Rotator Cuff Anatomy and Common Problems
Rotator cuff injuries are a common cause of shoulder pain amongst active people. This can cause considerable pain and difficulty both during training and everyday activities. The rotator cuff is made up of a small group of muscles and tendons surrounding the shoulder blade (scapula). They work together to help stabilise and control movement in the shoulder joint.
The smaller muscles are the infraspinatus, subraspinatus, subscapularis and teres minor and they are used together in almost all shoulder movements including flexion, abduction, and internal and external rotation.
Injury to the rotator cuff muscles is particularly common in people involved in sports which require repeated overhead movement, such as swimming, tennis, and pitching. Tendonitis can also occur in older people due to reduced ability of the tendons to repair themselves over time.
Specific shoulder mobility drills and strengthening exercises which target the rotator cuff and surrounding muscles can help prevent injury and increase stability and overall functioning of the shoulder region.
1. Doorway stretch
Standing in a doorway with hands at shoulder height, lean forward gently until you feel a stretch in the front of your shoulders. Hold for a minimum of 20 seconds and repeat 2-3 times. This is a great way to stretch the subscapularis and you can also do this as a single arm stretch against a wall or post.
2. Lying infraspinatus stretch
Lie down on the left side with the left arm extended in front of you away from the body, draw the shoulder blade in towards you and keep the elbow in line with the shoulder. Keeping the elbow on the floor, lift up the forearm to 90 degrees and use your right hand to gently apply pressure onto the left hand pressing it towards the floor. It is important that the left elbow stays in line with the shoulder. Hold for a minimum of 20 seconds. Repeat on the right side.
3. Banded internal and external rotation
You can use a theraband or light resistance band tied at the same level as your elbow to a door handle or post for this exercise…
External Rotation – keeping the elbow close in to the side of the body (ideally use a rolled up towel or small block in between the elbow and waist) start with the hand across the body at 90 degrees. Gripping the band with the hand opposite to the post/door, slowly rotate the arm in a backhand motion keeping the elbow in place. Only rotate as far as you are able without losing alignment, repeat 15 times on each arm.
Internal Rotation – simply turn to face the other way and repeat the exercise with the same side, this time rotating the arm in towards the body.
4. Forward flexion/abduction shoulder raise
You can use a theraband with one end under your foot or a light dumbbell for these exercises. Holding one end of the band or a weight, raise the arm straight out in front of you to nose height and slowly back to the start position with the hand at the side of the body. Repeat for 12-15 repetitions each side. For the side raise, start with the arm bent at a 90 degree angle. Keep bent whilst lifting the arm upwards at the side of the body until the elbow is in line with the shoulder. Ensure that the shoulders stay in line throughout – decrease the resistance if you find you are leaning to one side.
5. Banded rows
You can perform this exercise seated on the floor with your legs extended out in front of you and knees slightly bent with a theraband or resistance band over your feet or tie the band to a post for single arm rows. Gripping the band in one/both hands with the arms extended, pull the band in towards the waist and slowly control the movement back to the starting position. Repeat the movement for 12-15 repetitions each side. You can do this exercise with the band high or at shoulder height.
6. The bear hug
This exercise targets the serratus anterior muscle which primarily controls scapular protraction and also stabilises the scapular during upwards elevation. Weakness in this muscle can often result in overuse and inflammation of the rotator cuff tendons.
Using a Theraband or resistance band in both hands, start with the hands at the side of the body with the band around the back, round the shoulders and slowly arc the arms together in front of you, in a bear hug position, stopping just before the hands touch. Slowly control the movement back to the start and repeat 12-15 times.
Ali has over 10 years experience working as a professional aerialist. Combining this with her background in contemporary dance performance (BA), she brings a unique, whole body perspective to training. Ali has coached aerial arts & fitness to a wide range of clients, and is currently completing an MSc in Strength and Conditioning. Ali firmly believes it’s never too late to relearn a handstand!
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