Rotator Cuff Injuries

Rotator cuff problems are so pervasive and common that it is worth incorporating preventative strength training into your program to build strength and avoid injury.

As an anesthesiologist, I see a lot of patients who come to the surgery center to have their rotator cuff repaired.  I do anesthesia to repair tears in the rotator cuff six to seven times every week, and that’s in addition to surgery for other shoulder injuries. I also see rotator cuff problems in fellow yogis, tai qi students, people at the gym, and even surgeons! Injuries come from a variety of situations.  Sometimes people tear their rotator cuff playing sports, or while lifting something heavy at work, but this injury also can happen while performing daily living activities such as taking care of the kids or cleaning around the house. There are four keys to rotator cuff strengthening, or “prehab.”  If you follow these steps you may avoid joining the ranks of those with rotator cuff injuries.  Alternatively, if you already have an injury then these steps can still be beneficial to you as you begin the journey of rehabilitation.  Remember, if you have an injury always consult your physician before you begin any rehabilitative or therapeutic exercise program. 

Four Key Steps

• Learn how to use the big muscles in the shoulder girdle to help maintain shoulder stability. I am referring here to the Pertoral and latissimus muscles.  The Pectoralis major and minor muscles are the chest muscles, and they provide stability for the front of the shoulder.  The Latissimus Dorsi Muscle is a large back muscle that starts in the low back and reaches up to the posterior arm and helps maintain posterior shoulder stability.  Learning to use these muscles together is the key to taking pressure off the rotator cuff.  Once you learn to use these larger stabilizing muscles at rest, you must learn to engage them while performing exercises that use the shoulder and arm.

• Learn how to dynamically engage the cuff with low weights, using Indian clubs or similar techniques.  This dynamic low weight movement will teach you coordination and fluid integrated shoulder movement.  Once you learn coordinative exercises, the rotator cuff muscles will begin to naturally work with the larger muscles of the shoulder in all shoulder movements.  This will help you whether you are an athlete, want to feel safer lifting objects at work, or are trying to get o ut of a long cycle of shoulder pain.

• Begin static isometric strengthening.  You can do these exercises with equipment like a TRX, with light weights, or with your body weight.  Isometric exercises build muscle strength of the rotator cuff and the surrounding scapula stabilizing muscles.  They are excellent for building strength and are safe to perform.  However, once you build strength, don’t forget to go back to step two and relearn dynamic coordination.

• Finally, learn functional strength training with heavier weights. Start on these only when you have mastered the first 3 steps and you will avoid the injuries that come to many who undertake shoulder and rotator cuff training.  Heavy Indian club training, Mace training and kettlebell training are three outstanding examples of this type of training.  They build strength flexibility and fluidity of the shoulder girdle.

Practice Makes Perfect

When you learn to train with these tools you will learn how to actively engage the large muscles of the shoulder girdle to maintain structural integrity while at the same time maintaining fluid movement through coordinative firing of the rotator cuff and surrounding shoulder stabilizing muscles. Still wondering how to put these four keys into practice? Check back at this blog in the next few weeks for more details, tips, suggestions, and yoga practices for your rotator cuff.