Dealing With Rotator Cuff Injuries
You’ve been doing Olympic lifting for a while. Or stocking tall shelves. Or doing DIY in the house. Everything was great! Until suddenly, it wasn’t. Ice and ibuprofen didn’t quite do the trick, so you visited the doctor. And lo and behold, you’ve got a rotator cuff injury and two questions:
How on earth did this happen?
What on earth do I do now?
You and your shoulder: it’s complicated!
Despite all falling under one general name, the “shoulder” actually consists of four (or maybe five) different joints. The sternoclavicular joint is where your collar bone connects to your breastbone. The acromioclavicular joint (which even doctors just call the AC joint, because nobody has time for all that) is where the very top of your shoulder blade connects to the far end of your collarbone. The glenohumeral joint is where the ball of your humerus fits into the bowl of your shoulder blade. And then there is another joint (or maybe two, depending on who you ask) that is a “false joint” as well.
The meat of the matter
Into this complicated mechanical mess go a host of muscles. There are chest muscles that move the shoulder. There are back muscles that move the shoulder. And there are even muscles of the arm that help move the shoulder, even though that sounds weirdly like trying to pull yourself up by your own bootstraps.
But not everything is about movement, which is why you have a rotator cuff. These are the muscles that keep your shoulder stable. These four muscles (Yes, four. I told you it was complicated.) include supraspinatus, infraspinatus, subscapularis, and teres minor. If you feel like those all sound like fun spells you might learn at Hogwarts, you’re not alone. If they all sound very sensible to you, optime bene!
These four muscles keep your arm from dislocating when you lift it over your head or move it around. Which is kind of magical, if you think about it.
How rotator cuff injuries develop.
If you are building strength in the muscles that lift and move your arms at the shoulder, this allows you to lift more. But when this is done in a way that is very fast, with poor technique, when already tired, or without a corresponding amount of attention given to strengthening the stabilizers of the shoulder, this puts a lot of extra stress on those rotator cuff muscles. This can cause them to fail in their job, allowing the shoulder capsule to stretch (not good), the head of the humerus to start to migrate out of its spot in the shoulder (kind of bad), or the muscles of the shoulder literally shearing off from their bony attachment (DEFINITELY bad).
Actually, it turns out my shoulder is fine. But how can I prevent rotator cuff injuries in the future?
Get serious about form.
Yes, if you work out, it’s fun to see if you can do things as quickly as possible (lovers of Crossfit take note!), but that’s also the fastest path towards injury if the trainers aren't keeping an eye on your form. Working with a trainer or coach and really nailing down the details of form before increasing the intensity and speed of your exercise will help keep your shoulders working properly.
If you don’t really need to be reaching overhead, don’t do it.
Climb up on a stool when you’re pulling down boxes in the garage. Get a good stepladder when you’re painting your dining room. Reaching overhead is the toughest movement on your shoulder muscles, and adding weight or resistance to that only increases the strain. It only takes a minute to be kinder to your poor shoulder joint.
If you’re working out your arms, make sure to address your shoulder stabilizers too.
Working with a good personal trainer (ask me for recommendations!) can help you get on the right track with a routine to gradually build up more stability in your shoulders.
Can massage help with rotator cuff injuries?
If you’re an athlete or work in a field requiring a large amount of physical labor, it’s also natural to feel some degree of anxiety about being injured. This is an area where massage really shines, helping you relax and cope with the stress that comes along with injury.
How do I find a good massage therapist to help me with my shoulder?
You’ve already found one.