Rotator cuff injuries are very common among active adults and a common reason to see physical therapy in Durham. Due to the shoulder being a very mobile joint, overuse injuries tend to happen easier at the shoulder compared to other joints in the body. In this blog we’ll specifically talk about rotator cuff injuries and provide you with our top 3 exercises to overcome your shoulder pain.
What is the rotator cuff?
The shoulder joint is classified as a ball and socket joint, where the head of the humorous ( arm bone) is the “ball” and the glenoid fossa of the shoulder blade makes the “socket”
The rotator cuff is a group of 4 muscles whose primary job is to stabilize the shoulder and hold it in the socket. While the muscles are named “rotator” cuff, and they do help with arm rotation this is of less importance compared to stabilizing the joint while the bigger muscles, such as deltoid, lats and pecs do the moving and rotating.
The 4 muscles of the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis. The first 3 muscles sit on the back of the shoulder blade and are considered the “external rotators” while the subscapularis is considered an “internal rotator” and sides on the front side of the shoulder blade.
Other muscles of the shoulder
In addition to the rotator cuff muscles, the lat muscles, the deltoid, pecs, triceps and biceps also attach on the shoulder joint. That is a lot of muscles controlling our motion, which means an injury or dysfunction in one of these muscles can also contribute to compensation patterns. Due to all of these other muscles being so large, they can sometimes “overrun” the rotator cuff muscles. In cases like these strengthening the rotator cuff to better match the power of the bigger muscles is important.
Why do rotator cuff injuries happen
While traumatic events such as a fall or a car accident can injury the shoulder, most of the time rotator cuff injuries happen over a period of time due to overuse. As mentioned before the shoulder joint has a lot of range of motion – you can bring your arm up, out, back, and move it around in a circle. Due to all of this motion it is imperative to have good mechanics, otherwise the tendons of the rotator cuff and become impinged (i.e. pinched) in the joint.
Other part of the body that can affect the mechanics at the shoulder include flexibility of the lat muscles, mobility of the upper back and movement of the rib cage. If we are stiff or tight in any of these areas the shoulder joint may compensate by trying to get extra movement, which then puts pressure on the tendons and soft tissues of the joint.
Overcoming Rotator Cuff Injuries
Many people assume surgery is needed if they have a rotator cuff injury. While that is sometimes the best option for severe rotator cuff tears, many times the injury can be resolved with conservative treatment and physical therapy.
The first step to overcoming rotator cuff injuries to modify and avoid aggravating activities. This allows the tissues time to calm down and heal. Working with a knowledgabe physical therapist can also be extremely helpful to identify form break down during lifting and help you find non-aggravating exercises to perform in the meantime. Additionally, a physical therapist can perform hands on treatments such as cupping, dry needling or massage to help decrease your pain.
The second step is to identify and treat the root cause of your shoulder pain. Many people think that they just need more flexibility, and while that is sometimes the case, others may need more strength and stability. This means getting a thorough evaluation is imperative in overcoming your shoulder pain.
Once the pain is calmed down and the root cause has been treated you can then start to resume activities. At this point it’s also important not to just jump back in at 100% (even though your shoulder is probably feeling really good) because overloading the body to fast can also result in injury. Starting with lower weight and gradually building back up will give the body time to adjust and build resilience.
3 Exercises for rotator cuff injuries
Here are our top 3 exercises for those suffering from rotator cuff pain. While seeing a physical therapist is important these exercises should help you get off to a good start.
Scapular Push ups
The scap push up strengthens the rotator cuff and serratus anterior muscles – the main muscle involved in helping our shoulder blade glide properly. If it’s too hard to perform in a plank position, you can go down to your knees or standing with your hands on the wall. Start with 2-3 sets of 8-12 reps.
Shoulder External Rotation Isometric
Working the rotator cuff muscles in an isometric fashion (meaning engaging the muscle but not moving the limb) is a great way to decrease pain. When performing this movement a slight discomfort is okay, but we do not want to create pain. Start with 10s holds for 5 reps and perform at least 2 sets per day.
Banded Row
The row is an amazing exercise to work the shoulder and muscles around it. Many times the muscles in the upper back are weak, which leads to the shoulders rolling forward. By working the muscles in the upper back it helps to put the shoulder in a better position and allow the rotator cuff to work more efficiently.
When performing the row, focus on squeezing the shoulder blades together and keeping the shoulders away from the ears. Start with 10-15 reps for 2-3 sets.
If these exercises do not provide relief, then you may also need to consider other factors that contribute to shoulder pain. Due to the complex nature of the shoulder joint, taking a whole body, root cause approach ensures that nothing is missed.
If you are dealing with a rotator cuff injury or shoulder pain, contact us today. We help active adults with shoulder pain every day get back to the activities and workouts they love, pain free.
