Rotator cuff injury management series : 4/5

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Exercises in this stage should include drills specific to the demands of sport and an individual’s position. Careful collaboration between medical, rehab, and strength & conditioning staff is required to progress the athlete back into sports.

Strength training should address:
Upper body pulling exercises.
Upper body pressing exercises.
Core stability exercises.

[1]
Upper extremity plyometric exercises can be introduced and it can  improve proprioception, kinesthesia, and muscular endurance for the rotator cuff.

Plyometric exercises involve three distinct phases:
1. Eccentric pre-stretch
2. Amortization phase
3. Concentric contraction. .

The amortization phase, defined as the time between the eccentric and concentric phases, should be as short as possible to allow for adequate energy transfer.

Upper extremity plyometric exercises usually include throws, which are progressed from two-handed to one-handed drills.

[2]
Rhythmic stabilization exercises can be progressed to more complex exercises. You should include unstable surfaces and performance on a physioball to improve overall neuromuscular control.

For the overhead atheletes, a throwing program can be initiated and should include a graded training with  carefully monitoring quantity of throws, distance, intensity, and types of throws.

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5. Future Directions and Conclusions

Reference:

1) Management of Rotator Cuff Injuries in the Elite Athlete. Cur Rev Musc Med Weiss et al. 2018.