The rotator cuff is a group of four muscles in the shoulder; the Supraspinatus, Infraspinatus, Subscapularis, and Teres Minor. Each of these muscles attaches to the shoulder blade, or scapula, and the humerus. Together, these 4 muscles are responsible for the majority of shoulder stability and initiation of most shoulder movements.
These muscle act synergistically to stabilize the shoulder while performing complex movements. If there is an imbalance or injury to one of these muscles, it will affect the entire shoulder girdle. This can result in pain, weakness, and impact your ability to train other muscle groups. In fact, many people report increasing their bench press & military press by 20 lbs. after training their rotator cuff!
How Do You Prevent Rotator Cuff Injuries?
Strengthening the muscles of the rotator cuff is the best way to prevent injury. As you increase the weight you are lifting, additional strain is placed on the rotator cuff to stabilize the shoulder joint. A session with a personal trainer is one of the most sure-fire ways of addressing your muscular imbalances and ensuring proper form during your lifts. We usually prescribe exercises using low-weight dumbbells or therapy bands to go through each motion the rotator cuff is responsible for; Lateral Raises, Front Raises, Internal & External Rotation, and Extension. These exercises should be performed in the 10-15 rep range. Start with low weight (under 8 lbs. or your larger muscles will take over) and progress as the exercise becomes easier and you can hit 15 reps with proper form. Your posture also has a SIGNIFICANT impact on protecting your rotator cuff from injury. According to this study in the Journal of Shoulder and Elbow Surgery, after examining over 500 patients, "Prevalence of rotator cuff tears was 2.9% with ideal alignment, 65.8% with kyphotic-lordotic posture, 54.3% with flat-back posture, and 48.9% with sway-back posture. Logistic regression analysis identified increased age, abnormal posture, and past pain as factors associated with rotator cuff tears.” Improving your posture is one of the best ways to decrease risk of rotator cuff injury, and comes with other benefits such as increased strength, increased respiratory function, less pain and fewer headaches.
How Do You Know If Your Rotator Cuff Is Injured?
Pain, weakness, decreased range of motion, and clicking/ratcheting through your range of motion can all be symptoms of rotator cuff dysfunction. In office, we run through a complete set of orthopedic tests to determine the specific cause of your shoulder pain. Here are a couple of simple tests you can do at home to check your rotator cuff.
First, have a partner evaluate your range of motion behind your back. Place a hand as high between your shoulder blades as you can and compare both sides. As you can see, Dr. Jeremy is demonstrating a significant loss of range of motion on the right side. Overuse tendinitis resulting in loss of range of motion is very typical in right-handed people. Since we perform many actions with our dominant hand, it is common for damage to build up over time.
Next, check your internal and external rotation against a wall. Place your arms in the 90/90 position and rotate as far back and as far forward as you can. You should be able to touch the back or front of your hand to the wall. Dr. Jeremy is bending his wrist and cheating to touch the wall in internal rotation, and his right hand can’t touch the wall in external rotation. Again, this is classic for rotator cuff tendinitis.
The last test is called the Empty Can Test. To perform this test, pretend you are holding a can of soda, then rotate your arm as if you were dumping the can out (Empty Can Test). With severe tendinitis, this motion will be painful. If no pain is present at this time, resist an upward force with your arm. Mild to moderate tendinitis will usually produce pain with resisted motion. This is a specific test for the Supraspinatus muscle.
How is a Rotator Cuff Injury Treated?
The treatment for a rotator cuff injury depends on the specific injury. A full thickness tear will not heal on its own, and will require orthopedic surgery to repair. If a full thickness tear is suspected (usually a traumatic injury and more severe pain) we will refer for imaging to evaluate the need for surgery. A partial thickness tear will heal on its own in conjunction with aggressive therapy and rehabilitative exercises. For most tendinitis injuries, the first line of treatment is RICE (rest, ice, compress, elevate). Home strengthening and stretching exercises are also recommended and should be obtained from a trained professional. Additional treatment is primarily aimed at the soft tissues involved. Therapeutic ultrasound, electrical muscle stimulation, myofascial release, and Graston Technique are all valid treatment options used for a variety of injuries to the shoulder. To learn more about rotator cuff injuries or other conditions, visit http://www.martychiropracticandwellness.com.
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