Yoga Therapy For A Rotator Cuff Tear
Listen in as Brandt shares strategies and discusses best practices for working with rotator cuff tears.
One was a question about rotator cuff tears. What’s the deal with them? Can you tear it more and how careful do I need to be? That’s really the basics of this question. So, the answer to that is, it depends. Without giving an hour lecture on rotator cuff tears, I’ll say this – that basically tears have different sort of grades to them. So, it depends how severe the tear is, so you need some information from their doctor about tears. There’s no way for you to know how torn something is. But that said, unless it’s really intense, so they usually grade them, so if it’s a low-grade tear which is kinda the most common thing especially if it’s not a trauma, if it’s just like over time. I see a lot of people have tears and, you know, usually when a yoga therapist gets, and they’ve been to PT, and so this has been my experience. This is just one possibility, but a lot of times they’ve gone to PT and they’ve done rehab exercises that have either worked partially or not worked. When they haven’t worked, it’s usually has something to do with – well, there’s lots of reasons they could not work. But often what you see as a yoga therapist coming in after all that is, or what I’ve seen is that the PT has given them exercises that were too strong. They didn’t work on them gradually and I think that was a problem.
The other thing I see kind of commonly is with older people, say above 60, sometimes they write them off like, “Yeah. You have rotator cuff tears and here’s a couple of exercises.” And, you know, obviously, no PT or Physio should do this, but it just kind of happens a lot. I don’t know if it’s just because of ageism or…because I just see so many and it’s kind of a mill and it’s hard to keep track of everyone. But they say, “Well, you’re good enough.” I get a lot of those. So, one thing you need to remember is that non-painful movement is really important. So the non-weight bearing, no-pain movement to warm up the area, and also to sort of treat whatever arthritis may not be in there coexisting with the tear, so that would be good. Do a lot of that, a lot of moving and breathing. And then when you start to strengthen, one of the key things is to do it in a way that’s suitable to their shoulder. And you can’t always tell while you’re doing it. So a lot of times it’ll feel fine in the session but what you want to do is follow up and make sure that you’re doing things that don’t really inflame it too much, say, the next day afterwards. I always follow up with my clients. So, those are the two things I would think about.
The third thing is a technique. Actually, Karina in this course was teaching that to us on the last retreat. But where I’ve used forearm stand against the wall, sometimes on the floor, depending on the shoulder to sort of reset the shoulder. I’ve used other techniques like that where you use the muscles and then the working theory is other muscles take over usually for the supraspinatus which is torn. Her group has a technique where you do forearm standing against the wall and you relax your upper traps, and then right afterwards, you kinda swing your arms up and down, and that sort of resets it for the day, or forever, or for a few hours depending on the person. So that’s another technique that I could show you sometime. The main thing is that you have to kind of stay on them and make sure that the strengthening exercises you’re doing are not inflaming it too much because, you know, it’s a sign of a couple of things. But one is that you’re really getting at the sort of attachment where it’s torn and that could be really dangerous.
Where I’ve seen people make mistakes in the past is that they don’t follow up properly. And so the person seems fine, and then it swells up, or it hurts a lot the next day, and then the person thinks, “Well, this is probably just part of me having a hurt shoulder. I’ll just keep doing what I’m doing.” And that’s kind of the danger zone. So I would be careful there. Make sure you follow up. You want to talk to them on the phone the next day. You can do it by email. I try to actually talk to them so I can ask them some questions. Questions like, “Well, does your whole shoulder hurt today more than it did yesterday? Is it more sore today than it was yesterday?” Some people are pain sensitive and they’ll always tell you something hurts. Other people go the other way and they’ll be like, “Oh, it’s fine.” I have a guy like this right now, actually, I’m working with who says, “Oh yeah, it’s fine.” But what he really means is that he can handle the pain. So you have to ask more specific questions like, “Look, is the pain today worse than it was when we were working yesterday?” That’s a very specific question as opposed to “Does it hurt?” So just keep all that in mind.