The Pathogenesis of Rotator Cuff Injury
Painful rotator cuff Injury is all too common with athletes, weightlifters and even the elderly. Causes for painful rotator cuff injury are varied. In some cases it is related to repetitive ballistic motions, in other instances it is related to a traumatic slip or fall. Here are a few cause and effects of painful rotator cuff injury.
- The ballistic overhead throw – Common in baseball or the sideways swing of a tennis racket which causes an impingement syndrome or a rotator cuff tear injury
- Inexperienced weightlifters who compromise form when lifting weights are at high risk. In particular, amateur Bench Pressers who bounce the weight off their chest, and arch their backs excessively. There are 9 strength training exercises that are destructive to your health that are commonly seen in the gyms. It’s best to avoid machine and focus on strength movements which allow natural flow and rotation from all joints in the body. The joints that are most susceptible to injury are the shoulder and rotator cuff, the hip joint and vertebrae of the lower back.
- Seniors who slip and fall. As we age our sense of proprioception or balance diminishes, leaving us at risk for falling. When we fall, our instinctual reaction is to extend the arm to buffer the impact of the fall. The end result is trauma to the shoulder joint, ligaments and soft tissue tear all related to the rotator cuff injury. In severe falls the hip joint and spine can also be compromised.
- Individuals with rounded shoulders aka upper cross syndrome. Rounding of the shoulders overstretches the trapezius and muscle of the rotator cuff. In addition, the pectoralis minor which sits anterior to the rotator cuff becomes over facilitated and tight and also contribute to pulling the shoulder forward into pronation. The end result is a biomechanical mal-alignment. Upper Cross Syndrome is very commonly seemed in women who have had breast augmentation surgery. Nature’s way of saying leave well enough alone or suffer the consequences. This accentuated pronation is also a leading cause of scapular winging which is the precursor to rotator cuff injury
Painful rotator cuff injury can render an athlete helpless, making sports performance difficult as well as activities of daily living. Examples of activities of daily living are, sleeping on your side, removing a shirt, washing hair, or rotating the steering wheel on a vehicle. In many cases, a painful rotator requires early medical attention. In many situations, continued abuse leads to a frozen shoulder.
- If a bone spur or osteophyte is present the physician will perform a cross-body adduction test to confirm. He will more than likely inject the shoulder with a local anesthetic to confirm his findings.
- A physical exam, X-rays and an MRI are usually done to further confirm the findings of the rotator cuff injury.
- If the findings are positive. You will be told to modify your activities. Which mean stop playing your sport, adjust your sleeping positions and perhaps immobilize the affected area in a brace or sling to limit the range of motion.
- You might also be placed on oral analgesics, lidocaine patches, or be a candidate for AC joint arthroscopy, osteotomy or dissection of the clavicle.
If you are smart you will go the holistic route before considering open shoulder surgery. In a recent Finnish study comparing shoulder surgery versus physical therapy for improving a painful rotator cuff injury, it was found that both modalities were equal in valued outcome. It is always best to approach the healing process of your painful rotator cuff injury from a physical therapy approach. It is far less complicated and more cost effective. Besides, most people don’t relish the idea of surgery and a very long rehab schedule.
Most at-home treatments can help heal painful rotator cuff injury if done properly. If you are ambivalent and unsure how to implement these exercises, it is suggested that you recruit the expertise of a professional Post Rehab or Medical Exercise Specialist. A one-month investment of your time will be a wise choice.
Here are a few of the latest valuable exercises you can try at home or at the gym.
They are designed to pre-stretch and then strengthen the rotator cuff These movements reduce the likelihood of further rotator cuff injury.
Exercises that stretch and mobilize and comfort the rotator cuff injury.
- Anterior shoulder stretch with a towel
- Wall stretch of each shoulder.
- Pendulum rotational exercises.
- Foam roller mobilization of latissimus dorsi muscles
- Swiss ball pectoralis major and minor stretch
- Trigger point release of Levator scapula teres major with Backnobber
Exercises that increase the strength the weakened antagonistic muscles commonly seen in rotator cuff injury.
- Internal and external rotation with light bands.
- Wall pushup with minimal body weight
- Shoulder blade (scapular) retraction with light tubing and without tubing.
- Arm reach while positioned against a wall.
- Seated rows with lightweight loads only
- Swiss ball prone cobra with arms in I-T-Y positions.
Be careful when implementing these techniques designed to improve a rotator cuff injury.
- All movements should be performed slowly in a deliberate manner
- It’s considered OK to first touch the pain point, however, do not go deep into the pain. Simply back off.
- If at all possible, monitor your rehab movements carefully with the use of a large mirror at the gym or at home.
- Remember your goal is to improve your rotator cuff injury, and if you have any doubts on how to do this, then recruit the help from a professional who knows more.
About The Author
Rivak Hoffman is a former surgical physician assistant. He made a change to holistic medicine and rehabilitation some 12 years ago. He is now a Scottsdale Arizona Medical Personal Trainer, Scottsdale Arizona Post Rehab Trainer, Scottsdale Arizona Nutritionist, CHEK Practitioner, and CHEK Holistic Lifestyle Coach. He niche is Scottsdale Arizona Medical Weight Loss Coach and Personal Trainer, Scottsdale Arizona Hip Rehabilitation, Scottsdale Arizona Lower Back Pain Rehabilitation Specialist Scottsdale Arizona Knee Rehabilitation, Scottsdale Arizona Shoulder Rehabilitation, Scottsdale Arizona Tennis Elbow Rehabilitation Specialist, Scottsdale Arizona Stroke Rehab Specialist, Scottdale Arizona Cancer Exercise Specialist, and Scottsdale Arizona Multiple Sclerosis Exercise Specialist. For more information on Rivak Hoffman’s services, visit EverybitfitAZ and apply for a complimentary consultation and see what we can do to improve the quality of your life!