Rotator Cuff Tear 101

Rotator Cuff Tear

Does your shoulder ache when you move it above your head or behind your back? If so, you may have torn your rotator cuff. This small band of tendons can either tear in one big accident or gradually wear down over time. Postural awareness and strengthening exercises are the key to strengthening these tendons for a pain-free shoulder.

The Facts

The shoulder joint is composed of the arm bone (humerus) and shoulder blade (scapula), which form a ball-and-socket joint. The rotator cuff is composed of the tendons from four muscles (the supraspinatus, infraspinatus, subscapularis, and teres minor). Any or all of these can be torn, although the first two are the most common. The tendons run in between the ball and the socket, and act to push the ball down relative to the socket to allow it to glide smoothly.

The Symptoms

Patients with a torn rotator complain of pain when they lift their arm, usually overhead or behind their backs. The pain is located deep in the shoulder joint, and can be mild to severe. Pain can also radiate down the arm, usually no more than several inches, but can go as far down as the forearm in severe cases. Patients often complain of pain while sleeping. Pain usually occurs with movement while awake, but with severe cases, can also be present at rest.

What Is Happening

With a rotator cuff tear, a piece of tissue, specifically one or more rotator cuff tendons, gets stuck between the ball and socket when the arm is compressed or elevated. As a result, the pressure from the ball rubbing up against the tendon causes irritation and inflammation, and results in painful motion. It can also occur from blunt force, as the small tendons, which can only withstand several pounds of force, are made to resist a big compressive or stretching force, and cannot withstand it, causing a tear.

Why Is This Happening

Rotator cuff muscles can tear as a result of an injury, where the muscles overstretch or the shoulder is landed on, as well as throwing and climbing. Everyday wear, which makes the threshold low for tearing, is also a common culprit. If the mid-back muscles that surround the shoulder blade (specifically the lower and middle trapezius muscle) are weak, then the shoulder blade will not rotate properly along with the arm bone. If the arm rotates and the shoulder blade doesn’t, the tissues between the ball and socket (i.e., the rotator tendons) can get pinched. This can also occur due to rotator cuff weakness. Weakness in these muscles will cause the ball to be too high in the socket, and grind against the tissues that pass between them. Strong rotator muscles can push the ball away from the socket and allow proper movement.

Lifestyle Adjustments
  1. Equalize your weight. Notice your sit bones, those protruding bones in the middle of your seat, and how you distribute weight on them while seated. Sit in your office, kitchen, or living-room chair and ask yourself, “Is there more weight on my right sit bone as compared to the left or more weight on my left sit bone as compared to my right?” If the answer to either question is yes, take time to fidget until the weight is evenly distributed. Memorize that feeling of equalizing your weight on your sit bones and remind yourself to find that equalization each time you sit.
  2. Sit tall. Measure the distance between your last rib and the top of your hip with your thumb and pointer finger. Now, challenge yourself to lengthen that distance by sitting tall—creating more space between your last rib and the top of your hip. Now, organize your shoulders by opening your collarbones—pulling them away from each other to broaden your chest—and pull the tips of your shoulder blades down your back. Notice how you suddenly look and feel taller. Sitting tall keeps your upper body in optimal alignment, reducing any chance for slumping. The seated slump overstretches your shoulder and neck muscles, weakening them and increasing the possibility for shoulder and neck injury.
  3. Get in shape! Building muscular strength, particularly focused on the shoulder, arms, and wrists, avoids overuse of the muscles affecting the rotator cuff and further builds your resistance to injury.
Prevent It
  1. RICE up! Rest, ice, compress, and gently elevate your arm after mild injury to prevent further tearing.
  2. Know your limits! Do not play contact sports unless you are in proper physical shape.
  3. Stay loose. Add shoulder and wrist stretches to your exercise program after strength training to keep the joints mobile.
Fix It

The fix for this malady is the same as the prevention: stop performing irritating activities, and start strengthening your weak muscles! Do not perform any shoulder exercises that result in pain. If you feel pain while performing shoulder exercises, stop, rest, and ice the injury for several days. Here are exercises designed to strengthen your rotator cuff and scapular muscles.

Exercises

Side-Lying External Shoulder Rotation

External Rotation_B_with blancket


1. Lie on your side, supporting your head with your arm. Hold a weight in your hand.

2. Place a towel between the body and the elbow, and lock the elbow against the body.

3. Drop the weight toward your stomach. Lift weight up toward the ceiling. Exhale; drop the weight. Inhale; lift the weight.

4. Repeat until exhaustion. Perform 3 times a day.

 

Wall Push-Ups

PushUpOnWall_B


1. Stand facing a wall, about 12 to 18 inches away.

2. Place hands on the wall at shoulder height and ground feet into the floor.

3. Bend elbows, pulling hips, back, neck, and head toward the wall.

4. Push back to start position.

5. Repeat 8 to 12 times.

Note: When you can perform the exercise comfortably against a wall, try it against a counter and then slowly progress to the end of a couch, then to a sturdy chair, and finally to the floor.

 

Scapular Retraction on Roller

Scapula Retraction_ Bolster B


1. Sit at one end of the roller with feet flat on the floor, about hip-width apart, knees bent. Place hands on the floor, and lower the torso along the length of the roller. Touch the top of the head to be certain it is fully supported by the roller.

2. Raise hands toward the ceiling, palms facing each other, elbows and fingers straight, and arms about shoulder-width apart.

3. From this position, keep elbows straight and reach fingers higher toward the sky or ceiling. Initiate the motion solely from the shoulder blade.

4. Now, keep elbows straight and lower the arms. Pull the shoulder blades toward the roller as if trying to wrap them around the roller.

5. Repeat 8 to 12 times.

 

Internal Rotator-Strengthening Exercise

Internal Rotator Strength_ Standing With Tubing B


1. Tie a piece of elastic exercise material, such as exercise tubing or Thera-Band, to a stationary object such as a doorknob or bedpost.

2. Stand with shoulders relaxed. Bend elbow to a 90-degree angle, and rest upper arm comfortably against your side. Squeeze a rolled towel between the elbow and the body for extra comfort.

3. Hold one end of the elastic exercise material in the hand of the affected arm. This is start position.

4. Rotate your forearm toward your body until it touches your belly. Keep the elbow and upper arm firmly tucked against the side of the body or towel roll during this movement.

5. Repeat 8 to 12 times.

 

External Rotator-Strengthening Exercise


1. Tie a piece of elastic exercise material, such as exercise tubing or Thera-Band, to a stationary object such as a doorknob or bedpost.

2. Stand with shoulders relaxed. Bend elbow to a 90-degree angle, and rest upper arm comfortably against your side. Squeeze a rolled towel between the elbow and the body for extra comfort.

3. Hold one end of the elastic exercise material in the hand of the affected arm. Pull forearm across the stomach. This is start position.

4. Rotate the forearm away from your body, keeping the elbow and upper arm tucked against the side of the body or towel roll until you feel tightness in your shoulder. Bring arm back to start position.

5. Repeat 8 to 12 times.

 

This information is not intended to replace the advice of a doctor. Yoffie Life disclaims any liability for the decisions you make based on this information.