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Working out with rotator cuff tear

I have a client who has a tear in their rotator cuff and doctor says that surgery is an option but she doesn't want to get it done.

She is in her early 50's and wants to still workout 3x's a week.

What exercises do you recommend and what are one's that you wouldn't recommend?

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Working out with rotator cuff tear

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Shoulder Girdle Position & Trunk Flexor Extensor Balance
by: Monica

In 2007 I had 13 clients on my training schedule all with some type of shoulder issue.

Most of them were told they needed surgery and all refused to get it. The fact is only one of them needed surgery (doctors will just recommend it because it makes them more money).

The one client who had a full blown tear, opted for no surgery and is currently training with me and has ZERO issues with her shoulder (she is 70).

Here's what you need to do:

1. Avoid any arms overhead motions including incline presses, bench presses, lat pulldowns, pullups (she can get back to this soon enough). Also avoid shoulder raises, floor pushups, chest flys, tricep extensions, and forget about internal external rotators with exercise bands too. All useless at this point and can and will make this persons's shoulder worst and only reinforce faulty movement patterns.

2. Assess her trunk flexor extensor balance. Chances are she is suffering from one of three very common postural imbalances.

Kyphosis, Lower Cross Syndrome, or Sway Back Posture. All three look somewhat similar but have very different postural symptoms (most trainers can't tell the difference just by looking at a person so don't guess assess.

Best tests to use are Thomas test, wall standing test for lordosis, hamstring flexibility test, and the entire functional movement screen by Gray Cook and Lee Burton (this stuff is so simple and so useful for program design).

3. Reposition the shoulder girdle back where it belongs with my shoulder mobility workout in the video. I do this with every client with shoulder issues, every single time they come in and if they are proactive then I also tell them to do it at home first thing every morning. This ridiculously easy and quick routine has saved tons of clients from surgery and keeps them pain free too. Take it slow the first time. Usually 2 sets of 8-10 of everything is good the first few weeks. Then increase to 2 sets of 15.

Once you have the shoulders back in alignment you can begin isolation work and if this goes well and her strength increases without pain then you can begin integration work.

I'll be posting more video of what you can do here so be sure to check back if you need more help.

Pigeon Stretch for Shoulder Rehab
by: Monica

The pigeon stretch is one of the most overlooked solutions for shoulder rehab. This stretches the glutes, inner thighs, hip flexors and the infamous IT. It is a very simple exercise that also reinforces trunk flexor extensor balance.

My clients hate this at first then they beg to do it because it really relieves tension in the entire body and gets those shoulders to come back into proper alignment.

Stability Ball Alternating Supermans for Shoulder Rehab
by: Monica

The alternating superman is a great exercise for clients with shoulder problems.

It helps strengthen all the muscles of the back which help pull those shoulders back into alignment.

If doing it on a ball is too challenging then try it hands and knees on the floor but still try to incorporate the rounded back as you flex.

TRX T Deltoid Fly for Shoulder Rehab
by: Monica

Most of the TRX letter exercises can be used for shoulder rehab because the TRX allows you to make the exercise as easy or as challenging as you need to.

Start with the letter T exercise also known as a reverse fly or deltoid fly. Be sure to engage the core, keep the body straight, and use all the upper back muscles.

The more upright you are the easier it is and using an offset foot position makes it even easier.

Once you get the hang of the T you can add the W and then the Y.

Letter drills can also be performed prone on the floor or over a stability ball if the TRX is still too challenging.

Hip Flexor Stretch for Shoulder Rehab
by: Monica

Tight hip flexors are a huge problem for many people with shoulder issues (not all but many). The hip flexor stretch below allows the trunk to go back to it's proper alignment and this has a direct effect on the positioning of the shoulder girdle.

If you do not have hip flexor or quad tightness then only use this stretch minimally.

Foam Roller Lat Exercise for Shoulder Rehab
by: Monica

Foam roller exercises are also very useful for releasing tension in all those areas that are tight and causing postural imbalances.

The most important foam roller exercise for shoulder issues is the lat stretch. 100% of people experience intense and horrific pain while doing this exercise but after 2 or 3 sessions the pain is minimal and there is a huge difference in thoracic extension and thoracic mobility in general.

This exercise helps eliminate shoulder pain, helps correct postural imbalances, and improves lung capacity too.

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