The Rotator Cuff is a group of four muscles originating from different parts of the Scapular (Shoulder Blade) and attaching to the Humerus (upper arm). These muscles work together to stabilize and move our Shoulder through its large range of motion. The Shoulder is a ball and socket joint and has sacrificed a level of structural stability shown in most of our joints to allow the mobility we have at this joint. The Rotator Cuff is therefore relied on heavily to keep the humeral head (ball) centralized in the glenoid (socket) and keeping it strong, or improving it's strength after injury, remains very important. Additionally it is useful to improve the control of the Scapular in order for there to be a stable base for the arm to move on. STABILITY IMPROVES MOBILITY!
As the video above demonstrates, the shoulder is a complex joint with lots of movement in lots of directions. Furthermore, movement of the shoulder relies upon a coordinated interaction between the rotator cuff muscles and other large muscles such as the pecs, lats and deltoids. Additionally, the movement of the shoulder blade must be controlled for their to be a stable platform. Therefore, when we train the rotator cuff muscles to become stronger, we need to use exercises that train them in a way that is functional, multi-directional and relevant to your recreational, sporting or occupational pursuits. This is where traditional exercises involving elastic bands or light dumbbells can be insufficient and not sufficiently challenging to strengthen the shoulder.
There are literally hundreds of ways to develop specific, functional and challenging rotator cuff strength, even when recovering from an injury. Your physio should be able to tailor an exercise for you to achieve this goal. The videos that follow demonstrate three very effective exercises for developing good rotator cuff strength and shoulder blade control, and they are far more challenging and functional than generic band or dumbbell work.
In this first exercise, theraband is used to bind the arms together at the wrists. Holding tension outwards onto the band, rotate your palms slightly outwards and keep your elbows and wrists in line. The wrists are then placed onto a foam roller on a wall with the shoulders at approximately 80 degrees elevation. From here, move the roller up the wall (so it rolls down your arm to the elbow) by reaching upwards. Focus on keeping the outwards tension onto the band and maintain your wrist, elbow and palm position. This exercise really works the external rotator muscles and serratus muscles of the shoulder!
This second exercise is known as a 'face pull'. This exercise is popular among gym goers lifting heavy weights, especially in bench press and military press. It makes a good warm up to recruit the rotator cuff muscles and facilitate good posture. In isolation it is also a great way of strengthening the shoulder for overhead activities. To do this exercise you will need cable pulleys, or elastic tubing can also substitute. Hold on to double handles on the cable machine, with the pulley at shoulder height. Begin by retracting your shoulder blades. Then, draw your elbows back so they are bent to around 90 degrees. From here, rotate the shoulders back so the cable is pulled in to your face (hence the name face pulls). Focus on a slow controlled squeeze. Your arms will be in a 'stop sign' position. From here, return to the start position in the reverse order.
In this final exercise, another area of rotator cuff training is highlighted. In our sporting population, especially throwing athletes or racquet sport athletes (cricketers, javelin, tennis) the rotator cuff not only needs strength, but also good reaction times and control. There is not much point in having a strong muscle if we cannot contract it quickly enough to stabilize the ball and socket joint in a demanding situation. For this exercise, the arm is held out to the side with the elbow bent at 90 degrees. Holding this position, bounce a ball (ideally a springy yoga ball or bouncy ball) against the wall by rapidly rotating your shoulder back and forth and flexing your fingers/wrist. This challenges reaction time and control in the rotator cuff muscles and trains their endurance.
So in wrapping up - there is more to rotator cuff strength than just rotating your arm with a band or dumbbell for resistance! For the best results you need to develop strength and control in a way that is functional and challenging. This will depend on what you need to do with your shoulder and what injury you are recovering from. Talk to your physio about the best ways to strengthen your shoulders and start seeing progress.
The Gap Physio