“I was told that if I strengthen my rotator cuff, I should be fine.”
I have been doing the rotator cuff exercises faithfully, but I still keep tweaking my shoulder. It started two months ago, and it’s still painful just reaching back to put on my seat belt. I want to get back to tennis and wood working without pain.”
Joe had been doing these band exercises for months:
Here is what Joe didn’t know:
The rotator cuff should actually be called the compressor cuff. True, that term doesn’t exist in any medical literature, but it’s a more accurate term. Here’s why:
The rotator cuff is made up of 4 small-ish muscles. 3 of the 4 muscles rotate the arm when working in isolation, but that isn’t their main purpose. The rotator cuff muscles work in concert to compress the humerus onto the scapula and keep it in place as the larger “mover” muscles (pecs, lats, deltoid) move your arm. Every single arm movement you do (reaching, pulling, pushing, karate chopping), your rotator cuff is working.
Think of your shoulder joint as a golf ball sitting on a golf tee: the head of the humerus (golf ball) is much larger than its counterpart the glenoid fossa of the scapula, (the tee). And with reaching, the golf ball needs to roll on the tee. In a weight bearing position, like a plank, you are trying to balance the tee (and the rest of your body) on a golf ball. The rotator cuff’s job, then, is keeping the ball centered on the tee.
Rotation exercises strengthen the cuff when the shoulder is stable, but how well do they work to improve other motions you do with your arm? (Not well is the correct answer).
A better way to target the rotator cuff is to start with activation exercises that help you wake up the lazy rotator cuff muscles. Once you can feel them engage, strengthen it, by performing a functional movements (reaching, pushing, pulling, cartwheeling). The activation exercises will heighten your awareness of your rotator cuff, and keep it engaged, as you move.
To start: lie on your back with your arm out to the side and elbow bent to 90 degrees. You should be able to pull your shoulder straight back (not down towards your hip) into the surface you are laying on without increasing the pressure on your elbow. Maintaining that position, rotate your hand back above your head into the ground. Then rotate the other way, reaching down towards your hip (stopping before your shoulder lifts off the ground). You can hold at the end ranges for a minute, appreciating how your shoulder fatigues, or keep the shoulder back as you rotate back and forth.
Once you get the hang of engaging the rotator cuff, it is time to apply this skill to different activities. This includes every single movement that your shoulder does. Whether it is pulling, reaching, lifting or pushing, your rotator cuff is being asked to work. Here are some of the most common painful movements of the shoulder, and how to engage the rotator cuff:
Reaching is the most common use of the shoulder, because the main purpose of the shoulder is to move the hand so we can manipulate our surroundings. An easy way to engage the rotator cuff with reaching is to loop TheraBand, around the back of the shoulder – then pull the shoulder back into the band, and maintain this as you reach up.
To progress: add resistance in various directions to challenge the cuff in all directions:
Weight Bearing is a another more specific way to engage the rotator cuff. In a front plank, the surface of that shoulder blade is not directly above the head of the humerus, and it would simply fall off if it weren’t for the compression applied by the rotator cuff. Add a push-up to the mix, and the ball is rolling, while the tee is relatively stationary. Imagine the coordination required to apply a consistent compression into the joint!
The rotator cuff doesn’t need its own special exercises