Your shoulder is the most flexible joint in your body. When healthy, the shoulder has an incredible range of motion made possible by the round head of your upper arm bone, or humerus, rotating within the round socket, or glenoid, formed by the scapula and clavicle.
Introducing The Rotator Cuff
The flexibility and stability of this ball and socket joint is made possible by a series of tendons and muscles that keep your humerus in proper alignment known as the rotator cuff. The four muscles of the rotator cuff criss cross the shoulder and surround the joint forming a web or net to hold the ball in the socket, securing it in place while allowing it to be flexible.
Unfortunately, shoulder injuries are fairly common, and once injured, the flexibility and stability of the joint are compromised. Most shoulder injuries are overuse athletic injuries from repetitive or excessive movements from activities like throwing a baseball, swinging a tennis racquet, swimming or olympic style weightlifting. More serious injuries occur from physical contact or jerking motions, an example would be seat belt injuries from a vehicle accident. Injuries can also be the result of work related or everyday activities resulting in strain or overuse like painting a wall with a roller or improper lifting techniques.
Shoulder Injury Treatment Considerations
- Shoulder injury treatment depends on the type of injury. Treatment could be as simple as rest and ice followed by altering or avoiding the activity that caused the injury.
- More serious injuries may require physical therapy to strengthen the rotator cuff muscles and to increase strength and range of motion to the level prior to injury.
- Painful injuries to the muscles, tendons or the actual socket may require prescription medications to reduce pain and swelling. This is an injury often associated with injectable anesthetics and steroids to promote healing.
- Fortunately, most shoulder and rotator cuff injuries respond well to non-invasive treatments, but tears or joint repairs may require arthroscopic surgery in combination with the treatments and rehabilitation outlined above after surgery.
Shoulder Injury Prevention
There are simple steps that you can take to prevent shoulder injury. Condition your shoulders and rotator cuff through proper stretches and strengthening exercises and you will be less susceptible to injury.
- Always warm up before training. Take time to increase your heart rate and increase the blood flow to your muscles, tendons and joints. Shoulder shrugs and shoulder rotations or windmills are good warm ups for your shoulders.
- Slow stretching, after warming up, will reduce injury. Perform static stretching including internal and external rotational stretches. One popular shoulder stretch involves holding a towel or pole with both hand behind the back, one over the other, and pulling the lower hand upward and the upper hand downward. Research stretches performed by Olympic swimmers and gymnasts for effective stretches.
- Increase shoulder strength. Increasing the strength and tightness of the rotator cuff muscles and tendons will help prevent athletic or overuse injuries.
- Stand up straight. Posture is important for proper body mechanics and especially so for your shoulders. Maintaining good posture when standing and prolonged sitting will promote shoulder health. Be aware of your posture relative to your shoulders while using computers and electronic devices.
- Cross train. Repetitive actions from one sport can cause overuse injuries, cross training can strengthen the shoulder from different angles and activities. If you are a tennis player, try swimming, a baseball pitcher or volleyball player may benefit from moderate weight training or gymnastics training.
- Rest your shoulders. Adequate rest after your athletic training or strenuous everyday activities will allow the micro tears in your shoulder and rotator cuff to repair and rebuild. Rest is when the majority of strengthening occurs.
Shoulder Exercises for Injury Protection
There are basically two types of shoulder and rotator cuff exercises, those that stretch and those that strengthen. Stretching exercises are intended to increase mobility and range of motion while increasing circulation which promotes growth and healing of your shoulders. Always perform your stretching exercises before your strengthening exercises.
These stretching and strengthening exercises fall into two categories, internal rotation which involves rotating the shoulder toward the center of the body and external rotation which involves moving the shoulder outwards, away from your center.
Eventually you will be using weights or some type of resistance in your shoulder training. Keep in mind that your rotator cuff muscles are small and require little weight. If you are just beginning to strengthen or rehabilitate your shoulders, you should start with NO weight and increase resistance gradually. Here are some general suggestions for shoulder training that will reduce pain, increase range of motion and develop and maintain strength.
- Train slowly. Do not use jerking motions or momentum to complete the exercise. Use the muscles surrounding the joint and maintain full control.
- Don’t bounce. When stretching, or stretching at the end of a strengthening exercise, avoid bouncing which may cause injury. Hold the stretch for a count of ten and then slowly relax.
- No pain. You may feel discomfort when stretching or strengthening to rehabilitate and injury, but don’t train to the point of pain. If it hurts - stop.
- Remember posture. Stand or sit straight with your shoulders pulled back when performing rotator cuff exercises. Bad posture will limit your range of motion and the effectiveness of your workout.
- Don’t lock your elbows. Locking your elbows when you straighten your arms during an exercise transfers the stress away from your shoulder to your arm and elbow. Keeping your elbow just slightly bent will increase the effectiveness of your movement.
Suggested Shoulder Exercises
Exercises that you can use to stretch your shoulders include:
Front shoulder stretches with arm across the chest.
Behind the back stretch by pulling the opposite hand to left and right.
Anterior shoulder stretch with a towel or stick.
Wall stretches work your shoulders from a variety of angles.
Exercises that you can use to strengthen your shoulders include:
Internal and external rotational exercises.
Isometric shoulder exercises.
Wall push-ups at a variety of angles.
Weighted alphabets - hold a weight or medicine ball at arm's length and trace the alphabet.
Draw a sword - reach across your body holding a weight or resistance and simulate drawing a sword.
Use this outline and guide to help prevent rotator cuff and shoulder injury - prevention should always be your first priority. If an injury should occur, you are now knowledgeable in the functional anatomy and possible treatments of shoulder and rotator cuff injury and can confidently work with your Coach, Trainer or Physical Therapist to design a program to strengthen and rehabilitate your injured shoulder.