ROTATOR CUFF INJURIES

Restoring Shoulder Function
Shoulder exercises such as these are designed to help restore your shoulder's function. They may be assigned before or after surgery, depending on your injury. Follow all exercise instructions from Dr. Nguyen carefully.

Pendulum Exercise
1. Lean over with your good arm supported on a table or chair. Relax the arm on the injured side, letting it hang straight down.
2. Slowly move the relaxed arm in a small circle. Rotate 20 times. Reverse direction and repeat. Then, slowly swing the arm back and forth. Next, swing it side to side.

Wall Walk
1. Stand with your injured shoulder about 2 feet from a wall.
2. Raise your arm to shoulder level and gently "walk" your finger tips up the wall as high as you comfortably can.
3. Hold for 10 seconds. Then walk your fingers back down. Repeat 5 times.
*NOTE: Ask Dr. Nguyen if it's safe for you to do this stretch.

Pretzel Twists
1. Reach the injured arm over your good shoulder, keeping your arm level. Use the back of your good hand to gently press your injured arm toward your shoulder. Repeat 1 to 3 times, holding for 15 seconds.
2. Reach behind your head with your good arm, holding a towel. Grasp the towel behind your back with your injured arm. Gently pull up with your good hand. Repeat 1 to 3 times, holding for 10 to 15 seconds.
3. Place your hands together behind your body. Gently use your good hand to lift your injured arm up and back. Repeat 1 to 3 times, holding for 10 to 15 seconds.

Restoring Shoulder Strength
Exercises such as these might be assigned by Dr. Nguyen or a physical therapist. They can help to strengthen your shoulder and protect it from future injuries. Again, be sure to ask Dr. Nguyen if exercises like these are right for you.

Internal Rotation
1. Attach rubber tubing or a bungee cord to a doorjamb or other stationary object.
2. Stand with your injured side toward the door-far enough away that the tubing is just starting to stretch.
3. Keeping your elbow against your side and your arm in an "L" shape, slowly pull the tubing across your body.
4. Slowly return to the starting position. Repeat 5 to 15 times.

External Rotation
1. Attach rubber tubing or a bungee cord to a doorjamb or other stationary object.
2. Stand with your injured side away from the door-far enough away that the tubing is just starting to stretch.
3. Keeping your elbow against your side and your arm in an "L" shape, slowly pull the tubing from your body.
4. Slowly return to the starting position. Repeat 5 to 15 times.

Scapular Stabilization
1. Lean over with your good arm supported on a table or chair. Relax the arm on the injured side, letting it hang straight down. Form your hand into a loose fist.
2. Keep your shoulder down and your arm straight. Lift your arm up and away from your body until it points straight out.
3. Hold for 5 seconds, and then slowly lower your arm back to its starting position. Repeat 10 times..
*NOTE: If your elbow starts to feel tired or sore, you can change your arm position. Flex the elbow gently inward, so the arm no longer makes a straight line.

ROTATOR CUFF SURGERY
If your pain does not improve with other treatments, Dr. Nguyen may suggest surgery. Rotator cuff surgery can help correct problems like impingement, calcium deposits, or tears. You may need to stay overnight in the hospital or surgery center, depending on your type of surgery.

Things to do Before Surgery
- Stop taking anti-inflammatory medication, including aspirin, before surgery as directed.
- Tell your doctor about any prescriptions or over-the-counter medications, herbs, or supplements that you take. Ask if you should stop taking any of these before surgery.
- Don't eat or drink anything after midnight, the night before surgery. This includes water. If you have a medication you can't skip, take it only with a sip or two of water.
- Arrange for a family member or friend to give you a ride home.

The Day of Your Surgery
Arrive at the hospital or surgery center with enough time to check in. You will be given a gown to change into. Before surgery, a doctor will talk to you about the anesthesia that will be used to keep you pain-free during the surgery. You may be asked by several people to confirm which shoulder is being operated on. This is for your safety. Your injured shoulder may also be marked with a pen.

Helping Your Shoulder Heal
In the hours right after your rotator cuff surgery, Dr. Nguyen will check your shoulder. You will be given medication to relieve pain if you need it. You will go home that day, or stay in the surgery center overnight. As your shoulder heals from surgery, you can work with Dr. Nguyen to begin the process of regaining shoulder strength and flexibility.

Keep the Shoulder Moving
Right after surgery, you may be told to use cold packs and a sling. A rehabilitation (rehab) program will likely be prescribed to help you restore your shoulder's range of motion. Early, gentle use of your shoulder can be quite helpful. Talk to Dr. Nguyen and your physical therapist about what kinds of movement are safe for you.

During Recovery
After surgery, you will need to protect your healing shoulder. Depending on what kind of surgery you had, you may be asked not to use your shoulder at all untill cleared to do so. Once your shoulder has healed enough to begin gentle movement, be sure to follow all instructions from Dr. Nguyen carefully.

Call Dr. Nguyen if you notice any of these things after surgery:
- Increased pain or swelling at the incision site.
- Drainage from the incision.
- Numbness of the shoulder or arm that gets worse, not better.
- Increased redness at the incision site.
- Bleeding from the incision.
- Fever over 101°F (38.3°C)

Following Up
While your rotator cuff is healing after surgery, Dr. Nguyen will need to check your shoulder. This is to see if shoulder mobility and function are returning properly. Your treatment plan might be changed or adjusted to improve recovery.

A Shoulder That's Fit for Life
Whether or not you had surgery, you can work to keep your shoulder healthy and strong. Before using your shoulder, stretch and warm up. This will help prevent further injury and keep you feeling your best. Talk to Dr. Nguyen about the right kinds of warm-ups to use before any sports or other strenuous activity.