Five Good Ways to Avoid Rotator Cuff Injury

Rotator cuff tendonitis is one of the most common shoulder pathologies in the United States.  Studies have found that about 20% of the population has a rotator cuff injury at any point in time.  It tends to affect individuals of more advanced age and the prevalence greatly increases after the fourth and fifth decade of life.  In most cases rotator cuff tears are degenerative in nature and progress over time as apposed to being the result of an acute event.

But interestingly enough, for a extremely common pathology, the average person knows very little about rotator cuff tendonitis.  Very few individuals know what the rotator cuff muscles are, where they are located, what they do, and what they can do to avoid injury to them in the future.

The rotator cuff muscles are a group of four muscles which originate on the scapula (shoulder blade) and attach to the humerus (upper arm).  The job of this muscle group is to stabilize the large head of the humerus on the very small socket of the scapula throughout range of motion.  The shoulder joint is inherently unstable in order to provide the extreme amounts of motion that we rely upon at the shoulder joint.  This inherent bony instability is kept in check with the dynamic control of a high-functioning rotator cuff.

If there is insult to the muscles of the rotator cuff, things can go very wrong.  There are many reasons that can cause the rotator cuff to become less effective at its job and lead to injury.  People can develop muscle imbalances, they can lose the specific timing of muscle contractions, or they can become weak.  Here are a few principals that you can follow in order to have a better chance at avoiding rotator cuff pathology in your future.

  1. Stretch your pecs – Tight pec muscles can pull your shoulders down and put your rotator cuff muscles in a inefficient/ineffective position.  This downwardly rotated position is correlated with degenerative tears of the rotator cuff.  Make sure to incorporate pectoral muscle stretching into your daily exercise routine.
  2. Strengthen your upper back – Another large contributing factor to poor shoulder blade positioning and rotator cuff pathology is weak scapular (posture) muscles.  Positions at desks and computers can stretch out and weaken upper back muscles like the middle and lower trapezius.  Make sure to include a few upper back exercises to work on your shoulder blade position.  Hinged rows are a good bet.
  3. Keep your palms up – Putting your palms up during exercises rotates your humerus into a position which leaves more space for the rotator cuff muscles and keeps them in a safer position.  Be sure to keep your thumbs up and palms up when doing exercises such as anterior shoulder raises.  These are very challenging exercises for trouble rotator cuffs.
  4. Watch Deltoid Exercises – When in doubt, avoid the exercise until you’re sure that your rotator cuff muscle can control an activity without pain.  Anterior deltoid raises and overhead presses can close down the space where the rotator cuff resides and will challenge a poorly functioning rotator cuff.  Work up to these exercises when your shoulder can handle it.
  5. Do Rotator Cuff Exercises – Add exercises specifically for your cuff.  The rotator cuff does internal and external rotation of the shoulder.  Grab an exercise band/tubing with both hands (palms up), elbows at your sides, and rotate your hands to your side.  It is a great way to engage your cuff and promote shoulder help.  Ask a trainer for more rotator cuff training specifics.

Following these simple tips can help you not only get stronger shoulders, but they will also decrease your risk of injuring your rotator cuff in the future!

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Diana grew up in a small suburb north of Boston. She received her clinical doctorate degree in Physical Therapy at Boston University in 2006. Diana started practicing as a physical therapist at Massachusetts General Hospital. While at MGH, she developed a specialty in the evaluation and treatment of complex lumbopelvic dysfunction. Diana is currently practicing at Spaulding Rehabilitation Hospital in Boston where she is the Orthopedic Clinical Supervisor of the Spine program. She is presently a Boston resident and her interests outside physical therapy include cooking, walking on the Esplanade, and international travel.

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