3 shoulder physical therapy questions

[Jake LaMotta]

2 shoulder physical therapy questions

I asked my good friend muscle96ss these questions but I figured maybe you guys could help me as well.

My PT currently has me doing cable external rotations this way (from a low pulley with a towel roll under arm pit):

http://www.youtube.com/watch?v=O0cu...246/?icid=VIDURVHOV01&feature=player_embedded

He said doing it this way is better because it isolates the infraspinatus and teres minor more and decreases impingement in the subacromial space. He said when you do it the other way (that I will show below) you use too much tricep instead of strictly infraspinatus and teres minor. He also said the towel roll helps to isolate the infraspinatus and teres minor more and also decreases impingement in the subacromial space.

He also has me doing cable internal rotations from a low pulley with a towel roll as well claiming it isolates the subscapularis more and decreases impingement in the subacromial space.

Here is how I always thought external and internal rotations were to be done:

http://www.youtube.com/watch?v=p46vt2MDQiY&feature=related

http://www.youtube.com/watch?v=f1mDWivFzqM

A couple questions:

1. Is my PT right? Is it better to do it his way. Will coming from a low pulley isolate the intended rotator cuff muscles more and decrease subacromial impingement?

2. What about the towel roll, is it necessary? Will using it isolate the intended rotator cuff muscles more and decrease subacromial impingement?

Thanks guys.

 

[gassy]

Do all of them, from as many different angles as possible, just give your rotator cuffs a chance to heal and recover as you would any muscle. I've had a total of 4 shoulder surgeries and I believe that variety is the key to a good rehab program. Buy a "Body Blade", it really helps to work the rotators from every angle and in a way you may not be used to.

 

[cjjrwe]

Mine had me doing the same type of PT.

 

[Jake LaMotta]

Mine had me doing the same type of PT.

Can you explain cjjrwe?

 

[COASTAL]

Jake he is right about muscles being worked (teres minor and infraspinatus), but isolating....well lets just say the RC works as a whole in this position. Truly the reason they are done like this is because it causes you to keep you arm close to the body and not cheat so much. Yes the other way (the way you are used to doing them or seeing them done) is correct also. Its just that so many people cheat and use other muscles namely triceps, some lat minor, thus the roll helps eliminate this.

I always have athletes with rotator cuff problems do it this way (with towel) and progress them to 90 degree int/ext rotation.

 

[Jake LaMotta]

I will definitely keep using the towel roll. But what about doing external/internal rotations this way, is it OK?:

http://www.youtube.com/watch?v=p46vt2MDQiY&feature=related

http://www.youtube.com/watch?v=f1mDWivFzqM

Is this what you're talking about when you say you have athletes do "90 degree int/ext rotation"?

 

[COASTAL]

Is this what you're talking about when you say you have athletes do "90 degree int/ext rotation"?[/QUOTE]

Its hard to say if that way is ok or not without knowing exactly what your injury is or type of surgery.....

No, that's not what i was talking about. I eventually have them doing ext rotation with shldr abducted at 45 then 90 degrees. I will see if I can find a pic or video. The shoulder horn works great for this....

 

[Jake LaMotta]

...Its hard to say if that way is ok or not without knowing exactly what your injury is or type of surgery...

I'm 16 weeks post op from a repair of a full thickness supraspinatus tear.

 

[COASTAL]

NICE! What the heck did you do?

Yes you should be ok doing that particular ext/int rot. But they are both doing about the same thing. I would just listen to my PT since he's been with you for 16 weeks.....

Good luck with your rehab. You should be back to 100% soon...

 

[Thor]

AGREED

NICE! What the heck did you do?

Yes you should be ok doing that particular ext/int rot. But they are both doing about the same thing. I would just listen to my PT since he's been with you for 16 weeks.....

Good luck with your rehab. You should be back to 100% soon...

Both ways will help strengthen the rotators, but using the towel may keep your movements(form) stricter.

 

[COASTAL]

yes

Both ways will help strengthen the rotators, but using the towel may keep your movements(form) stricter.

See my first post...i agree completely

 

[Jake LaMotta]

Both ways will help strengthen the rotators, but using the towel may keep your movements(form) stricter.

Yes, but what about doing ER/IR from a low pulley as opposed to doing it the regular way? Does it really make a difference?

 

[COASTAL]

Yes, but what about doing ER/IR from a low pulley as opposed to doing it the regular way? Does it really make a difference?

No.

 

[cjjrwe]

Actually I was commenting on the towel, during PT I used a towel under the arm, though in the gym when I do them I do not use the towel. I also had to ice my shoulder for 20 minutes I think it was after each session. I will be having surgery on my AC Joint, to remove some bone, and a decompression to relieve pressure in my shoulder, at that time they will look around with a scope to see if there is any damage that did not show on the MRI, which happens often. I have some minor tears and inflamation from impinging my tendons. Anyway, I use the pulley level with where I place my hand, a lower pulley seems like it would work the muscle differently, however it may be so slight as not to matter. I would talk to your PT or just do what feels most effective to you.

 

[COASTAL]

Actually I was commenting on the towel, during PT I used a towel under the arm, though in the gym when I do them I do not use the towel. I also had to ice my shoulder for 20 minutes I think it was after each session. I will be having surgery on my AC Joint, to remove some bone, and a decompression to relieve pressure in my shoulder, at that time they will look around with a scope to see if there is any damage that did not show on the MRI, which happens often. I have some minor tears and inflamation from impinging my tendons. Anyway, I use the pulley level with where I place my hand, a lower pulley seems like it would work the muscle differently, however it may be so slight as not to matter. I would talk to your PT or just do what feels most effective to you.

correct