Rotator Cuff Exercises

WHAT IS THE ROTATOR CUFF? The rotator cuff is made up of four muscles: the supraspinatus, infraspinatus, teres minor and subscapularis. You can remember these muscles by the acronym S.I.T.S. These four muscles collectively help stabilize the glenohumeral (shoulder) joint or shoulder "girdle". The shoulder girdle is comprised of three bones: the humerus (upper arm bone), the scapula (shoulder blade bone), clavicle ( chest bone) and a series of joints including the acromioclavicular, glenohumeral and scapulothoracic (not a true joint). The glenohumeral (shoulder) joint is one of the most mobile joints in the body and when combined with the movement of the scapula (shoulder blade) provides a huge range of motion for the arm and hand. The rotator cuff muscles are deep stabilizers, located closest to the bones of the glenohumeral (shoulder) joint. They each attach to the shoulder blade and surround the head of the humerus (arm bone) like a cuff, hence their name. What do the rotator cuff muscles do? The Rotator cuff muscles (RTC MUSCLES) assist the larger, more superficial muscles like the latissimus dorsi, pectoralis major and deltoids. They are often neglected when training because the primary muscles take over the action. In an area like the shoulder joint that has so much mobility, we need to counterbalance it with stability. The rotator cuff muscles are a great place to start, although there are many other muscles that will contribute to stabilizing this area, such as the deeper core muscles ( abdominals/ pelvic girdle area ). Why is the rotator cuff easily injured? Since these small deep muscles are somewhat forgotten, they are often injured. When there is greater pull from the mobilizing muscles than the smaller rotator cuff muscles can manage, damage occurs. It is important to note that stabilization of the glenohumeral (shoulder) joint by the rotator cuff should be accompanied by appropriate stabilization of the scapulae. It is important that you do not over stabilize and/or try to hold the scapulae still against the rib cage. They are meant to glide and move in synchrony with the movement of the arm and shoulder. As local stabilizers, the rotator cuff muscles respond best to exercises done with low loads, small ranges of motion and shorter levers. Starting in a good neutral position of both the glenohumeral joint and the scapula will ensure that the exercises performed are targeting the correct muscles. Here are some suggestions: • Think of holding a book between your arm and your side. The goal is to keep your arm still in space to achieve adequate rotation • Imagine a row of green peas between your shoulder blades and try to squish them as you move your arms • If the wrist is twisting imagine a cast on the wrist to keep it straight • If you see the head of the shoulder rolling forward, then think of the front of the chest like wings, spreading out to the sides of the room Rotator cuff exercises In each case, remember that the resistance should be fairly light to ensure the proper muscles are executing the movement. 1. Internal rotation (to target subscapularis): Attach a Flex-Band® to something solid, then stand, kneel or sit and hold it in the closest hand. Neutral pelvis and spine, as well as the scapula and shoulder joint. Inhale to prepare; exhale to rotate the arm internally; inhale to return without rolling the shoulder forward as described above (keep squishing those peas through the movement ) 2. External rotation (to target teres minor and infraspinatus): Attach a Flex-Band to something solid, then stand, kneel or sit and hold the band in the hand that’s furthest away. Neutral pelvis and spine, as well as the scapula and shoulder joint. Inhale to prepare; exhale to externally rotate the arm; inhale to return. 3. Abduction long arm (to target supraspinatus): Place a Flex-Band under the knees and hold it in one hand. Kneeling, in neutral pelvis and spine. Inhale to prepare; exhale to abduct (move the arm away from the body with a slight bend in the elbow throughout the movement and thumb facing upwards ). You could also do this with a light dumbbell rather than a Flex-Band. Additional ways to intensify or modify rotator cuff exercises Place a small ball under the arm if having difficulty maintaining stability in the shoulder girdle, and try to move the arm holding the ball in place throughout all ranges of motion. Any questions please do not hesitate to get in touch! Lots of love, Fitt Chiro xx