Blog 4: The Rotator Cuff Fix
Part 4: How Dr. Keirstyn Treats Rotator Cuff Injuries - Soft Tissue Therapy & Comprehensive Care
Welcome to Part 4! You now understand what your rotator cuff is, the different types of injuries, and how they develop. Now let's talk about how to actually TREAT these problems and get back to pain-free movement!
As your Oakville chiropractor who specializes in rotator cuff injuries, I'm going to share exactly how I approach treatment—combining manual soft tissue therapy, hands-on techniques, exercise prescription, and guidance to get you better.
The Modern Approach to Rotator Cuff Treatment
Here's what's important to know: most rotator cuff injuries (even some partial tears!) can be successfully treated WITHOUT surgery when caught early and managed properly.
The old approach: Rest, ice, maybe physical therapy exercises, hope it goes away
The modern approach: Active treatment, targeted soft tissue work, corrective exercises, progressive loading, and addressing root causes
My 5-Phase Treatment Protocol for Rotator Cuff Injuries
Phase 1: Pain Management & Inflammation Control (Weeks 1-2)
Goal: Get your pain to a manageable level while protecting the injured tissue
What We Do:
- Modify your activities to avoid aggravating movements
- Use ice strategically (after activity that aggravates it)
- Manual therapy to reduce muscle tension
- Education on activity modification and sleep positioning
- Assessment of your specific movement patterns
Hands-On Techniques:
- Soft tissue therapy on tight muscles
- Joint mobilization to maintain mobility
- Muscle energy techniques to reduce muscle guarding
- Postural corrections and education
Phase 2: Early Loading & Mobility Restoration (Weeks 2-4)
Goal: Restore pain-free range of motion and begin gentle strengthening
What We Do:
- Progress from passive to active-assisted exercises
- Begin isometric strengthening (hold positions without movement)
- Restore normal mobility throughout your shoulder
- Continue soft tissue work to address muscle imbalances
Exercises Start Here:
- Pendulum exercises (gravity-assisted, pain-free movement)
- Isometric rotator cuff strengthening
- Scapular stabilization exercises
- Gentle stretching of tight muscles
- Postural correction exercises
Phase 3: Strengthening & Progressive Loading (Weeks 4-8)
Goal: Build strength in your rotator cuff and shoulder stabilizers
What We Do:
- Progress to active exercises against resistance
- Introduce light weights and resistance bands
- Address muscle imbalances throughout the shoulder complex
- Continue correcting movement patterns
- Integrate functional movements
Progressive Exercise Program:
- Light weight exercises with proper form
- Resistance band work for rotator cuff strengthening
- Scapular strengthening (crucial!)
- Core strengthening
- Gradual increase in resistance and complexity
Phase 4: Sport-Specific & Functional Training (Weeks 8-12)
Goal: Return to your sport or activity with proper mechanics and confidence
What We Do:
- Integrate sport-specific movements into your training
- Progress resistance and intensity
- Address any remaining movement pattern issues
- Build confidence for return to activity
- Prevention strategies to avoid re-injury
Phase 5: Return to Full Activity & Long-Term Management (Week 12+)
Goal: Maintain your results and prevent re-injury
What We Do:
- Full return to your sport or activity
- Ongoing strengthening and mobility maintenance
- Periodic check-ups (every 4-6weeks) to catch any issues early
- Prevention strategies for long-term shoulder health
- Education on recognizing warning signs
My Specific Therapy Techniques
Manual Soft Tissue Mobilization
- Hands-on treatment of tight muscles and fascia
- Focuses on muscles that are contributing to the injury
- Releases muscle tension pulling your shoulder out of alignment
- Improves blood flow to promote healing
Instrument-Assisted Soft Tissue Mobilization (IASTM)
- Uses specialized tools to mobilize tissue more effectively
- Breaks up scar tissue and adhesions
- Improves tissue quality and healing response
- More effective than hands alone for some conditions
Joint Mobilization
- Gentle, controlled movements of your shoulder joint
- Restores normal joint mechanics
- Reduces pain and improves mobility
- Safe and effective
What to Expect During Treatment
Initial Assessment (First Visit):
- Detailed history of your injury and symptoms and past injuries
- Physical examination and special tests
- Movement assessment
- Discussion of likely diagnosis and treatment plan
- Informed consent obtained
- First treatment session begins
Typical Treatment Session:
- Assessment of how you've progressed since last visit
- Hands-on soft tissue work (15-20 minutes)
- Manual therapy and mobilization (if needed)
- Exercise instruction and correction
- Home exercise assignment
Frequency of Treatment:
Acute phase: 1-2 times per week
Recovery phase: ~1 times per week
Maintenance phase: Monthly or as needed
The Exercise Component (This is HUGE!)
Here's something important: soft tissue work is only part of the solution. The exercises YOU do at home are equally important!
Why Home Exercises Are So Important:
- Soft tissue work releases tension temporarily
- Exercises create lasting changes
- Exercises address the ROOT CAUSE
- You're the one in control of your recovery
- Prevents re-injury long-term
Treatment for Different Types of Rotator Cuff Injuries
For Tendinopathy & Impingement:
- Very responsive to conservative treatment
- Soft tissue work is highly effective
- Progressive exercise program is key
- Usually 4-12 weeks to full recovery
- Excellent prognosis with proper treatment
For Partial-Thickness Tears:
- Can often be treated conservatively with regular care
- Requires more aggressive soft tissue work
- Progressive loading is crucial
- 8-16 weeks typical timeline
- Surgical referral if not improving after conservative care
For Full-Thickness Tears:
Depends on tear size and patient factors
Small tears: May respond to conservative care
Large tears: Often need surgical consultation
*Conservative care still helps reduce pain and improve function*
The Timeline: What to Expect
Week 1-2: Pain management, you feel some relief
Week 3-4: Improved mobility, starting to get stronger
Week 5-8: Significant improvement, returning to more activities
Week 9-12: Back to most normal activities, continuing maintenance
Week 12+: Full return to activity, ongoing prevention
Important: This timeline varies based on injury severity, your compliance with home exercises, and how your body responds to treatment.
Ready to learn how to stay healthy long-term? Read Part 5!
Dealing with shoulder pain or want to prevent rotator cuff problems? Dr. Keirstyn specializes in treating and preventing shoulder injuries in Oakville athletes and active adults. Let's get your shoulder healthy together! Book today or reach out to learn more!