ROTATOR CUFF STRENGTHENING

ROTATOR CUFF - What is it?

Rotator cuff strengthening is an integral part of the treatment of every shoulder injury, otherwise the shoulder will remain weak and prone to re-injury.

The rotator cuff is the name given to a group of four muscles that act to stabilize the shoulder. Shoulder pain and the so-called frozen shoulder often involve these key shoulder muscles.

• Subscapularis (which lies UNDER the shoulder blade), the

• Supraspinatus (which lies ABOVE the spine of the shoulder blade), the

• Infraspinatus (which lies UNDER the spine of the shoulder blade) and the

• Teres Minor. To these four muscles we will add the

• Biceps muscle for simplicity, since it also a common offender that needs strengthening.

These shoulder muscles allow you to raise your arm, turn it and move the arm into many different positions, each carefully controlled and cordinated, as in throwing a ball accurately, for example.

Unlike the hip joint though, the shoulder socket is very shallow to allow for greater range of motion of the shoulder. This makes the shoulder more vulnerable to injury, leading to shoulder pain, strains, tears and sometimes frozen shoulder.

Because the shoulder is non-weightbearing (as in the hip and knee) it is much less prone to arthritis. An exception here is the AC joint (Acromio-Clavicular). This joint that connects the collarbone to the shoulder blade is often injured in falls, and should it not be correctly managed with Rotator Cuff strengthening it becomes prone to Immobilisation arthritis.

The shoulder muscles are energised by nerves emerging from the lower neck. An old neck injury often lies at the root of shoulder pain. Have you perhaps been involved in a car accident or an old sporting injury?

In these shoulder syndromes, the muscles after being strained adhere to each other and the roof of the fossa which is formed by the AC-joint.

A sports-oriented chiropractor will not only adjust your neck but focus on these peripheral sites of injury, the four shoulder joints, and a complete set of rotator cuff strengthening exercises.

Strengthening

1. grasp your wrist with the 'good' hand, and press straight across (inwards) with your injured arm. Without movement! Against resistance from the good arm.

2. Adjusting the fingers slightly, in the same position, now pull outwards, again without movement.

3. Now pull your elbow straight against your chest.

4. Reaching across, grasp the elbow of the painful arm, with your 'good' hand. Now attempt to pull your painful arm away from the body, against the resistance of your good hand. Without movement. Gently, you're not going to the Olympics in Beijing!

5. Now press your elbow backwards against the back rest of your chair.

6. Lastly, make a fist with your sore arm, keeping the elbow at your side, and push straight forwards against the good hand. Again without movement.

Do about 5-10 reps of each, every time you take a tea break. Start slowly, particularly if these movements are painful. There's no rush.

Isometrics are more effective that dynamic exercises in the initial phase after injury when it comes to rotator cuff strengthening, but you must do it in different positions. When these six are painless, then do them with the shoulder flexed at 45 degrees, and then 90 degrees ...

Strengthening exercises with movement.

WEIGHT TRAINING

A used bicycle tube is excellent for Rotator Cuff strengthening. Hook it over some fixed point, and start doing gentle exercises against the resistance of the tube. Inwards, outwards, forwards ... you can use your imagination, but follow a routine, gradually expanding it as you feel the shoulder getting stronger.

Warm up routine

Golfer Padraig Harrington

Padraig was missing 4-5 tournaments per year due to injury. So he hired chiropractor Dr Dale Richardson to go on tour with him. Now he misses no tournaments. This is the routine that Dr Richardson has given him:

1. Early morning: 45 minutes of stretching, stability and core work to get warmed up.

2. Shower

3. Breakfast

4. 20 minutes with Dr Richardson checking that all the joints and muscles needed by a professional golfer - every one in the body! - are working right, followed by more stretching.

5. An hour at the range hitting shots to warm up further.

6. 4-5 hours on the golf course.

7. One hour with Dr Richardson getting treatment and cool-down procedures.

8. Gym work in the evening, time and energy levels permitting.

The basic principles here: Stretching, warm-up, checking that muscles and joints are working correctly, after-sport stretching and cool-down apply whether you are going to spend the day gardening, preparing for a game of squash, or even just going for a hike.

For a professional sportsman, Harrington's words are interesting: One thing I know through experience is that I need to keep having constant attention, even when I have weeks off, because I can see even though I would be injury-free for say a couple of weeks, I can feel symptoms building up, and if I don't deal with those early signs I'm going to be in trouble on the course.

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