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Sleeper stretch for RTC
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martyrosse



Joined: 10 Apr 2000
Posts: 92

PostPosted: Mon Jan 07, 2013 3:13 pm    Post subject: Sleeper stretch for RTC Reply with quote

Happy New Year All!

I'm wondering if anyone has experience using the sleeper stretch for rotator cuff rehab. I have tendonitis of the long head of biceps tendon and impingement. I have been assigned this stretch as part of my rehab program. I'm not sure it is proving productive, and may even be counterproductive. Or perhaps it just seems that way when you are building up you duration with this stretch? I do not experience pain doing the stretch. However, when I try to increase the duration to 1+ minutes/rep as my PT requested, any progress I've made in being able to raise my arm pain-free over my head seems to stall or go backwards. I've tried to just use the minimum downward pressure (just weight of my other hand/arm), but same results. I'm 46 and have been doing this stretch for a few weeks. The first negative outcome was just a few days into the exercise, and my PT said just lighten up on the pressure. But that hasn't helped. When I do it for a shorter duration 2 reps x 30/45 seconds, it seems to be ok. But he wants me up to 2 minutes/rep.

Thanks,
Marty
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Jaipal



Joined: 06 Apr 2002
Posts: 71
Location: Maui

PostPosted: Mon Jan 07, 2013 7:33 pm    Post subject: Reply with quote

Hey Marty,

I'm sorry to hear you are going through this. I know exactly how painful and frustrating it is. I have exactly the same injury/diagnosis. I too am doing the same stretch along with a slew of others. I'm seven months into it.

All I can say is to keep at it. Some days feel better than others. Lots of "two steps forward one step backwards" days too. I've gone through the wringer of emotions often wondering if this was the injury that finally knocked me out of sports. I am determined not to let it. It just takes so much time and focus to soldier on with the rehab.

Tendonitis is such a slow healing condition. But the bright side is the body is an amazing thing and time heals a lot of damage.

Hang in there and best of luck with the rehab.

-Jaipal
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poussin



Joined: 14 Sep 2000
Posts: 158

PostPosted: Tue Jan 08, 2013 11:32 am    Post subject: Reply with quote

Hey Marty,

That's a tough one, but it will heal in time.
If I understand your injury correctly, you have pain at the outer part of your
shoulder when you raise your arm, right?

Been there, done that. Mine was work related, and I had to keep working throughout the duration which greatly prolonged my healing time.

One thing that finally really helped me was to keep my elbow close to my body no matter what I was doing. As soon as your elbow moves away from your body, it puts a LOT of stress on that joint/tendon in your shoulder.

This also allows the tendon to rest and heal.

To this day (out of habit now), I am still careful not to extend my elbow away from my body too much when lifting anything remotely heavy even though I have long been healed. (it's been about 20 years now), but the possibility of re-injury is always looming.
A classic example of dangerous activity is when lifting something out of the back of a truck bed by reaching over the side or back of the truck to lift something out.

Anyway, I hope this helps.
It WILL get better, it's just a time game.

Cheers,

G
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sinusoidal



Joined: 23 Feb 2009
Posts: 32

PostPosted: Tue Jan 08, 2013 12:09 pm    Post subject: Reply with quote

Marty - Check this website out. Good luck with your rehab.
http://www.mikereinold.com/2011/07/why-i-dont-use-the-sleeper-stretch.html
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swchandler



Joined: 08 Nov 1993
Posts: 5820

PostPosted: Tue Jan 08, 2013 2:43 pm    Post subject: Reply with quote

Just curious. I've been having some problems with my right shoulder for some time. While originally my range of motion reaching across to my left side was becoming uncomfortable, more limited and difficult, lately it has become more problematic, as it seems to be radiating more pain and discomfort down the front (into the bicep) and outside my upper arm from the shoulder. My problem appears to be somewhat different than what is being discussed, because it doesn't seem to affect the action of raising my arm very much.

Given the fact that the problem is now advancing and becoming more limiting and painful, I been thinking about seeing a specialist. What kind of medical specialist would be best to get to the bottom of the problem and potentially resolve things?
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scorpionfish



Joined: 14 Apr 2000
Posts: 30

PostPosted: Tue Jan 08, 2013 6:48 pm    Post subject: Reply with quote

You may all be descibing the subtle differences of problems all associated with the shoulder. I would strongly suggest that you think about talking to an orthopedic doc. If you feel pt is making things worse, then question. I am not a doctor, just a patient. I'm not an alarmist. But experienced. Some may get better on their own, but it's best to know for sure. Get better soon.
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isobars



Joined: 12 Dec 1999
Posts: 14184

PostPosted: Tue Jan 08, 2013 10:23 pm    Post subject: Reply with quote

This all presumes you have an orthopedic sports physician in the loop. If not, go find one. This is too important to take straight to PT on your own.

I've had many shoulder problems including RCT, labrum, impingement, severance of both long bicep tendon heads, bilateral AC joint separations, atrophied supraspinatus, and probably more. Surgery fixed the impingement and the labrum, and time and exercises more or less fixed the rest. I don't recall the exercises; it was too long ago. What I DO remember is that it took many years of exercise and play for that damned RCT to fade from "view". I'm left with pretty much full shoulder capability and strength 30 years later, but have to be a little careful of the AC joints, have to keep that supraspinatus strong all the time so my right scapula doesn't wing, and remain strong and mobile only through continued exercise. Keep plugging, keep questioning, do lots of research*, keep playing (carefully until healed), and some year you'll fuhgheddaboutit.

* About that research ... have you searched medical sources for RCT rehab, including that sleeper stretch? My trusted orthopedic sports physician recently prescribed me the best exercises to rehab my supraspinatus ... again. I began them, but also Googled something like supraspinatus rehab strengthening. There I found a peer-reviewed study just going into JAMA publication showing that while his were favored a year ago, I should replace one of his two with a different exercise. His were good -- the gold standard a year ago -- but the ones I changed to are better.

Your problem is broader, more debilitating, and more subject to imperfect treatment. Medical journal research may spot some flaws or improvements in your treatment worth asking your providers about. Be aware; they deal only in evidence-based peer-reviewed research published in recognized journals. You'll need to cite your sources to persuade them, you'll want to help them rather than challenge them, and some will resent it anyway. Screw the latter; I've fired oncologists who tried to baffle me with BS and refused to discuss evidence thereof even when it came from the very references they cited.

Obviously, not all issues are worth that effort. Given the utility, complexity, and healing time of our shoulders, I'd guess a few hours clicking in the medical literature are worthwhile. Many thorough discussions pop up when I Google <"sleeper stretch" rotator cuff tear> (lose the < and >, keep the quotes); I'd guess some of those discussions cite some studies.

Mike \m/
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windoggie



Joined: 22 Feb 2002
Posts: 2396

PostPosted: Tue Jan 08, 2013 11:08 pm    Post subject: Reply with quote

I bet doctors love to see you walk into the office.
_________________
/w\
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martyrosse



Joined: 10 Apr 2000
Posts: 92

PostPosted: Tue Jan 08, 2013 11:41 pm    Post subject: Reply with quote

Thanks for the replies. Just able to skim through them right now. The pain is actually on the inside U area between the chest and shoulder--kind of feels deep in there and really only hurts when I extend my arm straight up or reach behind me.

I also found that "why-sleeper-stretch-is-no-good" link and shared with my PT. He had my try the alternative stretch recommended on that site as a test. It does not seem to bother me the way the sleeper stretch has, but I only tried it once. He says some people don't respond well to sleeper stetch, some do.

Anyway, was just curious about anectdotal sleeper stretch results for my specific tendon issue.

Jaipal--maybe you've checked the other posts on iWindsurf...seems to be some other good options worth trying out there....stay in touch or re-post and we'll see if we can both get out there pain-free at Waddell this spring!

Cheers,
Marty
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Jaipal



Joined: 06 Apr 2002
Posts: 71
Location: Maui

PostPosted: Wed Jan 09, 2013 1:59 am    Post subject: Reply with quote

Hey Marty,

Yeah it's cool people are discussing this topic. I'm actually doing really well now seven months into it but I sure wish this thread was around when I first had the injury. Glad you posted it.

Stubborn as I am, during the first two months I didn't want to believe it was an impingement issue and wanted it to only be tendonitis. Especially because it happened ten days before I left Santa Cruz and moved to Maui. I took a nasty wipeout on a really windy day at Waddell last June. The booms hit me under the right elbow and pushed my shoulder straight up to my ear tearing my supraspinatus, inflaming the tendon and creating the impingement.

I saw several doctors and eventually had a high-res ultrasound which revealed the damage. It was then that a physical therapist added the sleeper stretch to my routine and it seems to have worked really well for me. Freed up a number of degrees range of motion.

I too was having a tough time extending my arm overhead but now I can do that no problem. I did perform the sleeper stretch very cautiously and it hurt like hell. But I regained so much range of motion as a result. I credit it as the thing that finally got me over the hump in the rehab which, like I mentioned, had many steps backwards - mostly due to my stubbornness. I insisted on continuing windsurfing and, showing I am not joking about the stubbornness, Olympic Weightlifting.

Anyway, shoulders are complicated and injuries unique. Continue researching, questioning, following a rehab protocol that is suitable for you and, above all, not giving up. That is the only thing that guarantees you lose. I'm sure you will beat this and I'll be thrilled as can be to see you back at Waddell in the spring. Hopefully AWT time.

Cheers,

-J
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