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This website is under development - The information contained on this site is for guidance only and is not intended for self diagnosis or self treatment. This will not replace professional medical advice or consultation. Always seek the professional advice of a qualified health care provider like your doctor or specialist before embarking on  any treatment. If you have a problem please consult your doctor or specialist.
Torbay Massive Cuff Tear Protocol
Bobby Ainsworth  

I am indebted to Bobby for allowing me to use a link to her web site. She works as a Consultant in Physiotherapy and Rehabilitation and has a vast experience in the rehabilitation of patients with complex shoulder problems. She has developed a rehabilitation programme called “Torbay Cuff Tear Rehab Programme” for treating patients with massive rotator cuff tears. This has been adapted by many other centres throughout UK for treating this complex problem.

The aim of the cuff tear rehabilitation programme is to re-educate the remaining healthy muscles that may be present to compensate for the absent cuff tendons. It is achieved by stretching, strengthening and improving the feedback thus adapting these muscles to take over some of the functions of the absent rotator cuff. It requires number of steps including correction of poor posture and re-educating deltoid muscles especially those in the front (anterior deltoid) and the teres minor muscles in the back. This programme is best delivered by a trained physiotherapist.

Principles of the programme are

Steps in the programme

Early stage

  1. Start in supine (lying down position) with your arms by your side
  2. Bend your elbow to 90 degrees.
  3. Move your shoulder such that the back of the elbow is pointing directly towards the ceiling.
  4. Straighten your elbow so that your fingers are now pointing directly at the ceiling.
  5. “Sway” the arm gently forwards and backwards till you can control it without any ‘shaking’. Then gain control on side to side movements as well.
  6. Once you have established the above, try to paint imaginary circles SLOWLY towards the ceiling. Do it both in a clockwise and anticlockwise direction.
  7. Bend your elbow back to 90 degrees so that the elbow is facing the ceiling (back to same position as step 3)
  8. Move your shoulder and place the arm on the bed (back to same position as step 2)
  9. Straighten the elbow to reach the start position.
  10. Repeat 10 times. One cycle from start to finish should take 1 min and each set of 10 repetitions will take about 10 minutes.

Advanced stage

  1. All the steps are the same
  2. BUT now use a weight as resistance. Start with a small water bottle (500 ml bottle) initially  half empty and then progress to full bottle
  3. At the end of 10 minutes, drink the water from the bottle!
Torbay Cuff tear Rehab Pictures Torbay Cuff tear Rehab Pictures