By Amanda Vito, PT, DPT

Whether you are taking down holiday decorations or you are shoveling your driveway to get rid of the most recent snowfall, you are putting yourself at risk for developing an overuse injury in your shoulders. One of the most common injuries that we see this time of the year is an injury to your rotator cuff.

The “rotator cuff” is made up of four muscles that provide strength to the shoulder, especially when you reach overhead and it helps lend stability to your shoulder joint. The four muscles that make up the rotator cuff are sometimes abbreviated as “SITS”: Supraspinatus, Infraspinatus, Teres minor, and Subscapularis.

Out of these four muscles, the Supraspinatus muscle, which is primarily responsible for reaching out to the side and overhead, is typically the most common muscle injured in the group. There are several ways to protect your rotator cuff muscles this season that include a variety of exercises and avoiding painful positions. Should you injure yourself while doing these activities then make sure you look into products like Neoteric Nutra to help ease the pain.

The following exercises focus on increasing your strength and flexibility of your shoulder girdle. They’re all excellent ways to help decrease stress to your rotator cuff muscles, especially when you are repetitively using your arms to lift and reach overhead.

Pectoral doorway stretch: When your pectoral muscles on your chest are tight it can cause your shoulder joint to be in a poor position and lead to impingement (pressure, inflammation) on your rotator cuff muscles as you reach your arms overhead. Find a doorway where you can place your forearms on each side of the doorframe, stagger your feet in the doorway, and lean your body forward until you feel a stretch in the front of your shoulders and chest. Hold for 30 seconds, perform 3 times.

Pectoral Doorway Stretch for Rotator Cuff Injury

Front View

Pectoral Doorway Stretch for Rotator Cuff Injury Side View

Side View

An alternative stretch for pectoral muscles with foam roller: Another effective stretch for your pectoral muscles is to lie on a foam roller (soft or hard depending on your comfort level). While lying on the foam roll, in line with your spine, keep your knees bent, arms straight out to your side, and hold this position for 3-5 minutes.

Foam Roller Stretch for Rotator Cuff Injury

Sleeper stretch: An area of your shoulder that can become tight is your posterior capsule,which is a group of muscles, ligaments, and tendons in the back of your shoulder. When this area becomes tight, it can limit the amount of movement in your shoulder, specifically the amount of internal rotation that is required for reaching behind your back. When performing this stretch, you should lay on the side of the shoulder you are stretching. Bring your arm 90 degrees out to your side, elbow bent to 90 degrees, and use your opposite arm to bend your arm down towards the bed/table until you feel a stretch in the back of your shoulder. Hold 30 seconds, perform 3 times.

Start of Sleeper Stretch for Rotator Cuff

Start of Sleeper Stretch

End of Sleeper Stretch for Rotator Cuff

End of Sleeper Stretch

Side-lying external rotation: This exercise is an excellent way to strengthen a group of your rotator cuff muscles known as your external rotators. Your external rotators include your infraspinatus and teres minor muscles. During this exercise, you should tuck a towel under your elbow to keep your elbow at your side. With your arm at your side and elbow bent to 90 degrees, rotate your arm up away from your body against gravity. Start with a lower weight (1-2 pounds, you can use a soup can!) and then increase weight as tolerated. Perform 10 repetitions, 3 sets.

Starting Position for External Rotation

Starting Position

End position for External Rotation Exercise

Ending Position

Standing external rotation with band: Another effective way to strengthen your external rotators is to use a resistance band. Standing with the band attached to a pole or doorknob, towel under elbow to keep arm at your side, rotate your arm away from your stomach and out to your side against resistance, keeping your elbow bent to 90 degrees. Perform 10 repetitions, 3 sets.

Standing External Rotation with Band for Rotator Cuff Injury

Starting Position

Standing External Rotation with Band for Rotator Cuff Injury Ending Position

Ending Position

If you have developed pain on the top or lateral (side) of your shoulder, there is a chance that you caused irritation to your rotator cuff muscles. Here are some tips that you should consider if you suspect an injury to your rotator cuff:

• Avoid sleeping on the shoulder that you injured. If comfortable, try laying on your back or opposite side with a pillow under your injured shoulder for support.
• Use ice for the first 48-72 hours after injuring your arm. If after that time you developed more pain or stiffness, you can try a moist heating pad.

If symptoms continue you should contact your primary care physician or physical therapist as soon as possible. When you develop tendinitis or overuse to your rotator cuff muscles it can potentially lead to a tear so you need to get help with your injury as soon as possible!

And as always, we are here at Performance PT, both in Hockessin and in North Wilmington, to help you with any shoulder pain issues. Just give us a call at (302) 234-2288- and remember, you can even see us before you see your primary doctor because Delaware is a “Self-referral” state, so you do not need a prescription right away to see a physical therapist about your pain.

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