The rotator cuff is the dreaded body part no one wants to hear about. Rotator cuff surgery is very common (unfortunately) but many rotator cuff injuries do not require surgery. So I often see people very scared that they need surgery or rush into it. In most cases, people recover relatively quickly from rotator cuff injuries and can get back to what they love. However, I recommend some preventative exercise that isolate the rotator cuff muscles to avoid it coming back.
The truth is if you live long enough, you'll have a rotator cuff tear or injury.
The rotator cuff includes 4 muscles that primarily act as stabilizers in the shoulder. They keep the humerus (arm bone) in the socket of the scapula (shoulder blade). They work hard when we are reaching, pushing, and pulling especially when our arms above our shoulders. In general these muscles are smaller and not meant to lift heavy things. Primarily, they function to stabilize and endure rather than pure strength. Our pecs, lats, and deltoids are the true heavy movers. Unfortunately, most normal exercise does not target the rotator cuff specifically and must be isolated in your resistance exercise.
What issues can happen to the Rotator Cuff?
Rotator Cuff Tears
Rotator Cuff Strains
Rotator Cuff Tendinitis
Rotator Cuff Tightness/Flexibility
"Impingement" and Poor Mechanics
What causes Rotator Cuff issues?
Rotator Cuff Tears
Rotator cuff muscle and tendon tears can occur with trauma such as falling on your shoulder or trying to catch yourself. Any sudden stretch to the shoulder can cause a tear. Also, as we age, we tend to get degeneration and tearing in our tendons. Overuse is another related factor.
Rotator Cuff Strains
Strains, smaller muscle tears or injuries, can occur in similar ways to tears. In most cases, there was overuse in a single moment such as trying to lift a weight you aren't used to. In reality, these are often smaller tears that heal better since it is in the muscle.
Rotator Cuff Tendinitis
Tendinitis is an inflamed tendon. This is caused by overuse such as repetitive use doing a project at home like painting or completing a lifting routine with excessive shoulder exercise repetitions.
Rotator Cuff Tightness
An issue that usually is underlying rotator cuff injuries is a lack of flexibility to the rotator cuff muscles. This results in difficulty reaching behind the back or reaching across the body. It is benign until an injury occurs but keeping this flexibility can be key to avoiding reoccurrence.
"Impingement" and Poor Lifting Mechanics
Impingement is a natural occurrence in the body characterized by a "pinching" of tissue which, in this case, is the tissue between the shoulder blade and arm bone. The subacromial space has multiple structures including ligaments, rotator cuff tendons, and a bursa (cushion). If this space is encroached by positioning of the shoulder repetitively we can have soreness. It is usually just soreness to tell us to stop, but it has been related to other rotator cuff issues. With soreness in the front of the shoulder, certain movements should be avoided such as lifting with your arm across your body or with your palm/thumb facing down.
In general, this is not an issue with the rotator cuff as much as it is a poor movement quality from not knowing proper lifting form or just from odd activities such as plumbing work.
Conclusion:
Now you know a bit more about the rotator cuff. It should not be feared, but there is a lot to do to avoid injury and keep moving. If you have questions, please send them out to me. I’d love to help you maintain a healthy lifestyle.
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