The importance of a
healthy and strong rotator cuff
In a previous article I shared my experience
with calcific tendonitis and indicated that rotator cuff strengthening
exercises were part of the reconditioning therapy. Shoulder strength
is important for all activities involving lifting, pushing, pulling,
and throwing and the rotator cuff is not only involved in moving the
arm, but most importantly in maintaining dynamic shoulder stability.
Many shoulder injuries are the result of gradual overuse or sudden trauma
to the rotator cuff. The most common reason for rotator cuff injury
is the structure was not strong enough for the load or stress of the
tasks performed. Typically the two smaller external rotator cuff muscles
(infraspinatus and teres minor) are often weaker than the larger internal
rotator cuff muscle (subscapularis). Understanding the form and function
of the rotator cuff and the other supporting shoulder structures reinforces
the importance of maintaining rotator cuff health.
The rotator cuff is a group of four muscles
and their tendons that separately allow the arm to raise and rotate
and work together to keep the ball of the humerous centered or stabilized
during shoulder movements.
Four Rotator Cuff Muscles
Supraspinatus – located at the
top of the shoulder.
Origin. Supraspinous fossa.
Insertion. Superior aspect of
the greater tubercle of the humerus.
Primary action. Arm abduction
and assisting in stabilization of the head of the humerus in the gleniod
fossa (gleniod cavity) during shoulder motion.
Subscapularis – located at the
front of the shoulder.
Origin. Entire anterior surface
of the scapula.
Insertion. Lesser tubercle of
the humerus.
Primary action. Internally rotate
the humerous with the arm at the side and is the primary stabilizer
of the glenohumeral joint (shoulder joint).
Infraspinatus and Teres minor
– located in the back of the shoulder.
Origin. Posterior surface of the
scapula, below the scapular spine.
Insertion. The posterior aspect
of the head of the humerous along the greater tubercle, with the infraspinatus
inserting just superior to the teres minor.
Primary action. Externally
rotate the humerous and assisting with stabilization of the head of
the humerous in the glenoid fossa (gleniod cavity).
Other shoulder stabilizers include the
scapula and the bicep tendon. The rotator cuff muscles arise from the
scapula and attach to the head of the humerous. If the scapula is not
stable, undue pressure may be placed on the rotator cuff. The bicep
tendon runs over the top of the humerus and connects at the top of the
shoulder joint and also assists in the stabilization of the glenohumeral
joint (shoulder joint). Overloading the biceps without proper progression
may result in biceps tendonitis, also known as shoulder tendonitis.
Below are five exercises from the Hyperstrike
Library that can be prescribed for rotator cuff reconditioning.
Band Shoulder Abduction
– Standing
http://www.hyperstrike.com/Band-Shoulder-Abduction-Standing-Exercise-789.aspx
Purpose: activation of the supraspinatus.
Band Shoulder External Rotation
– Standing
http://www.hyperstrike.com/Band-Shoulder-External-Rotation-Standing-Exercise-734.aspx
Purpose:
activation of the infraspinatus and teres minor.
Band Shoulder Internal Rotation
– Standing
Purpose:
activation of the subscapularis.
Lying Scapular Retraction
http://www.hyperstrike.com/Lying-Scapula-Retraction-Exercise-757.aspx
Purpose:
activation of the rhomboids and middle trapezius
Lying Dumbbell Row (Prone Row)
http://www.hyperstrike.com/Lying-Dumbbell-Row-Exercise-951.aspx
Purpose: activation of the rhomboids
and middle trapezius.
The load should be appropriate to the
individual and the phase of the rehabilitation and reconditioning. Typically
lighter loads are used to engage the smaller muscle groups and decrease
the assistance of the major muscles. Body weight with progression to
bands and small dumbbells would be appropriate for these exercises.
Developing strong shoulders requires the health and strength of the
rotator cuff; we are only as strong as our weakest link.
Karen Moreno, MA Candidacy Kinesiology/Exercise
Physiology
BA Social Science/Education
Co-Founder Fitness In Action
References
Armiger, P and Martyn, M.A., 2010.
Stretching for Functional Flexibility.
Baltimore, MD. Lippincott Williams
& Wilkins.
Baechle, T. R. and Earle, R.W. 2008.
Essentials of Strength Training and
Shoulder-Pain-Management. Shoulder
Stabilization and Stretching Exercises.
Retrieved July 23, 2009, from http://www.shoulder-pain-management.com/shoulderrotatorcuffexercises.html
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