PNF stretches, or proprioceptive neuromuscular facilitation, for the rotator cuff combine stretches and contractions that target shoulder muscles after an injury, such as a sprain, dislocation or torn rotator cuff. PNF is used to help people improve muscle length and tone to achieve deeper stretching and relaxation in the shoulder. The PNF basic protocol for the rotator cuff includes more than stretching. Additional exercises tailored to improve joint control and internal and external rotation strength is a part of many shoulder rehabilitation strategies that should be designed and managed by a medical professional. The Rotator CuffThe four rotator cuff muscle tendons that connect to the shoulder include the supraspinatous, infraspinatous, teres minor and the subscapularis, known as SITS.

The SITS steady the upper arm bone to the shoulder socket and assist with a broad range of motion in the shoulder and arm. PNF PatternsPNF stretching typically requires help from a partner to alter the stretches and contractions of the agonist and antagonist muscles that control shoulder movement. Most PNF stretches include several rounds of pushing on the targeted muscles for a period of time, like 12 seconds, succeeded by period of muscle relaxation.

This is called the “hold-relax technique” and is part of a pattern that incorporates flexion and extension, abduction and adduction, and internal and external rotations of the shoulder. PNF for the Teres Minor and InfraspinatousLie on the floor, facing the ceiling.

There are two types of stretches – static and ballistic stretches. Static Stretches – stretching when the position is held for a given amount of time, usually 15-30 seconds. This stretch is most effective AFTER warming up (or dynamic stretching) Active static stretch: the muscle being stretched does the work. Example: cobra and downward dog.

Allow your partner to take the right arm out horizontally away from your body and support the elbow by cupping it in his hand. Let your partner bend your elbow 90 degrees from the floor, supporting the arm at the wrist. To work the stretch, the arm internally rotates forward to the point of resistance. Take a 12-second passive stretch in this position before allowing your partner to gently push down on the forearm as you contract the muscles and push upward to oppose the force. Stop contracting and relax. Repeat on the opposite side. PNF For the SubscapularisLie on the floor.

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Let your partner guide your right arm horizontally away from your body. Keep your elbow bent at 90 degrees. With the help of a partner, stretch the subscapularis muscle by rotating the arm overhead, easing the arm back, instead of forward with your partner’s help. Suspend the arm at your resistance point. You may feel mild discomfort. Stay in this passive stretch for 12 seconds.

Allow your partner to press the forearm down for 12 seconds as you resist the force by pressing up. Relax and repeat on the left side.