Rotator Cuff Tendinitis – Rehabilitation Tool

Dr Srinivas B S Kambhampati

MS(Ortho), FRCS(Eng & Glasg), FRCS (Tr & Orth), Dip (Applied Biomechanics)

Consultant Orthopaedic Surgeon, Vijayawada

Diagnosis Covered

✔ Rotator cuff tendinitis
✔ Subacromial impingement
✔ Early partial thickness cuff tears (non-operative)
✔ Post-injection rehabilitation (steroid / PRP)

Phase 1: Pain Control & Protection (Week 0–2)

Relative rest (avoid overhead activity)
Ice application 10–15 min, 2–3×/day
NSAIDs if prescribed
Pendulum (Codman) exercises
Scapular retraction exercises
Neck & thoracic mobility exercises

Phase 2: Restore Range of Motion (Week 2–4)

Passive & assisted forward elevation
External rotation in neutral
Posterior capsule stretches
Wall-climbing exercises
Continue scapular control drills

Phase 3: Early Strengthening (Week 4–6)

Isometric rotator cuff exercises
TheraBand external & internal rotation (elbow at side)
Scapular stabilisation (serratus anterior, lower trapezius)
Avoid painful arc activities

Phase 4: Advanced Strengthening (Week 6–10)

Progressive resistance exercises
Closed-chain shoulder exercises
Eccentric cuff strengthening
Proprioceptive training

Phase 5: Functional & Sports-Specific Training (Week 10–12+)

Overhead strengthening progression
Sport- or work-specific drills
Endurance training of shoulder girdle
Gradual return to full activity

Important Precautions:

❌ Avoid painful overhead lifting early
❌ No strengthening through pain
❌ Sudden jerky movements discouraged
✔ Pain during rehab should be < 3/10

Red Flags – Seek Urgent Medical Review

🚩 Sudden inability to lift the arm after a strain or injury (possible acute rotator cuff tear).
🚩 Rapidly worsening pain or severe night pain that is not improving.
🚩 Fever, chills, or feeling unwell with shoulder pain (infection concern).
🚩 Redness, warmth, swelling, or marked tenderness around the shoulder.
🚩 New numbness/tingling, increasing weakness, or hand clumsiness/dropping objects.
🚩 Neck pain with shooting arm pain and neurological symptoms (possible cervical nerve root problem).
🚩 Chest pain, breathlessness, sweating, jaw/left arm pain (possible heart-related pain).
🚩 Unexplained weight loss, night sweats, or known cancer history with new shoulder pain.
🚩 Severe pain after a fall/trauma, visible deformity, or inability to move the shoulder.
🚩 No improvement after 2–3 weeks of good rehab adherence, or progressive loss of movement.