If you have managed to damage your rotator cuff then you will need to consider some sort of shoulder rehabilitation to get things working properly again but what sort and when should you start them?

There are different types of rotator cuff injuries and the treatment may vary depending on what you have done and how long it has been going on.

There are four muscles in the rotator cuff group. These muscles all help to hold the arm tight against the socket of the shoulder joint to help with rotation of the arm. That and the fact that they combine to form a cuff of muscle around the joint is what gives them their name.

Two of these muscles, the supraspinatus and the infraspinatus are the most commonly injured muscles of the four. Any sports activity that involves a lot of shoulder rotation puts these two muscles under a great deal of stress, pitching in baseball or bowling in cricket are just two examples.

If you tear your rotator cuff it tends to come about in a couple of different ways.

An acute tear usually comes about as a result of a sports injury or fall. This is caused by a sudden force being exerted on the muscle. You will probably feel the tear as it happens and the muscle may well go into spasm when you try to move it. There may also be a specific tender spot at the sight of the tear. Moving your arm out to the side without help will be painful and at best difficult.

A chronic tear comes about as a result of wear and tear. It is caused by the tendons rubbing against bone. It could be work related, if, for example you are constantly working above shoulder height. Painting and decorating is an example of an occupation prone to rotator cuff problems. It could also come about through age. As we get older our posture changes sometimes resulting in muscles behaving differently which can cause the rubbing that eventually injures your tendons.

It is important with shoulder rehabilitation to stop using the shoulder. With an acute tear it could be worth immobilising the arm in a sling. But with both types of injury you need to avoid any movement that causes pain. At the same time treat the inflammation and pain with ice packs and anti-inflammatory drugs. If the problems persist for more than two or three days it is worth consulting your doctor.

Treatment may take the form of surgery especially if you have a shoulder impingement or use your shoulders a lot at work but the majority of shoulder injuries can be treated with rest, ice and anti-inflammatory drugs followed by exercise once the inflammation and pain has subsided.

Do not try working through a rotator cuff problem as it can only make it worse. Exercise will involve low resistance exercises aimed at isolating and developing the rotator cuff muscles. Yoga and Pilates based exercises are good for shoulder rehabilitation because they work with the body's natural resistance working one muscle against another so are unlikely to cause any further injury.

Whether you have surgery or not, gentle, shoulder specific exercise is the key to shoulder rehabilitation. The difference is in the timing.

Do not forget to keep up the exercises once your shoulder is better. Keep your rotator cuff strong and have healthy shoulders for life. One rotator cuff injury is enough for anyone.