Anyone who pays attention to sports will no doubt notice that there are plenty of rotator cuff injuries around. This is especially true in swimming, baseball, tennis, and football. Sports where there is a lot of throwing or shoulder rotational movement.
But the rest of us can be prone to this type of injury as well. In our daily lives we need to be able to reach over-head, across our bodies to grab a seatbelt, or behind us to put on our clothes. Often our jobs require us to do repetitive tasks with our arms that can overwork our shoulders.
The statistics on rotator cuff injuries vary, but one study showed that of 7.5 million annual doctors visits for shoulder pain, 4.1 million turned out to be rotator cuff problems. A couple of other studies have shown that the older we get (starting at age 50), the more likely we are to turn up with a rotator cuff problem.
Your Rotator Cuff
So, what exactly is the rotator cuff, and how can we protect it from becoming a problem for us?
Basically, the rotator cuff is 4 muscles that originate on the front, back and top of the shoulder blade. They attach to the front, back, and top of the bone in your upper arm very near the shoulder joint. Your rotator cuff muscles are primarily there to stabilize your shoulder joint. What this means is that your rotator cuff “works well with others” whenever you do something with your arm. It also means that it is working most of the time!
In order to bring you some key concepts in the quest to keep your rotator cuff happy, I am just going to list them here.
- One of the key things is to avoid classic “shoulder creep” upwards. Many of us unconsciously let our shoulders ride up when we are doing anything even moderately strenuous with our upper bodies. Not only that, but shoulders that are holding stress often end up heading toward our ears. What this means is that your upper trapezius muscle is overworking, which puts your rotator cuff at a disadvantage. It will have to work harder to stabilize, can get fatigued, and fail. To combat this scenario, please see exercise #1, the High to Low Row using tubing. This exercise works your middle and lower trapezius muscle. This is a good way to get these lower trapezius muscles (and some others) to balance out that shoulder creep.
- Good posture is a key component in shoulder health. If you have a forward head and/or rounded shoulders, those chronically tight muscles mean your rotator cuff cannot move well in relation to the other muscles that it works with. The exercise I gave you above, the High to Low Row, is a good one to help with this. Another one is exercise #3 below, the Dumbbell Row. In both of these exercises, it is important to be conscious of standing tall, opening your chest, and moving your shoulder blades towards each other. Do not just reinforce a rounded posture, or one where your shoulder blades do not move.
- Use your core and lower body for stability. Believe it or not, your core and lower body provide a solid base for arm movement. Without that, once again your rotator cuff can end up doing too much work. Take a moment to consider a baseball pitch. There is the wind-up, which is a total body move. Legs, hips, abs, and torso are all contributing to the final toss and follow through. Not that we are all heaving baseballs on a regular basis, but you get the idea. Again, while doing all of the exercises given here, make it a group effort. Tighten your abs, extend your spine, and feel the solid base that your lower body supplies.
- In order to help you get a feel for what your rotator cuff does kind of on it’s own, there is exercise #2 below, External Rotation. The muscles themselves are relatively small, and you may feel that during this exercise. Because they are mostly there to stabilize and contribute to movement, they do not need to be strengthened using a lot of resistance. I put this exercise in so that you can learn to isolate that rotation. Again, stand tall, open your chest, and keep your elbow planted against your waist. If your elbow starts to migrate away from your waist, you will notice that other muscles, not the rotators, start to jump in. But, you should feel your deltoid (the superficial muscle on top of your shoulder) working with the rotator cuff as you rotate your arm to the side. These guys are true partners in this endeavor, whereas this time your trapezius or other back muscles should not be helping.
Exercises for Rotator Cuff
Briefly, here’s how to do each exercise.
Exercise #1. High to Low Row.
Using tubing with door attachment or a cable machine in the gym, put the attachment high. Standing tall and bracing with your abdominals, pull the handles on a diagonal so they end up by your waist. Repeat 10 times for one set.
Exercise #2. External Rotation.
Using tubing with door attachment or a cable machine at the gym, put the attachment waist high. Standing perpendicular to the attachment, grasp one handle (hold the other one in your other hand). Keeping the elbow planted at your waist and keeping your arm at a 90 degree angle, rotate the arm to your side. You will NOT get it directly out to the side when your range of motion is completed. Repeat 10 times for one set.
Exercise #3. Dumbbell Row. Stand tall, take a dumbbell in each hand with palms facing up. Keeping your arms bent at the elbow 90 degrees, pull both weights straight back. Also draw your shoulder blades together and open your chest each time you do this. Repeat 10 times for one set.
As always, please contact me with any questions or comments.
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