Rotator Cuff: Exercises and Strategies to prevent Injury

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Have you ever experienced a dull ache or sharp pain in your shoulder or upper arm? Maybe you are unable to sleep on one side because your shoulder wakes you up at night. Perhaps, you have discomfort reaching behind your back to tuck in your shirt or grab your wallet. If so, you may be suffering from a rotator cuff injury.

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Rotator cuff injuries, such as tendonitis, bursitis and tears plague any population in our population. The rotator cuff consists of four small muscles, which form a sleeve colse to the shoulder and allow us to raise our arm overhead effectively. These muscles, consisting of the supraspinatus, infraspinatus, teres minor and subscapularis, oppose the activity of the deltoid and depress the head of the humerus (upper arm) while shoulder elevation to prevent impingement.

The most commonly injured muscle is the supraspinatus. It is responsible for initiating and aiding in elevation of the arm. If torn, the private typically experiences persistent pain in the upper lateral arm and essential strangeness raising the arm without compensatory appeal from the scapula (shrug sign). The hallmark signs of a tear are nocturnal pain, loss of strength, and inability to raise the arm overhead.

However, acute tendonitis may also present with similar signs and symptoms, as pain can inhibit appeal and strength. Yet, symptoms connected with tendonitis normally respond to rest, ice, anti-inflammatory medication and therapeutic exercise.

Rotator cuff tears are most coarse in men age 65 and older. Tears and/or injury are typically connected to degeneration, instability, bone spurs, trauma, overuse and diminished strength/flexibility connected to the aging process. However, youth are also at risk for injury if they are complex in repetitive overhead sports, including swimming, volleyball, baseball, softball, tennis, gymnastics, etc.

Many population can function adequately with a torn rotator cuff in case,granted they have a low to moderate pain level. The traditional conjecture for performing rotator cuff surgical operation is to alleviate pain rather than to restore function. It is coarse for post surgical patients to lose some mobility/range of motion. power salvage is dictated by the size of tear, capability of the torn tissue at the time of surgery, time elapsed in the middle of injury and repair, and the surgeon's capability to recreate the allowable anatomical relationship.

It may take up to 18 months following surgical operation to wholly recover, although most population return to normal activities of daily living in 3-6 months. On the contrary, tendonitis normally resolves within 4-6 weeks, depending on the supervision of the injury.

The key to avoiding rotator cuff injury is performing enough conditioning prior to stressing it with vigorous activities. Many weekend warriors try to pick up the softball, baseball, football, etc. And begin throwing repetitively and forcefully without properly warming up. In addition, they are not likely to health before the season like competitive athletes.

This often leads to excessive strain on the rotator cuff and swelling. The definite follow is soreness, especially with overhead movement or reaching behind the back. The act of throwing is the most stressful appeal on the shoulder. The rotator cuff is forced to decelerate the humerus while follow straight through at speeds up to 7000 degrees/second.

Without allowable power and conditioning, the shoulder legitimately becomes inflamed.
Since the rotator cuff muscles are small, it is best to use lower resistance and higher repetitions to sufficiently improve them. Sample exercises include theraband or light dumbbell external and internal rotation exercises, which can be performed at discrete degrees of abduction.

Other coarse exercises include forward elevation to shoulder height in the plane of the scapula (scaption), press-ups, prone dumbbell horizontal abduction with external rotation, and diagonal arm patterns with bands, weights or rehabilitation balls. In addition to cuff definite exercises, it is also important to improve the muscles colse to the shoulder blade. These exercises include wall push-ups with a plus (rounding shoulder blades), shrugs, rows and lower trapezius exercises.

Finally, it is important to note some precautions with normal exercises routinely performed in health clubs. I propose the following suggestions to prevent rotator cuff problems:

o Avoid lat pull downs and military presses behind the head, as they place the shoulder in a poor biomechanical position encouraging impingement.

o Do not lower the bar or dumbbells below parallel with incline/flat bench press for the aforementioned reason.

o Refrain from using too much weight with lateral shoulder raises. This practice increases the load on the shoulder to 90% of the body weight, so there is no need to use heavy weight. It is best to speak an arc of movement slightly in front of the body with lateral raises to decrease stress on the rotator cuff, while avoiding elevation above 90 degrees.

o Specific rotator cuff exercises can be incorporated into upper body workouts. perform 2 sets of 15-25 repetitions for each exercise. These exercises should be done no more than three times per week to avoid overtraining.

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