Shoulder Injuries – (Rotator Cuff)

Shoulder Injuries – (Rotator Cuff)

Shoulder injuries are very common in many areas of sport and fitness. They are particularly common in swimming, shoulder workouts and other overhead activities (Javelin etc). These injuries can be irritating and debilitating as well as enforcing prolonged stints on the sideline. The most common shoulder injury is the rotator cuff injury. The shoulder joint is a ball and socket joint and allows the most range of movement of any joint in the body. The rotator cuff supplies the shoulder with connection, protection and mobility of the joint. These actions are performed by the SITS complex (Subscapularis, infraspinatus, teres minor and supraspinatus). The rotator cuff monitors and allows the following movements:

There are a range of injuries that can affect the rotator cuff muscles and tendons. A typical tear is normally categorised as an acute injury, thus not from overuse or repetitive loading. There are certain injuries that can occur, all being the result of overuse (generally in rotator cuff). Impingement of the supraspinatus becomes apparent from forward and internal rotation of the arm. This is common in swimming and the end of throwing phase. This results in tenderness and inflammation of this tendon, which, in addition to being uncomfortable and painful, will also result in decreased performance. The increased range of movement in the shoulder joint also results in decreased shoulder stability, which is the basis of many other injuries.

Rotator cuff injuries can be divided into three phases, they are as follows

In order to decrease the occurrence/susceptibility of these injuries, maintain strong shoulders and rotator cuff muscles. Pre-habilitation. All these exercises are to be done with the assistance of resistance tubing (Unless otherwise stated). All exercises should be done 15-30 times on each arm:

Initial PositionExercise NameDescription
Secure tubing to object, so can reach with arm extended above head.Throwing accelerationFace away from anchor point and grasp overhead (thumb down). Pull arm down toward opposite hip.
Shoulder ExtensionFace toward anchor. Arm forward, pull back as far possible.
Secure to level in line with fingers, with arm at side.External humeral rotationArm abducted to 90°, elbow flexed 90° with maximal int rotation. Rotate shoulder to be external rotation.
Throwing decelerationFace anchor, shoulder flexed 30°. Cock shoulder, arm and elbow 90° and shoulder ext rotated. Move as in throwing motion.
Shoulder flexionFace away, straight arm externally rotated. Move to fully flexed position, keep straight. Repeat.
Scapular rowFace, elbow extended, shoulder flexed, scapula protracted. Pull back on tube by squeeze scapula and flex elbow.
Scapular punchFace away. Arm by side, elbow flexed and scaps together. Punch forward extending elbow.
Tube centre underneath feet.Full canAbduct arm away from side with thumb upward in scap plane (30° from body horizontal). Flex till arm 90°.
General StretchesChest StretchOn back arms out stretched, knees bent with feet on ground. Allow knees to fall to ground whilst try keep shoulders planted. Hold for one minute.
Posterior capsule stretchReach arm around body and try touch opposite shoulder blade. With other hand push elbow. Hold for one minute.

If these exercises are performed correctly and frequently they should increase shoulder stability and strength. This will lead to a decrease in shoulder injuries.