Rotator Cuff Injuries | Tendonitis: Treatment and Strengthening Exercises

Types Of Rotator Cuff Injuries

Rotator Cuff Injuries | Tendonitis: Treatment and Strengthening Exercises 

• Overview
• Types of Rotator Cuff Injury
• Treatment
• Preventive Measures

Overview

The previous article swivels around the different muscles that make up the rotator cuff, and the also the function of each one of those. 

Due to the significant importance of these muscles in stabilizing and providing motion to the shoulder joint and the arm, special care should be directed to them. 

However, if neglected, the rotator cuff is prone to suffering from injury that can range from mild to severe.

Damage can occur either at the level of the four rotator cuff muscles or their tendons as a result of a trauma, aging, or prolonged overuse. 

injury is also prone to happening as a result of using these little muscles especially with bad form as when training, or doing any physical activity that particularly involves using too many internal rotations of the arm while carrying weights.

The shoulder joint is a ball and socket structure that allows for a greater mobility than any other joint in the body, and it’s stabilized and kept in place by only a group of muscles, tendons and ligaments. 

However, its very nature makes it quite likely to get injured easily, especially if it’s weak and undertrained. 

Damage to the rotator cuff can cause pain and a decreased range of motion of the shoulder joint.

Types of Rotator Cuff Injury

Rotator cuff injuries can be commonly classified into two categories. 

1. Impingements 

Impingements occur at the level of the tendons especially due to pinching them. 

The supraspinatus tendon impingement is the most common because it runs through a narrow space between the acromion and the head of the humerus.

If the deltoid muscles are stronger as compared to the rotator cuff muscles, the space between the ball and socket (humerus head and the acromiom) becomes even narrower, making it a difficult time for the supraspinatus tendon not being pinched every time the arm is elevated.

What makes pinching even worse is when the arm is raised with in interior rotation; as when doing lateral raises with the thumbs down to train the lateral delts.  

Repetitive pinching of the supraspinatus tendon causes swelling and pain which may develop into a tear if not treated and not correcting the arm motion (arm elevation with thumbs up).

2. Tears 

Tears can happen either on the muscle itself or its tendon.

Although rotator cuff tears are not very common, some cases happen due to repetitive moves that involve interior rotation of the arm particularly overhead if too much weight is carried. 

Partial tears generally don’t require surgery; rest and medication would do.

Symptoms

Treatment

In case of impingement or minor tears home remedies can really help. 

Applying ice to the affected area for about 20 minutes on three separate occasions daily reduces swelling and pain. 

Also, limiting the arm range of motion especially in the direction that causes pain is advised in order to relax the swollen tendon and give it some room to heal. 

However, doing this for long may make the shoulder stiff and needs stretching (As well as rehabilitation exercises) after recovery in order to gain its mobility again.

Along with rest and icing, taking over the counter anti-inflammation medicine is recommended for faster healing. 

If these medicines cause any irritation to the stomach or kidneys, they can be replaced by foods that naturally have anti-inflammatory properties. 

Mind! Avoiding foods that cause inflammation is also a wise decision.

Physical therapy can be followed after the symptoms start to reduce. Some simple moves of the arm will re-establish stability and restore full range of motion of the shoulder joint.

Preventive Measures

In order to prevent any rotator cuff impingement and tears, strengthening exercises and stretching routines are required.

As for the exercises, targeting the weakest rotator cuff muscles more than other strong ones is one of the best injury preventing measures. 

Usually, the three posterior rotator cuff muscles (Supraspinatus, infraspinatus and teres minor) are underdeveloped and are pulled and stretched out in most people. 

This is because both the anterior rotator cuff (Subscapularis) and the chest muscles (Which are strong and tight due to overtraining) are pulling the shoulder forward, and contributing to bad posture (Rounded / gorilla shoulders).

In this case, exercises that involve external rotation of the arm are highly recommended. 

For instance, side external rotation with a resistance band or cable machine, external rotation with arm abducted, W raises, face pulls with overhand grip or high to low row using D handles and with an external rotation of the arms at the end of the move.

With regard to stretches; and in case of weak posterior rotator cuff muscles (Which are the most common), the subscapuralis and the pectoral muscles and tendons need to be stretched in order for the shoulder joint to sit in its natural space. For the subcapularis, the broomstick stretch is perfect. 3 sets of 20 to 30 seconds hold can be done a couples of times a day for better results.

Now, for the pectoral muscles, there’s a modified version of the doorway stretch which focuses on stretching the muscles and tendons without straining the anterior deltoid like the original version might do. 

The only tweak is to stretch one side at a time by having the front of the shoulder rested on the door frame and the body stretching forward at the doorway space. 

The arm should be bent at 90 degrees and in contact with the wall while raised at shoulder level. This is for pec major. 

As for pec minor, the only change is that the arm now should be reaching upwards while in contact with the wall. 

The stretch is effective if held for 20 – 30 seconds for a few sets daily.