The "rotator cuff" is the set of muscles that connect your shoulderblade to your shoulder joint and arm, and are responsible for things like throwing and lifting your arm. It is made up of four muscles primarily: the Supraspinatus, the Infraspinatus, Teres Major, and Subscapularis, whose primary functions are internally and externally rotating the shoulder, as well as stabilizing the shoulderblade while the arm is lifting.
The primary reason for injury in the rotator cuff is imbalance between the muscles. When lifting or rotating the arm, the rotator cuff is responsible for pulling the arm downward, while the deltoid muscle on the top of the arm lifts the arm up. Often, the tiny rotator cuff is not strong enough to pull the arm down against the heavy deltoid muscle, so the arm never gets centered in the joint. Instead, the deltoid muscle pulls the arm further upward into the joint, pinching the rotator cuff tendon between two bones. When the rotator cuff is constantly pinched, the tendons begin to fray and inflame, which is called tendonitis. Tendonitis is extremely painful, and limits the arms motion. If the tendonitis goes untreated long enough, or if the cuff is subjected to more trauma, the tendon can tear off the bone, causing the need for rotator cuff surgery. It is best to treat the tendonitis early on, as surgery often means being in a sling and not being able to use the arm functionally for six to twelve weeks. Surgery also requires extensive rehabilitation post-operatively.
The people who are most subjected to rotator cuff tendonitis are throwing athletes, such as baseball and softball players and quarterbacks, as well as athletes who receive a lot of trauma to the joints, such as wrestlers, swimmers, and gymnasts. In addition, people who do a lot of heavy lifting at work are also subject to rotator cuff issues. Some less common rotator cuff problems include:
1) bursitis, or inflammation of the bursa, a water balloon sack near the rotator cuff.
2) traumatic cuff tear as the result of a shoulder dislocation
3) "Paralyzed" rotator cuff --> damage to the nerves as a result of trauma can cause the rotator cuff to be rendered non-useful.
It is important to strengthen the rotator cuff daily so that this imbalance between the cuff and the deltoid does not occur. Since the rotator cuff muscles are so tiny, it is appropriate to do the following exercises once a day, three sets of ten repetitions:
1) Empty Cans --> hold your arm out straight to a 45 degree angle with your body and turn your hand so that your thumb points down. Lift your arm up until its even with your shoulder line and back all the way down. This exercise is named for it looking like you are emptying a can of soda. Do this exercise with a small weight.
2) Internal and External Rotation --> Laying on your side, bend your elbow you are laying on to 90 degrees, and then lifting a small weight, bring your arm towards you. This is for internal rotation. For external rotation, lay on your other side, and with your arm bent at 90 degrees, lifting a small weight, move your arm away from you.
3) Prone Supermans --> Lying on your stomach, straighten your arms out to a 45 degree with your body (like you are flying!). With your thumbs pointing downward, lifting a small weight, bring your arms up until they are off the bed. Repeat.
4) Seated push-ups --> Sitting on the edge of a chair, make two fists and push up on your fists until your bottom is off the chair. Repeat.
These simple exercises can prevent rotator cuff injuries by balancing the muscles in the shoulder. Remember to always consult your physician if pain in the shoulder persists.
