Injured Rotator Cuff of the Shoulder

The shoulder joint (and its connective muscles, tendons, and ligaments) has a greater range of motion than all other joints. It can allow your arm to move outward to the side, forward and back, do circles in a windmill fashion, and rotate your arm from palm up to palm down. No other joint allows all these movements.

However, the complex anatomical structure that allows such flexibility of movement also makes the shoulder joint somewhat susceptible to injury. The cluster of muscles and connections that facilitate this movement is called the rotator cuff. The muscles of the rotator cuff are:

• Teres minor
• Subscapularis
• Infraspinatus
• Supraspinatus

These muscles control the shoulder girdle and its movement. Injury can occur when muscles are strained, torn, or inflammation occurs in the joint as a result of damage.

Injuries to the Rotator Cuff

A rotator cuff injury often results in pain when the arm is lifted outward or overhead, restricted range of motion, and pain when sleeping on the shoulder. In mild cases of injury, inflammation is present, and in more severe forms, a tear can be present. However, rotator cuff tearing is a degenerative process that increases with age, and tears can be identified on MRI even in patients with asymptomatic shoulders.

A similar condition, which can only be determined by medical diagnosis, is "frozen shoulder." Both conditions can be painful, restrict movement, and take many months to resolve — and even then, the range of motion in the shoulder joint may be limited compared to the previous uninjured shoulder.

Weight training injuries to the shoulder can occur. Exercises that place higher stress on the rotator cuff should probably be avoided or at least performed with lighter weights if you know your shoulder is susceptible to injury, or if an injury is already present. Avoid these and similar exercises:

• Lateral raise: lifting weights (dumbbells, kettlebells) to the side
• Anterior raise: lifting weights to the front
• Overhead press
• Bench press, particularly if done with an excessive range of motion. Don't lower the elbows below parallel (to the floor); pretend you're on a flat surface.

Treatment

Rotator cuff injuries are common in occupational, recreational, and sports activities. You don't have to guess too much; pain and restricted movement usually let you know you have a shoulder injury. Here is what to do:

• Get a diagnosis and treatment advice from your doctor.
• Be patient. Often, rotator cuff / frozen shoulder injuries can take many months to recover even when managed correctly.
• A physical therapist may recommend exercises during recovery.

Exercises for Strengthening the Rotator Cuff Muscles

Although you should follow medical advice for treating a rotator cuff injury, you can protect healthy shoulders by performing exercises that strengthen the rotator cuff. The main ones are:

• External and internal lateral rotation using cables or stretch bands. With the arm bent at the elbow, swing outward (rotation), then inward by reversing stance. Load the cable or band so that some light resistance is applied.
• Empty the can. Hold a very light dumbbell out in front (anterior raise) and rotate the arm inward (medially) to simulate pouring fluid from a can.

Summary

Chances are you will encounter some problem shoulder at some time. As we age, such injuries seem to be more frequent, sometimes occurring for no discernible reason. As inconvenient as they are, don't panic, be patient, and seek medical advice at first signs. Moderate rotator cuff injuries are inconvenient and sometimes painful and disabling, but rarely without remedy.