulling type movements rather than pushing movements. These movements are rowing with a band around the doorknob or pulling apart a band held with bend elbows by your side.

    Again, if you want a copy of these exercises please call our office and we will gladly mail you a copy of the top exercises for weakened tendons of the rotator cuff!

    4. What are the top exercises for irritable nerves related to rotator cuff problem?

This exercise is the most basic and simple. In fact it seems too simple!

First, hold a one or two pound can of common household food can at your side. Then raise the food can up to the side up to about shoulder level. Find an angle away from purely to the side that has little or no pain. Repeat lifting to shoulder level 10 times. Do this once every day. Every other day add one more round of 10 reps until you have three rounds of ten. You can then increase the weight by a pound or two at the most and start the process over again from one round of ten repetitions.

Seems too simple doesn’t it…..yeah, thought so at first, but this is a terrific simple way to promote strength while reducing irritable nerves AS LONG AS THE PAIN DOESN’T GET ABOVE A 3-4 out of 10!

And yes, you can request this exercise from us as well by calling 920-230-2747. We want you to improve as fast as possible with your shoulder problem.

5. What can I do to keep my rotator cuff and shoulder problem away once it is under control, and will it come back?

The best thing to do for rotator cuff related problems, if you are worried about it coming back again in the future, is to complete all 3 phases of healing.

Phase One is where you focus on getting rid of the inflammation and stiffness.

Phase Two is where you focus on getting normal movement back and full strength.

Phase Three is where you go back to previous activities YOU want to do.

In our clinic, we find out DAY ONE what activities you have been MISSING OUT on.It is those activities that guide our work right FROM THE START OF CARE.

Some will say this activity is family time like lifting children or grand children, or golfing, or gardening, or sports like tennis/pickle ball or …something along those lines.

Your family, work, and active lifestyle can’t wait forever.

And we’ll guide you to take the next month or two and do everything you want to do that you couldn’t do before.

They keep doing their simple, customized-to-them exercises at home to get stronger and stronger.

Most come back for a recheck appointment in 2 months and have no trouble at all.

Some do have a relapse, but that isn’t typically a big problem.

At the two-month follow up we then take a look at the activity and at the program and help them get on the right track.

Conclusion

So there you have it. The answers to 12 top questions regarding the rotator cuff and shoulder pain. You now have knowledge on the possible sources of your rotator cuff and shoulder problem. You have some tips to start managing the pain on your own. If you take the advice you have learned to heart and use the tips you learned in this report you will be on your way to solving your problem.You will be pleasantly surprised that using the tips in this report, when combined together, can get you back to your active life. Your fears worries and concern about increasing pain, stiffness and inability to enjoy your favorite activities can be replaced with confidence in knowing what is going wrong, knowledge about the path to recovery looks like and you have been shown hope as you get back on path to your active lifestyle.

We at Physical Achievement Center want to assist you with the knowledge and skills to help you achieve greater mobility and strength for your active lifestyle in a natural way without medications, injections, or surgery-especially when “nothing else” has worked.

In the next few weeks you will be receiving even more valuable information and tips on how to restore you active and healthy lifestyle. I hope this is the beginning of a great long-term relationship where my friends and I at Physical Achievement Center provide you with valuable knowledge to transform you difficulties and fears into restoring your life!

Dedicated to Restoring your Active, Pain Free Lifestyle,

Dr. Eric Koehler

Rotator cuff and shoulder specialist

Physical Achievement Center

3475 Omro Road Suite 300

Oshkosh, WI 54904

920-230-2747