Rotator Cuff Injury? Rehabilitation and Prevention – Ask a Kinesiologist!

There are approximately 680 muscles in the human body. Muscles function to produce movement and force. Muscles are what drive our voluntary movements, such as walking or standing but also involuntary movements such as moving food through our digestive tract or the diaphragm, which controls breathing. When training the body there are muscles that most people tend to forget or ignore. Neglecting these muscles can cause imbalances in the body and opens the door to potential injuries. When you train the body, you need to take your time and be patient and ultimately focus on the most important goal: STABILITY. What does stability exactly mean? It means having your body moving optimally, effectively and efficiently. It means working ALL the muscles to ensure each muscle is able to do its job and not require assistance (compensation) from other muscles. It means training each muscle individually, and also when it must function with other muscles to produce a movement. It means having good balance, strength, power, endurance and flexibility. It means moving with proper gait, standing with proper posture, and moving with optimal efficiency. When you think about the number of muscles in your body, the complexity of movement, and what you expect of your body, you can appreciate the effort it takes to train your body properly to meet all these goals, which is why patience and proper instruction/programming is important. There are several “common” neglected muscle groups in the body, but one common group is the muscles of the shoulder. These muscles are commonly referred as the Rotator Cuff.

Rotator Cuff Muscle Group:

The shoulders have the most mobility of any joint in the body, so they are also the most unstable, hence why Rotator Cuff muscles play an important role in shoulder stability.  These muscles arise from the scapula and connect to the head of the humerus (arm bone) where they form a ‘cuff’ at the shoulder joint. Think of your shoulder joint like a golf ball on a golf tee, not very stable. The Rotator Cuff muscles stabilize the joint, and also work together to produce the many different movements of the shoulder joint. The 4 muscles are: Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. You typically only see people training these muscles after they’re injured, therefore taking a preventative approach to training them will reduce the risk of going through rehabilitative training. The most commonly affected muscle is the Supraspinatus who’s responsible for abduction of the arm (moving the arm away from the body laterally).

How do you train the Rotator Cuff muscles?

The only difference for training these muscles is dependent on whether or not they are injured. If you have a Rotator Cuff injury, you are going to start with PASSIVE RANGE OF MOTION AND ISOMETRIC STRENGTHENING. Isometric strengthening is a form of strengthening where you activate the muscle, without moving the joint. This allows the muscle to be strengthened, without putting the joint in a vulnerable position. If you are not injured, then you are going to start with ACTIVE RANGE OF MOTION AND ISOTONIC STRENGTHENING. Isotonic strengthening is when tension remains the same on the muscle, when the length of the muscle changes (so the joint is moving). The main difference between the two approaches is that if you are injured, you need to limit the activation in the joint and therefore you guide the injured side (with your other arm) through the ROM and you activate the muscles without any changes in joint angle and muscle length through isometric contractions.
Rotator Cuff injury is common, because of the nature, and anatomy of the shoulder joint. It is estimated that 1/10 Canadians will suffer from a shoulder injury, and rotator cuff weakness/dysfunction can account for almost all of these injuries.

Risk factors associated with a Rotator Cuff tear:

– sports with repetitive overhead motions such seen in baseball, tennis, weightlifting, etc.
– jobs with overhead work such seen in carpeting and painting for example
– acute tear seen in falling on an outstretched arm or lifting something with a jerking motion
– age —> increased risk as you age since the body goes through natural wear and tear
If you can relate to one of the risks, then the best advice one can give you is to start with a preventative program right away in order to minimize your risk of a Rotator Cuff injury. By properly training, engaging, and strengthening your Rotator Cuff muscles, you are greatly decreasing your risk of injury, pain, and dysfunction.

Oggie Bovan
Registered Kinesiologist
ALPHA Health Services
Kin Pro Exercise

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