EXERCISES
Strengthening
the four rotator
cuff muscles is essential to prevent and rehabilitate shoulder
injuries. There are many different types and ways to stretch and strengthen
these four small, but very important, muscles in the shoulder.
Stretching the Muscles
of the Rotator Cuff
Gentle
stretching of the rotator cuff muscles can aid in prevention of injuries
when done on a regular consistant basis, especially before and after exercise.
Basic stretching can be done in four directions--across the body, up the
back, to the side, and overhead. Each stretch can be held for 3 to 5 minutes
and repeated as much as 5 to 10 times a day.
Some simple
specific stretches for each muscle are as follows:
Supraspinatus stretch--Gently
adduct the arm behind the back while keeping the shoulder internally rotated
and extended. Hold for about one minute and switch arms. Repeat 2 or 3
times. This passive stretch can be done against a wall, or with a partner.
-
Subscapularis stretch--Gently
externally rotate arm while adducted by the side of the body and at 90
degrees of flexion at the elbow. Slowly increase stretch to maximum range
of motion and hold for one minute. Switch arms. Repeat stretch 2 to 3 times,
while increasing angle of hold each time. This stretch can be done against
a wall or with a partner. It can also be done with the arm abducted 90
degrees, while maintaining 90 degrees of flexion at the elbow.
Strengthening the
Muscles of the Rotator Cuff
Overall
shoulder strength is very important for shoulder stability. Good rotator
cuff strength is very important, especially for athletes who do repeated
over-arm/ over-head motions for long periods of time. These strengthening
exercises should help increase rotator cuff strength and stability at the
shoulder joint. They are also very useful in preventing and rehabilitating
shoulder injuries. (For a website with pictures of the four exercises
click here)
Overall Shoulder Strength:
Raise straightened, relaxed arm, not higher than 60 degrees from the
body. Work the shoulder with the arm about 30-40 degrees horizontally adducted.
Keep hand in the "thumb-up" position. Hold arm up for a count of two, bring
other arm over and slowly push the exercising arm down as it resists, while
slowly lowering to the side. Add or increase weight with time, but do not
increase weight resistance too much. Instead increase reps to increase
strength, after a certain weight is attained.
External Rotator Strength:
These exercises are focused on strengthening the Infraspinatus and
Teres
Minor, the two external rotators of the four cuff muscles.
Using surgical tubing, or "Theraband", attach one side to a doorknob or
post, and hold the other end in right hand. Shoulder to be exercised should
be farthest away from the doorknob or post. While either sitting or standing,
hold right elbow in 90 degrees of flexion and tucked into hip, while the
forearm and hand are against the stomach. Left hand can assist in keeping
right elbow stable. In 0 degrees of abduction, externally rotate arm out
laterally to the side, no more than 90 degrees from the start position.
Slowly rotate arm back to the stomach while keeping muscles tensed and
movements controlled. Do exercise for 15 to 20 repetitions, then switch
arms. Exercise each arm with three sets of 15-20, two times a day. Increase
repetitions and sets as muscles become stronger. Can move to a 90 degree
abducted position of the shoulder when the muscles are strong.
Using dumbells: Lie on left side and lift free weights with right arm,
using the left hand to keep the right elbow tucked into the hip. Right
elbow should be in 90 degrees of flexion. From starting position, against
stomach, slowly externally rotate the arm up to 90 degrees and then slowly
down to the origional position. Complete 10-15 reps on each arm and exercise
each arm 3 times. Make sure all movements are controlled and muscles remain
tensed. Do this exercise twice a day.
Internal Rotator Strength:
These exercises are focused on strengthening the internal rotator, Subscapularis.
Similar to working the external rotators, but start with the exercising
arm closest to the doorknob and in 90 degrees of external rotation of the
shoulder, away from stomach. The slowly bring hand and forearm in, medially,
to stomach, internally rotating the arm. Keep arm and elbow firmly tucked
against side of body, with 0 degrees of glenohumeral abduction.
The dumbell exercises are just a little different in that the side to lay
on is the side to be exercised.
Do exercise for 3 sets of 10-20 repetitions on each arm, twice a day.
Supraspinatus Strength:
The "empty-can exercise" strengthens the Supraspinatus muscle, a
weak abductor of the rotator cuff muscles.
Internally rotate the humerus, followed by abducting the arm to 90 degrees
in a 30-45 degree horizontal adducted position. As if one were emptying
a can, thumb down. This is the starting position. Slowly adduct the arm
down to hip and then return to start position. Repeat this exercise for
15-20 reps for 3 sets on each arm, twice daily.
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April Ptak
Laina Hovsepian
SPME 400
Dept. of Sports Medicine, Pepperdine University