Rotator Cuff & Biceps Tendinitis (Non-Op)

Rotator Cuff / Biceps Tendonitis Non-Operative Management

Phase I - Inflammatory Phase

Modalities to Control Inflammation

• NSAIDs – Aleve (Naproxen) 220mg – take 2 twice a day for 14 days • Ice
• Ice or Ice Machine (Breg Polar Care Wave), (at least 20 minutes at a time, 4-5 times per day)

Cervical & Thoracic Spine:

• Evaluate and treat Cervical & Thoracic dysfunction contributing to shoulder pathology

Glenohumeral Range of Motion:

• Apply appropriate joint mobilization to restrictive capsular tissues
• Implement wand stretching as indicated
• Supplement with home program:
  • Cross arm stretch
  • Side-lying internal rotation
  • Thumb up back
  • Triceps stretching

  Scapulothoracic Range of Motion:

  • Treat restricted soft tissue contributing to impingement

  Scapular Strengthening:

  • Begin scapular stabilization with appropriate instruction in mid and lower trapezius facilitation

  Phase II – Subacute Phase; Early Strengthening

  Continue with modalities and ROM outlined in Phase 1

  Begin Rotator Cuff Strengthening:

  • Theraband internal/external rotation (0° abduction)
  • Rows
  • Prone table extension
  • Scaption (not above 90°)
  • Ceiling punch
  • Biceps
  • Triceps

  Phase III – Advanced Strength & Proprioception

  Continue with Phase II strengthening with the following additions:

  • Prone horizontal abduction at 90° with external rotation
  • Prone row with external rotation
  • Theraband IR/ER at 90° abduction
  • Push-up progression
  • Advance gym strengthening: front latissimus pulls, light chest work in protected range of motion
  • Seated press-ups
  • Resisted PNF patterns
  • Begin two arm plyometric exercises, advancing to one arm

  Phase IV – Return to Sport

  Continue with Phase III program

  Re-evaluation with physician (6-8 weeks of therapy)

  Advance to return to sport program as motion and strength allow