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The Question: A torn rotator cuff can be a common yet serious injury for athletes. Proper recovery is the key element to getting back in the gym as soon as possible. What is the best injury rehabilitation workout for a torn rotator cuff? Be specific. What are some signs or symptoms of a torn rotator cuff? How can you prevent a torn rotator cuff injury? Bonus Question: Have you or someone you know have a torn rotator cuff? What kind of treatment was used? How long did it take to recover? Show off your knowledge to the world! The Winners:
2nd place - 50 in store credit. To use your credit, e-mail Will @ will@bodybuilding.com for more info.
A torn rotator cuff can be a common yet serious injury for athletes. Proper recovery is the key element to getting back in the gym as soon as possible.
The human shoulder is certainly one of the most complicated and fragile joints in the human body. Although to the common man, this joint seems similar to the ball-in-socket type joint like the human hip, the shoulder is much different. The ball of your shoulder basically sits in between a very shallow socket in the scapula (shoulder blade) in addition to a notch in your collar bone (clavicle). (1) Now if you think about it, how stable does the ball of your humorous (upper arm bone) floating in between your shoulder blade and your collar bone sound? That's not very stable sounding to me.
Now, what keeps this joint stable is a group of small muscles that not only keep the ball part of the humorous in the right spot, but allow a very wide range of motion while keeping it there. These muscles include the Supraspinatus muscle, Infraspinatus muscle, Teres minor muscle, and the Subscapularis muscle. (2) These four muscles are what are typically referred to as the rotator cuff of the shoulder. Now, keep in mind, these muscles allow for rotation in the shoulders, not shrugging motions.
Now, when a person says they've torn their rotator cuff, they typically mean that they have torn one or more of these muscles, or one of the tendons attaching these muscles to the humorous. When attempting to recover from an injury of the rotator cuff, the main goal is to strengthen the muscles of the shoulder evenly, while encouraging as great a range of motion as possible. Now this workout will be unlike almost all of the other workouts featured in this section because the goal is not to build muscle, but rather strength and flexibility. Therefore, very light weights will be used at all times. Rotator Cuff Articles:
Complete a circuit of all of the below exercises, 3 sets of each.
  Click Image To Enlarge.It Will Be More Like A Physical Therapy Session Than A Day At The Gym.
Although it will vary from person to person, there are a few typical signs and symptoms of a torn rotator cuff. The first most obviously is pain. Pain in the shoulder is not natural and should never be ignored. It signifies that something is wrong, and will get worse if the abuse continues. Now pain does not have to mean a torn rotator cuff, it can mean that there is simply strain on the muscle or tendon. Unfortunately, that is exactly what will lead to the actual tearing of the rotator cuff, so be sure to take care of your shoulder if you feel any pain and seek medical attention.
 Click Image To Enlarge. Pain Does Not Have To Mean A Torn Rotator Cuff. The second most important of the signs and symptoms is swelling. Although it isn't common, some people have torn their rotator cuff and experienced little to no pain. Swelling will most certainly occur regardless of the amount of pain a person can endure or ignore. If you have significant amounts of swelling, seek medical attention. The third of the signs and symptoms that could signify a torn rotator cuff is changes in the range of motion. If you could raise your arm to vertical yesterday, and can't even raise it parallel to the floor today, there is most certainly something out of the ordinary occurring. If you are experiencing any of these three symptoms, make sure to seek adequate medical attention because a torn rotator cuff in many cases requires surgery to repair the problem.
One of the biggest keys in prevention of a rotator cuff injury is to keep the muscles of the shoulder strong and balanced. This means that although you may have your absolute favorite shoulder exercises, varying your choice in exercises is absolutely essential. This is because each variation of an exercise will require the engagement of different muscles, and even stimulate the same muscles in different ways. Including a wide variety of exercises in your shoulder workout will help prevent any unnatural stress due to muscle imbalances or overexertion of the muscle. This is not only important in the shoulders, but the whole body. The more variety you put into the workouts you do, the more well rounded of an athlete you will be and will be much more capable of avoiding injury. Injury Prevention Articles:
About 5 years ago, one of my older cousins, Jerry was a pitcher for his D2 college baseball team. He tore his rotator cuff during the 8th inning of the second to last game of the season before the playoffs, crippling his team as he was the most consistent starting pitcher on the team. He underwent surgery the day after, having suffered a complete tear of the muscle away from the arm bone (I'm not sure which muscle it was). After weeks and weeks of icing and heavy pain medicine, he began doing exercises to get his shoulder moving again. He was carrying around a specially insulated and shaped shoulder ice pack for months.
After months of physical therapy, he is back to normal, although he hasn't thrown a baseball since. Certainly, it would be better to do workouts such as the one shown above as a preventative measure, because a tear can ruin your hopes of becoming a pro athlete or even the next top IFBB pro bodybuilder. An injury like this is can hinder your ability to train fully for months, or even permanently depending on the location and severity of the tear. Keep variety in your training and you'll be much less likely to experience a tear.
Thanks for reading! References:
The rotator cuff tendon is the common attachment of the Supraspinatus, Infraspinatus, Teres Minor and Subscapularis, and is the prime stabilizer of the humeral head in the glenoid fossa. The key stabilizer is the Subscapularis, as an injury to this specific Rotator Cuff muscle results in a loss of 90% of shoulder stability. Collectively, their job is to help keep the subacromial space open to allow for full ROM in the shoulder joint. It achieves this by keeping the head of the humerus pulled in and down to oppose the action of the deltoid muscles, which is to abduct the humerus by pulling it out and up. A healthy subacromial space is 10mm.
In a shoulder with weak or overpowered Rotator Cuff muscles, the head of the humerus is pulled out and up too far by the deltoid muscles, thus decreasing the subacromial space and causing the head of the humerus to rub against the acromion Process. Unfortunately, the portion of the humerus head that the acromion process rubs against is right where the Rotator Cuff tendon is located, and this is when impingement occurs. Impingement occurs when the subacromial space is 6mm, compared to the normal healthy 10mm. Initially, the impingement will cause pain with any overhead activity. This pain will commonly occur in what is commonly known as the "painful arc", which is between 70 to 120 degrees of shoulder abduction or flexion (arms raised directly out to the sides or out to the front). Another sign of shoulder impingement is when an individual is unable to sleep on their side without experiencing some pain and discomfort. Continuous impingement will quickly cause the structures in the subacromial space (Rotator Cuff tendon and subacromial bursa) to become inflamed, eventually causing bursitis and/or tendonitis in the shoulder. If the impingement is left untreated, then it will eventually result in a tear in the Rotator Cuff tendon, further weakening the Rotator Cuff muscles, which in turn will cause further impingement.
 Click Image To Enlarge.A Tear In The Rotator Cuff Will Occur If Impingement Is Left Untreated. Injuries to the Rotator Cuff often occur in people who perform repeated overhead activities, such as throwing motions, racquet sports, swimming, and occupations that require a lot of overhead work. It also can affect the general population, as the subacromial space will naturally decrease with age. It is also one of the most common injuries seen in gyms and health clubs, as most fitness and bodybuilding enthusiasts focus primarily on deltoid work and often ignore the muscles of the Rotator Cuff. If someone feels pain and discomfort in their shoulder, especially in the "painful arc", then they should seek medical attention as soon as possible. Once they are discharged from physical therapy and have received medical clearance, they can then proceed with an exercise program to help complete the rehabilitation process and to minimize the chance of re-injuring the Rotator Cuff.
One can prevent a Rotator Cuff injury by simply putting as much emphasis on Rotator Cuff work as they do for the deltoids. A good rule of thumb to follow is to "prime" the shoulder for exercise by performing one set each of Rotator Cuff External and Internal Rotations before performing any deltoid work, then to end the shoulder workout with some more Rotator Cuff work (at least one set of each exercise). Here is an example of what this would look like:
Another method one can use to prevent a Rotator Cuff injury is to design their workout so that for every Pec exercise, he/she performs one Posterior Shoulder Girdle (Lats, Rhomboids, Lower Trapezius) exercise both before and after. This would ensure the scapular musculature remains balanced, ensuring maximal stability of the humeral head in the glenoid fossa. So it would look something like this:
I used to train with someone who was diagnosed with a Rotator Cuff tear. He was in so much pain, but mostly because he couldn't hold his ego in check and continued to perform Bench Presses and Shoulder exercises until he couldn't tolerate it anymore.
He originally had it diagnosed by his doctor, but didn't use the referral to go see a Physiotherapist since he figured a little rest and some direct Rotator Cuff work would heal it just fine. It affected him for almost 2 years (with some 2 month breaks from the gym to "rest" it) before he finally agreed to go see the Physiotherapist. Once he had this "awakening", it took him approx. 5-6 months to rehab it, and he was just starting to perform some upper body work.
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