Many of us have heard of someone with a rotator cuff tear, or as the old baseball greats would say, "rotary cuff tears." Most of us have friends or family members who have developed tendinitis in their shoulders, especially when trying overhand activities such as swimming or playing tennis. There is help for those painful shoulders, and in many cases it may even be as simple as doing a few exercises at home.

What is the rotator cuff?

The rotator cuff is composed of four muscles (see figure): subscapularis, supraspinatus, infraspinatus, and teres minor. (When we speak of irritations to the rotator cuff, we are generally referring to the supraspinatus and infraspinatus muscles and tendons.) The rotator cuff attaches to the humerus (the upper arm bone) and helps lift the arm overhead; it rotates the arm outward, or pulls the hand up behind the head. It also stabilizes the humeral head, or ball, in the shoulder socket and keeps it in the proper position for good use of the arm. Unfortunately, because of its exposed position, it can easily be injured.
In overhand activities, such as throwing and hitting a tennis serve, the rotator cuff slows the arm down after ball release or racquet contact. This deceleration activity can wear down the rotator cuff and eventually injure it if too much throwing is done or if mechanics are poor. The rotator cuff can also be damaged by "butting" against the roof of the shoulder socket during activities such as swimming.

Rehabilitation

Many rotator cuff injuries can be effectively rehabilitated by a correct exercise program, but rehabilitation should always be initiated under the supervision of a physician and a therapist. Stay away from heavy weights and exercises that irritate the shoulder. Lower weights and higher repetitions, used in the proper manner, seem to work best. Some exercises from a typical program are illustrated below. Your trainer, physical therapist, or physician may prescribe any or all of these exercises, depending on your particular problems. Remember that it generally takes at least 6 weeks to gain good strength and flexibility. If you are returning to an athletic activity, you must return gradually, according to guidelines outlined for you by your health care specialist.

Tab Blackburn, MEd, PT, ATC
Columbus , GA