Stabilising the Shoulder - Townsville Massage

The Rotator Cuff is a group of four muscles and their tendons, which cover the Glenohumeral or shoulder joint where the Humerus fits into a shallow socket in the shoulder blade.

The Rotator Cuff is an amazing piece of kit that allows the arm to raise and rotate at the shoulder and helps to stabilise the shoulder joint during movement.  Although each Rotator Cuff muscle moves the arm from the shoulder joint in a specific direction, they all work together to stabilise the shoulder joint.

A strain or tear in the Rotator Cuff may occur suddenly from trauma like a fall or happen gradually from overuse.

Strengthening exercises for the muscles that control the Shoulder Blade is also important, as the Shoulder Blade (Scapula) helps the Rotator Cuff to dynamically stabilise the shoulder.

The Importance of Strengthening the Rotator Cuff

Many muscles are involved in shoulder movement and all work together, but strengthening the Rotator Cuff is especially important. The Rotator Cuff is the main stabiliser of the shoulder joint during movement of the shoulder.

If the ball of the upper arm is not kept centered, abnormal stress is placed on surrounding tissue and may cause gradual injury. Strengthening the Rotator Cuff helps prevents common Rotator Cuff injuries including Tendonitis, Rotator Cuff tears, and Shoulder Impingement Syndrome.

As we get older, Rotator Cuff tendons reduce in elasticity and become more susceptible to injury. There is also a gradual loss of muscle mass that occurs, but this can be counteracted with strengthening exercises.

Rotator Cuff Muscles

The Supraspinatus is located at the top of the shoulder and abducts the shoulder – it raises the upper arm and moves it away from the body.

The Subscapularis is at the front of the shoulder… same side as your face.  It internally rotates the shoulder.
The Infraspinatus and Teres Minor are in the back of the shoulder – they externally rotate the shoulder.

Though each Rotator Cuff muscle moves the shoulder in a separate direction, though they all work together to stabilise the shoulder joint.

Strengthening the muscles of the Rotator Cuff is important.
The two small external Rotator Cuff muscles are often weaker than the larger internal Rotator Cuff muscle.

The Rotator Cuff muscle involved in abduction (taking the arm away from the body) is the Supraspinatus, and is the one most often injured of the Cuff muscles due to its position between two bones which often squeeze this tendon during overhead movement.

Other Shoulder Stabilisers:
The Scapula or Shoulder Blade helps the Rotator Cuff to stabilise the shoulder joint as it moves. The Rotator Cuff muscles rise from the Scapula and attach to the head of the upper arm bone or Humerus.

If the Shoulder Blade isn’t stable, pressure may be placed on the Rotator Cuff, so strengthening the muscles that support the Scapula are important.

The Bicep Tendon is the one that runs over the top of the Humerus and connects at the top of the shoulder joint helping stabilise it. Overloading the Biceps by lifting something too heavy can result in Biceps Tendonitis (also known as Shoulder Tendonitis).

Strengthening the Biceps helps prevent injury.

Exercise after Shoulder Injury

The question is… how long should the shoulder be rested?
The amount of time to rest an injured shoulder before starting rehabilitative exercises hinges upon how quickly one heals, as well as the type and the severity of the injury.  Working it too soon may cause further damage.

On the other hand, if the shoulder is not used enough, the shoulder muscles weaken, so strengthening exercises are an important part of rehabilitation. Stretching exercises increase the range of motion of the shoulder.

Stretching exercises may… may… help prevent Frozen Shoulder from occurring after an injury that causes one to restrict shoulder movement due to excruciating pain.
Stretching exercises are often started after a few days of rest, but it’s best not to overdo it.

Building up Strength:
Warming up with five minutes of ‘a mini version’ of the exercise you are about to do prepares the body by increasing heart and breathing rates, and increasing blood flow to the muscles, and raising body temperature. Warming muscles and tendons improve range of motion and reduces the risk of injury and warm muscles are more flexible than cold muscles.

Have Patience. Too much too soon can cause overuse injuries. Strengthening a group of muscles should only be done every second day to give the muscles a chance to heal. Strengthening exercises load the muscles slightly beyond their limits and cause micro tears. If given a proper chance to heal, muscles become stronger. If not given a chance to heal, chronic inflammation and problems may develop.

You should feel a bit fatigued by the end of a dozen reps. If you feel fatigued after just a few reps, reduce the difficulty of the exercise by lowering resistance (e.g. use lighter weights or no weights). If you do not feel fatigued after a set, increase the difficulty of the exercise by increasing resistance, but again… not too much.

Don’t “lock” the elbows. Your elbows should be slightly bent. This makes the muscles work harder to increase the effectiveness of the exercise. Locking a joint while exercising also increases the chances of injuring the joint.

Posture: The shoulders should be kept back and down during exercise.  The same goes for when you are standing or sitting.  Slouching reduces the space the Rotator Cuff tendon passes through and puts unnecessary strain on the shoulder joint.

Take it easy and don’t  jerk. Proceed slowly and steadily to use the muscles, not momentum, to complete the exercises. For exercises involving lifting or pulling, slowly lift or pull, hold for a second, and slowly lower or return.

Stretching:
Stretch Gently:  No bouncing. Stretch until you feel a tug but don’t go past. Always hold a stretch for about 30 seconds. Do not stretch to the point of pain. Over-stretching can tear muscles.

Breathe normally during stretching exercises.

Dumbbells or resistance bands are often used to provide resistance in strengthening exercises. Handheld weights come in a variety of weights, so you can gradually increase difficulty of exercises.
Resistance bands provide resistance when stretched. They come in a variety of thicknesses to provide different levels of resistance and are usually color-coded. When using resistance bands, increasing the distance you stand from whatever you have them attached to increases the resistance.

Part of your Shoulder Stabilising should incorporate Remedial Massage and its wise to see a qualified therapist.  If you’re experiencing shoulder problems, call me and book a massage today and see what a difference it can make.