The Caveman Explains Rotator Cuff Injuries


Rotator Cuff

The rotator cuff is a group of four muscles that work together to stabilize your shoulder.

The four rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) are the key to providing stability to the shoulder complex. Given the relatively small size of these muscles and the amount of work that is demanded of them, they can be torn due to trauma or inflamed from overuse.

These muscles arise from the scapula and connect to the head of the humerus, forming a cuff at the shoulder joint. They hold the head of the humerus in the small and shallow glenoid fossa of the scapula. The glenohumeral joint has been analogously described as a golf ball (head of the humerus) sitting on a golf tee (glenoid fossa).

A rotator cuff tears occurs when the rotator cuff muscles can become torn or irritated, leading to pain and restricted movement of the arm. This injury can happen after trauma to the shoulder or through “wear and tear.” A torn rotator cuff is most often associated with repeated overhead motions (think throwing a football) or forceful pulling motion (think extreme weight lifting).

If you do injure your rotator cuff use R.I.C.E. as an initial response to the injury. R.I.C.E. is the procedure recommended by health providers:

  • Rest means ceasing movement of the affected area.
  • Icing uses ice to reduce inflammation.
  • Compression limits the swelling.
  • Elevation involves placing the area higher to reduce inflammation and swelling.

Cold compression therapy shoulder wraps facilitate the icing and compression of an otherwise difficult body area to ice and compress.

If the injury is severe, go to your doctor. He may order a radiograph or MRI to check for underlying bone injuries and to see if surgery is needed.

Exercises to strengthen the rotator cuff

The rotator cuff can be strengthened to heal shoulder injuries, and prevent future ones. There are different exercises to target the individual rotator cuff muscles. Keep repeating each of the following exercises until your arm is tired.  All of these should be done with a light enough weight that your arm doesn’t get tired until you’ve repeated the exercise 20-30 times. Increase the weight a little each week (but never so much that the weight causes pain). Start with 2 ounces the first week. Move up to 4 ounces the second week, 8 ounces the next week and so on.
Each time you finish doing all 4 exercises, put an ice pack on your shoulder for 20 minutes.


Side-lying External RotationRotator Exercise

Lie on a bench sideways, with the affected arm next to the side and flexed about 90 degrees at the elbow. Put a rolled up towel under your arm. Rotate the upper arm outward, keeping the elbow flexed and the arm close to the body, until the lower arm is perpendicular to the ceiling (see picture). Perform this exercise at a pace of two seconds out and four seconds back.



Propped External RotatorRotator Exercise 2

Sit perpendicular to the dumbbell with arm flexed at 90 degrees at the elbow, and the forearm resting parallel on the dumbbell. Raise the dumbbell up until the forearm points up. Slowly lower the dumbbell and repeat, exercising both arms. You can also do this exercise lying face down on a bench. If performed this way, the arm should still start flexed at 90 degrees, but pointing straight down to the floor then rotated to parallel with the bench.



Lateral RaiseRotator Exercise

Grasping a dumbbell in each hand, internally rotate the arms so that the thumbs point towards the floor when extended (as if emptying a drink into a bin). Raise the arms sideways, keeping the thumbs pointing downwards, until the dumbbells are just below the shoulders.



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