The shoulder joint is formed by the ball of the humerus and the socket of the Scapula (shoulder blade). A group of four tendons stabilize the shoulder joint and form the rotator cuff, they also facilitate the movement of the joint. If you really want to know their names then they are listed below:
The subscapularis muscle, which moves the arm by turning it inward (internal rotation);
The supraspinatus muscle, which is responsible for elevating the arm and moving it away from the body;
The infraspinatus muscle, which assists the lifting of the arm during turning the arm outward (external rotation);
The teres minor muscle, which (like the infraspinatus) helps in the outward turning (external rotation) of the arm.
On top of the shoulder joint is a bone called the acromion. In the gap between the shoulder joint and the acromion is a space that some of the rotator cuff tendons run through. In this space is a fluid-filled pad called the subacromial bursa, which cushions the tendons
Rotator cuff injuries are usually either an inflammation of the muscles tendons that form the rotator cuff or a tearing of the muscle or tendons.
When the tendons become inflamed they can pinch against the structures that make up the shoulder joint. When a tendon becomes trapped or squeezed, it's known as impingement syndrome. The subacromial bursa can also become swollen and inflamed, and this is called bursitis.
Tendons that make up your rotator cuff can also become completely or partially torn. These can be caused by a sudden impact, such as a fall, or due to tiny tears to the tendon through use and wear over time
Common Causes
-Repetitive overhead lifting
-Lifting or pulling a weight that's too heavy for you, causing a tear or strain
-Muscle imbalance. When some of the muscles in your rotator cuff are stronger than others, your shoulder may be more prone to injury.
-Age – As you age you are at increased risk of rotator cuff injuries as your tendons start to wear down and become more prone to injury
The risk of sustaining a rotator cuff injury increases if your posture is poor. Rounded shoulders are an indication of weak scapula muscles and may lead to pinching of the rotator cuff
Symptoms of a rotator cuff injury may include pain and tenderness in the shoulder (particularly when raising the arm to the side or moving across the body), a limited range of motion in the shoulder, a feeling of weakness around the area or pain while sleeping.
Tendonitis usually comes on gradually over time and may increase in severity if left untreated but a tear will commonly appear as a sudden twinge of pain. If a tear is present then it may need to be diagnosed by an MRI or ultrasound scan as it will not appear on an Xray.
How to treat rotator cuff injuries
Rest the shoulder and avoid movements which might cause it pain, if you can, try and sleep with your arms by your sides
Applying ice to the area will help reduce swelling and avoid further irritation to the tendons, but always remember not to apply an ice pack directly to the skin, wrap it in cloth first.
Anti-inflammatory medications like Ibroprofen can also help to reduce the pain and swelling allowing the area to heal faster
Strengthening exercises can then be used to build up stability in the area and address any muscle imbalances. If the muscles are not strong enough, or one part of the cuff is working harder than the rest, then the shoulder will be pulled out of alignment and pain will result
Strengthening exercises for rotator cuff rehab
Isometric push
The iso push up hold allows you to build up strength around the joint while avoiding excessive movement that may cause pain. As pain in the area decreases you can return to lifts with an increase range of motion like the bench press. The iso push up is a closed chain movement which makes the shoulder more stable and less likely to inflame the injured area.
The iso hold can also help to reinforce correct benching technique with arms tucked in so once you return to open chain movements you will be less likely to get injured again. This was given to me by my old personal trainer Tony McClellan to help sort out my tendonitis a few years back and it's probably the movement that's had the most dramatic effect on my performance ever. When I returned to open chain movements I was pressing more than ever.
Turkish Get-ups
This is an exercise that will get you funny looks, but works very well, it was originally suggested to me by friend on a fitness forum and it'll amaze you with how difficult it can be at first (especially if you are riddled with imbalances like I was).
You just hold a weight vertically and stand up from a supine position. This forces your shoulder to stabilize the weight through a very broad range of motion.
Face Pulls
Face pulls simultaneously train scapular depression and retraction which strengthens the muscles that pull the shoulder blades down and back.
There are many other exercises I could list but those three are the ones that I perform consistently, regardless of training programme or goals and since I have incorporated them into my training I have been completely pain free in my shoulders for many years now.
www.thestrengthsociety.com
A Basic Guide To Maintaining Shoulder Health & Treating Rotator Cuff Injuries
