It’s snowing this morning in Winnipeg; the first heavy blast of winter this season. Car accidents, falls and shovelling injuries are inevitable. Beware of your posture, the load, your balance and fitness level before you ‘shovel for hours’. The shoulder, and its supporting rotator cuff group of muscles are highly susceptible to those strains n sprains of high repetition and little prep.
Rotator cuff injuries are common in all sports and can be career enders for athletes likes quarterbacks and pitchers. But even if you’re just throwing snowballs with the kids or working out to stay fit, it’s important to keep the shoulder joint healthy. Here, physiotherapist Chris Bisignano, answers some of the important questions.
Q1: What exactly is the rotator cuff?
“The rotator cuff is a group of muscles, that act almost like a dynamic ligament. It is comprised of four muscles: the supraspinatus, which is the most commonly injured, the infraspinatus, the teres minor, and the subscapularis. The rotator cuff’s functions are to assist with arm movements and provide stability to the glenohumeral [shoulder] joint.”
Q2: Why does the rotator cuff get hurt so often, and what are the common issues?
Most of the exercises we do actually do not specifically target the RC enough to make a difference to its actual strength.
“Up to 67% of the population will have a shoulder problem at some point in their lifetime, and the rotator cuff is most often the source of the pain. The primary reason for rotator cuff pain is that pinching sensation or ‘impingement syndrome,’ which may be the result of rotator cuff tendon inflammation caused by an activity or trauma. Over time, this can lead to a rotator cuff tear. To make matters worse, evidence suggests that most individuals are likely to experience rotator cuff degeneration by age 40 and rotator cuff tearing by age 60. Thus, in many cases, a seemingly normal exercise session or home-repair project may incite shoulder pain.”
Q3: What kinds of moves should I avoid if I want to stay injury free?
Repetitive reaches with even a simple load can isolate alot of force upon the RC. Movements above shoulder become risky when a joint is not supported well, or even unstable because of weakness.
“Many of the more common gym exercises—such as upright rows and lateral deltoid raises—may lead to rotator cuff injuries. Modifying these exercises to keep the end position of the arms or elbows below shoulder height may help prevent injury.”
Q4: How can I tell if I have a rotator cuff injury?
“Many people already have a rotator cuff injury and aren’t aware of it. Unfortunately, evidence suggests that these individuals will eventually develop symptoms. Early on, if you have pain when reaching overhead—pain located at the tip of the shoulder or the outside of the arm, where the lateral deltoid is located—that suggests a rotator cuff injury. Weakness when reaching the arm out to the side is also suggestive of a tear.”
Q5: How can I prevent a rotator cuff injury?
“Three key measures can be taken to reduce the chances of experiencing a rotator cuff injury.
“First, strengthen the external rotators; specifically by tubing or dumbbell exercises that need to be learned from a professional; these will help restore and maintain shoulder stability and may prevent impingement.
“Second, avoid sleeping on your side with your arm positioned overhead.
“Finally, try to achieve muscle balance—that’s key. Many weight-training routines are inherently biased, creating muscle imbalances that may lead to a rotator cuff injury. Try to perform an equal number of ‘pull’ versus ‘push’ exercises. Moreover, try to replace a few sets of shoulder exercises—such as lateral deltoid raises or shoulder presses—with exercises that strengthen both the deltoids and the rotator cuff, such as prone ‘Y’ or ‘T’ exercises.”
Visit yourPhysio or ask your healthcare provider for specific RC education and exercises.