3 Exercises to Prevent a Rotator Cuff Injury

Rotator cuff injuries are the most common of all shoulder injuries. The rotator cuff consists of four muscles, the supraspinatus, infraspinatus, teres minor and subscapularis. Each of these muscles assists in holding the shoulder joint in place, by wrapping around the front, back and top of the shoulder. All of the muscles attach to the clavicle (collarbone), scapula (shoulder blade), and to the top of the humerus bone. A rotator cuff injury is an injury to one of these four muscles in the shoulder.

There are several different ligaments helping to stabilize the shoulder joint, and to assist the shoulder through its motions. Ligaments are thin structures that attach bone to bone, and are primarily in the front and back of the shoulder joint. The muscles and ligaments found in the shoulder, allow the shoulder socket to have the greatest range of motion of any joint in the body.

Reasons for a Rotator Cuff Injury

1. Acute injury: can occur from a specific incident such as a fall, causing a partial or complete tear, where surgery would be needed to fix it. Pulling or lifting an object that you are not strong enough too such as luggage. Falling on an out stretched arm down.

2. Chronic injury: can occur from an overuse of a particular tendon and/or muscle, causing inflammation. Examples of this include tendinopathy and bursitis.

With age, it is normal to have some wear and tear, and especially on the shoulder of your dominant arm. Also, the intensity of wear and tear on one’s shoulder can be increased with having poor posture where the neck and shoulders are slouched forward, which closes the joint where these muscles glide. This is known as an impingement.

Signs and Symptoms of a Rotator Cuff Injury

Some of the signs and symptoms that one might have a rotator cuff injury include a loss of shoulder range of motion, and pain or tenderness in the affected shoulder (especially when lifting anything overhead or sleeping on this particular side). The most common symptom is pain and can create the tendency to keep the injured shoulder inactive, causing it to become weak, short and stiff.

Rotator Cuff Injury Prevention

Shoulder strengthening exercises should be an intricate part of everyone’s workout program, and there a few in particular that can be performed to specifically strengthen all four of the rotator cuff muscles. Blood flow to these muscles also decreases as we age, thus increasing our risk of injury and importance in stopping them from atrophying.

Focusing on strengthening all four muscles will reduces the risk of injury. Each can be completed with resistance tubing, pulleys or dumbbells, while performing the motions of internal rotation, external rotation, and lateral raises.

Beginner Pulley Rotator Cuff Exercises

1. Internal Rotation (closed door) (subscapularis): adjust pulley height to belly button height. Place towel between elbow and ribs. Use a light weight. Stand 90 degrees to pulley. Hold handle with arm closest to pulley. Pull weight towards you, patting your belly button. Keep your shoulder still and chest open. Do 10 – 15 nice and slowly until fatigue, but without pain.

2. External Rotation (open door) (teres minor, infraspinatus): now take the handle with the opposite hand, with a pad between your elbow andribs. Reach out across a horizontal plane away from your body to about 45 degrees away from your abdomen. This is going to be more difficult than the above one, so use a lighter weight.

3. Side Raise or Lateral Raise to 20 degrees (subscaularis): lower the pulley handle down to the ground. Grab on to the handle with the arm furthest away from the pulley (you are standing perpendicular to the machine). Sweep your arm across your hips, bending your elbow, – finish as if you had just elbowed someone in the guts and your hand is at your same side hip (left side, left hip, vice versa).

STOP DOING: We see too many people still standing using dumbbells with their elbows bent to 90 degrees, swinging the weights out and in. This only works your biceps!

All shoulder exercises should be completed in proper posture (shoulders pulled back, and down) and only after having completed some gentle range of motion exercises.

References

Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med. 2009; 39(8): 663-85. Review PubMed PMID: 19769415

Boettcher CE, Ginn KA, Cathers I. Which is the optimal exercise to strengthen supraspinatus? Med Sci Sports Exerc. 2009 Nov; 41(11): 1979-83. Review PubMed PMID: 19812522

Baydar M, Akalin E, EI O, Gulbahar S, Bircan C, Akgul O, Manisali M, Torun Orhan B, Kizil R. The efficacy of conservative treatment in patients with full-thickness rotator cuff tears. Rheumatol Int. 2009 Apr; 29(6): 623-8. Review Epub 2008 Oct 12. PMID: 18850322