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Mike's Home Exercise
How I fixed my rotator cuff tear and avoided surgery
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How I fixed my rotator cuff tear and avoided surgery

Mike Nelson, CSCS, PTA
May 22, 2023

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Mike's Home Exercise
How I fixed my rotator cuff tear and avoided surgery
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This is not medical advice.

That title is somewhat of a misnomer. I didn’t “fix” my rotator cuff muscle, I “rehabbed” my shoulder enough that my other intact cuff muscles compensate, and I have no pain.

Those of you who know me personally, I am not a natural smiler for pictures. One minute with my interminably smart assed wife fixes that pretty quick. See proof above.

I frequently respond to comments on social media in rotator cuff and shoulder forums. It’s hard to type out my experience every time, so I decided to lay out the whole story here. If you don’t want read how it happened, you can skip to the part of how I fixed the problems myself, and avoided rotator cuff surgery.

How I tore my rotator cuff and bicep muscle

I strained my supra spinatus about a year ago in jiu jitsu. It wasn’t anyone else’s fault, I just strained too hard against some movement. Didn’t really feel it when it happened, and this is common. I should have rested it longer than a couple weeks. I went back too early, and kept re injuring.

One day we were stand up sparring, and I swung my arm up high for an attempted (and embarrassingly poor) judo throw. This time I tore my bicep muscle. That was much more painful, and instantaneous. I could feel the fibers continue to tear away from the bone slowly, for the next two hours. That was fun.

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Glad the whole bicep eventually tore away, as I think partial fibers hanging on would be much more painful. After a week, most of the pain was gone. Swelling and stiffness lasted a few more weeks.

I now had two problems. I couldn’t raise my shoulder overhead, likely due to a tear of the supraspinatus, and my biceps was torn. I could have had one or both repaired, but wasn’t sure I would trust the repairs going back to sports later. Plus the time out of work, out of pocket costs, risks with surgery, etc.

I was having shoulder pain at night, and it was limiting my sleep.

The routine that worked for me ( and may not work for everyone)

If you are going to consider this route, you need to consult with a surgeon first. Some people who may not be able to tolerate this, or should be even more careful, are those with osteoporosis, history of shoulder dislocation, labrum tears, or multiple rotator cuff tears.

I do rehab for a living, so figured I would try to avoid surgery. Dr Kirsch is a retired orthopedic surgeon who wrote a book about fixing problems associated with rotator cuff tears through a hanging stretch. I found his protocol to be too aggressive initially, so I started using the lat pull bar stretch featured in this article,

Mike's Home Exercise
Have we been stretching the shoulder incorrectly all these years?
This is not medical advice. Consult your doctor and therapist first before attempting any exercises. I recently learned about a retired orthopedic shoulder surgeon named Dr. John Kirsch. He wrote a book titled, “Shoulder Pain? The Solution and Prevention.” In the book he hypothesizes that our shoulder was designed for hanging, like primates hang from…
Read more
3 years ago · Mike Nelson, CSCS, PTA

I started this about 4-6 weeks after the last shoulder injury. It was excruciatingly painful when I started, and I could only hold maybe 25 pounds for 10 seconds. But I also noticed it felt better afterwards. That is the key.

The worst left over deficit, noticed in an upright row. Consistent with rotator cuff tear

Every day, and every stretching session I started, was “1 step back, 2 steps forward.” Get stiff, stretch. Over and over, yet each time got easier and felt better. Within 2 weeks I was able to sleep, and my shoulder motion was improving.

It took 6 months total to reach 90% of overhead range of motion. I worked my way up to this protocol;

2x/day, everyday

6 - 1 minute sessions (or more)

I started with 25 pounds on the bar, but gradually worked my way up to 95 pounds on the bar, and then after 4 or 5 months was able to hang full body weight from a pull up bar.

After 9 months, I no longer have shoulder pain. I can throw a football 30-40 yards. It still has a tear that the rest of my rotator cuff is compensating for, as seen above with the kettlebell. I no longer perform upright rows, but am able to do push ups, pull ups, dumbbell presses overhead, etc.

I also performed traditional rotator cuff strengthening exercises 30 minutes a day. I always started with stretching though, as that was the priority. You can always get stronger later, you can’t always restore range of motion later. Once scar tissue sets in after a few months, the joint can become frozen, and that routine is much harder and much more painful.

I also added this exercise, which I think is the most important counter movement to raising your arm overhead. It is often ignored in rehab circles.

Mike's Home Exercise
Rotator cuff muscles are less important than the latissimus for shoulder health
This is not medical advice. Yeah, that’s a wonky title. Search engines work better with rotator cuff listed first. The title is sure to cause a shit storm. Physical Therapists’ heads are exploding. “You can’t say that without scientific, double blind studies performed at the exact same time, with an atomic clock, on opposite ends of the Earth, performed …
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2 years ago · 1 like · 3 comments · Mike Nelson, CSCS, PTA

Context, and was it worth it?

I’m 52, and no longer competing in sports. I am able to do the things I want, and didn’t have to go through surgery. I am uneven, which is a large focus of posture forums on social media, however no posture is perfect.

Mike's Home Exercise
No posture is perfect
This is not medical advice. I keep seeing posts on Reddit where people are taking pictures of their posture, and posting it. Is it good, bad, pelvis or collarbones tilted? Uneven? I think this is partially a generational question. Younger people are more concerned with appearance, and tech savvy enough to quickly upload pictures to social media, while bl…
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2 years ago · Mike Nelson, CSCS, PTA

Buy Dr Kirsch’s book and read all the negative reviews on the internet. As of writing this article, 86% of the reviews were 4 or 5 stars. 14% of the reviews were 1 to 3 stars, with reports of injuries completing the protocol.

The clinical side of me is happy I had this experience. Now I know some of the pain and dysfunction my patient’s are experiencing.

And at some point, you might need this advice,

Mike's Home Exercise
Can't lift your arm?
This is not medical advice. Sometimes we have an injury or condition that prevents us from rotating our arm overhead. This problem is mostly at the shoulder. I have several articles describing why this happens, or why your shoulder hurts in the first place…
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2 years ago · Mike Nelson, CSCS, PTA

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Mike's Home Exercise
How I fixed my rotator cuff tear and avoided surgery
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Discussion about this post

Miss Rodeo
May 15

Love your attitude toward surgical intervention, which my natural tendency is to avoid. Never had elbow or shoulder issues until the last 6 months. A steroid shot immediately quieted the elbow pain, so this week I received the same for my shoulder with little result. Surgeon didn’t recommend an MRI, so not really sure what I have going on. No pain with golf swing or reaching overhead, but “sewing with a needle” motion (right arm- left to right lateral motion) lights me up! Sometimes it makes a popping sound during this motion. I golf almost every day and am worried I might end up with a tear similar to yours. Turning 70 this year (no Spring chicken). Not sure WTH to do. I’ll keep hanging around (smile). Headed to Alto, NM, soon. Are you nearby?

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