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Rotator Cuff Pain ...

Posted Jun 10 2009 12:20am 1 Comment
Rotator Cuff Pain

Rotator Cuff Pain

It’s just as important to strengthen and rehabilitate the rotator cuff as it is to heal it in the first place. Treatment is needed to restore proper function, decrease inflammation and generally heal the shoulder joint. After this, it is crucial to ensure that the muscles that make up the rotator cuff are strengthened and stabilized so the same problem doesn’t happen again.

I prefer a two-part shoulder rehab program – early and late.

Early rehabilitation when the shoulder is not quite 100% is aimed at restoring proper functioning of the shoulder blade and shoulder joints (scapulo-humeral joint). This involves gently activating  the muscles around the shoulder blade, which include the rotator cuff muscles. Two examples of such exercises (which are listed in this research paper) are:

1.    Inferior Glide – Sit beside a flat surface (such as a table) that is slightly lower than your shoulder.  Raise your shoulder to 90 degrees and place your arm flat on the surface. Press down through your fist like you are attempting to return your arm to your side. At the same time, draw your shoulder blade down your back and hold for 5 seconds.

2.    Low Row – With your arm at your side, place your hand (palm facing you) on the front edge of a table or counter.  Extend your trunk and push your hand into the edge of the table like you are pulling your shoulder back. At the same time, squeeze your shoulder blades backwards and down your back and hold for 5 seconds.

Late shoulder rehabilitation involves more active movements of the rotator cuff including internal rotation, external rotation and abduction. I’ve included a copy of the handout I use below.

The main thing to remember about rotator cuff rehab is to make sure all movements are done in a pain-free zone. Any pain or pinching indicates impingement or irritation a structure and will further aggravate the condition. And finally, make sure you consult a health care provider in order to get a proper diagnosis for your shoulder, and get the right exercises to help your specific condition.

Rotator Cuff Exercises

Rotator Cuff Exercises

Rotator Cuff Exercises

Rotator Cuff Exercises

Dr. Debbie Wright is a practicing Vancouver Chiropractor.

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Original article in Scientific American:

New analysis identifies pitchers at risk for shoulder injury: Scientific American Blog

Arm injuries are commonplace among Major League Baseball pitchers, and such impairments may have cost a few notable pitchers, such as Randy Johnson and Brandon Webb, a chance to play in the 76th All-Star Game tonight.

A pitcher’s shoulder joint can rotate as quickly as 7,000 degrees per second—nearly 20 complete revolutions in one second if the shoulder could rotate completely freely—during a pitch, making it one of the fastest movements possible by the body, and this repetitive motion of the arm contributes to the fatigue-related injuries. Ian Byram and his colleagues at Vanderbilt Medical Center are hoping to reduce the damage by identifying pitchers at risk for injury during the preseason, allowing teams to design unique strength training routines for susceptible athletes.


The group studied 144 major and minor league pitchers from the Colorado Rockies organization. Over a five-year period they took preseason strength measurements of the four muscles that make up the rotator cuff, which holds the shoulder joint intact. They found that weakness in the muscles for rotation away from the center of the body or for lateral movement increased a pitcher’s risk of sustaining an injury.

The results, presented at the American Orthopedic Society of Sports Medicine conference last week, are the first data directly correlating preseason strength of the specific rotator cuff muscles with injury.  Byram also showed the data to the Colorado Rockies trainer last weekend and says the team is excited that the finding may be another useful tool to study players’ injuries.   

My letter to the editor:

Re:Weak shoulder in preseason ups pitcher injury risk-  Ian Byram  Vanderbilt Medical Center
Last Updated: 2009-07-10 12:11:33 -0400 (Reuters Health)

By Megan Rauscher

Hi. My name is Brad Beldner. I am an Anat Baniel Practitioner and Feldenkrais Movement Teacher in the San Francisco Bay Area. It is disappointing that sports medicine still has limitations when trying to understand the dynamics of human movement, causes of repetitive stress injuries, and the ingredients needed to upgrade athletic performance. As a therapist and movement teacher working with many athletes, I find most rotator cuff pain and limitations in movement and performance of the arm, are usually a reflection of how a person organizes their whole body for the specific action they are trying to execute. The rotator cuff muscles will always get over used, inflamed and weak etc, when the rest of the body isn't organized well to support and participate with the movements of the arm. You create a stronger, more powerful, freer and efficient throwing arm, by not having the arm at odds with the rest of the body.  For example, if the structures of your chest (spine, ribs, sternum, clavicles) aren't free enough to organize themselves to accommodate what is happening with the actions of your arm, your arm will always have to work harder at the ball and socket joint and the rotator cuff (and junctions of the humerus, scapula, acromion process, clavicles and their supporting muscles, etc). In other words, any place our bodies do not have good distribution of effort (work load) and movement throughout, the places that aren't doing an efficient job at helping with an action, create pain and stress in the places that are taking on the brunt of the work ( i.e. pitching arm and its rotators cuff muscles). It is very simple to predict who will have a weak rotator cuff and inefficient pitching arm, by looking at how the rest of their body is supporting the action of pitching the ball. Trying to improve the pitching arm by only strengthening the rotator cuff (and surrounding muscles) is an attempt at trying to over power (or compensate for) the 90% of the body that is usually creating the difficulty. Success is attained when integrating the arm with the rest of the body to get the entire body all on the same page to perform the pitch. 

 Predicting performance outcomes and helping athletes organize themselves for optimal action is easier when you step out of the limitations of looking myopically at a one point in a dynamic system, and problem solve by examining the system as a whole and how it relates to its environment.

I am curious what others think about this idea especially Ian Byram and his colleagues  


Brad Beldner

Brad Beldner, CFT, SEP, NCMTB
Anat Baniel Method for Children
Feldenkrais Method
Somatic Experiencing
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