02/12/2025
From Fear of Movement to Functional Recovery
I recently had the opportunity to work with a patient who came to my clinic following a fall that resulted in a significant rotator cuff injury. After undergoing surgical repair, she presented with muscle strength at Grade 0 and a great deal of apprehension toward moving her shoulder.
🔹 Initial Assessment:
The primary challenges were complete loss of muscle activation, restricted ROM, and a profound fear of movement (kinesiophobia). This fear was not only limiting her physical progress but also affecting her confidence during rehabilitation.
🔹 Intervention Approach:
I designed a progressive, structured rehabilitation plan focused on safe activation, gradual loading, and reassurance-based therapy:
• Isometric exercises to initiate early muscle engagement
• Progressive resistance training using bands and later free weights
• Dry needling and soft tissue mobilization for pain modulation and tissue quality
• Nerve stretches and targeted triceps/biceps flexibility work
• Electrical muscle stimulation (EMS) to facilitate muscle activation
• Taping techniques for proprioceptive support
• ROM training, advancing from assisted to active movement
Alongside the physical work, a major part of the process involved education, graded exposure, and building trust in movement to overcome the patient’s fear.
🔹 Outcome:
Today, the patient has achieved significant improvement in ROM, reduced pain levels, and much better neuromuscular control. While we’re still navigating the psychological hurdle of movement fear, her confidence has grown remarkably—and so has her functional ability.
🔹 Reflection:
This case reinforced something vital: rehabilitation is not just physical—it’s behavioral, emotional, and educational. Helping someone rebuild trust in their own body can be just as important as strengthening the muscles themselves.
Proud of her progress and grateful for the privilege to be part of her recovery journey. 💪
