ROTATOR CUFF EXERCISES ARE ALL ABOUT KEEPING HEALTHY SHOULDERS

The primary reason we have arms is to move the hand to different positions so you can use your hand. This means that the arm has to be able to move a lot and once the hand is where you want it to be, the arm is held still. The four rotator cuff muscles that surround the shoulder joint play a big role in making sure the way that the arm bone and shoulder blade are connected stay in healthy positions while we move the arm to prevent injury and long term damage to the joint. Strengthening these muscles with exercises like this one helps keep the shoulder joint healthy.

HOW ROTATOR CUFF EXERCISES CAN REALLY HELP US 40's AND UP LADIES SPECIFICALLY:

Much of the damage done to our bodies is when we are in our 20-30s, small amounts of damage over the years add up - examples are poor posture, working out with poor form, repetitive job tasks - repetitive lifting, too much sitting (desk jobs), especially when the chair, desk, computer set-up is incorrect and previous injuries - car accidents, falls, sports injuries. The body has an amazing way of compensating by using other muscles, or moving in different ways to accommodate for tight, weak or painful joints and muscles. Many times we are completely unaware of this, but eventually, it catches up. 

Wear and tear over time, with the development of compensatory movement is the most common case for people to be in physical therapy, and mostly in people between the ages of 40 and 60. Fortunately, that is an age group that can still make a great difference in their physical abilities if they know what to do and what not to do. 

Damage and weakness of the rotator cuff muscles can be caused by normal daily activities such as using a computer, texting, driving, reading, eating, cleaning, all involve using our arms in front of us, frequently with our shoulders rounded forward, slouched posture, and forward head. This position tightens the pectoralis muscles, and pulls the shoulders forward and into internal rotation, decreasing the space where one of the rotator cuff muscles travel through. Over time the joints of the upper back and ribs will become stiffer and the muscles of the back will weaken due to disuse. In the beginning you may not feel any restrictions, pain, or be aware of any weakness. If you continue down this path and don’t correct your posture, strengthen, and stretch, the joints will become even more restricted and the muscles weaker. The body has an amazing ability to compensate without awareness. You may begin to stand on your tiptoes to reach objects without realizing that your shoulder motion is limited. 

As we age we do lose the elasticity of the soft tissues - the tendons and ligaments become stiffer. This makes them more prone to tearing (imagine a new rubber band that can easily be stretched, compared with an older one that may crack because it is not as stretchy). The production of the fluid in the joints can decrease (although it increases with movement). This reinforces the importance of taking time to warm up properly before exercise. 

Additionally, disease processes can affect the rotator cuff muscles: for example, cardiovascular disease, diabetes, hypothyroidism all can affect the health of the tissues. 

Stretching, strengthening, and correcting posture and movement can improve the health of the rotator cuff muscles and prevent future injury. With age you will lose muscle mass, beginning at 40. Exercise can prevent or reverse muscle loss - it is possible to gain strength even at 90 years of age. Bone density can decrease (with disease - osteoporosis/osteopenia) which can be slowed/reversed with exercise.

IDEAS FOR WHEN TO DO THESE MOVEMENTS:

PART OF DYNAMIC WARMUP: These are great to do as a part of a dynamic warm-up prior to working out. Warm-up movements increase blood and lymph (part of the immune system) flow, warms the connective tissue (muscle, tendons, ligaments, fascia) to improve their elasticity (will stretch instead of tearing), “wakes up” the muscles that will be worked - brings awareness to the muscles to improve the mind-body connection by actively contracting the muscles.

ON A REST DAY: Muscles get stronger by working them to the point of fatigue, this results in tiny tearing, called microtrauma of the tissue. The message sent to the brain is that the muscles are not strong enough to do the job that the body is trying to do. The response from the brain is to strengthen the muscle in order to improve its capability. Rest days are needed to allow the tissues to heal and grow. Part of the healing process is to remove the wastes and send in nutrients. Gentle movement will accomplish this.

END OF WORKOUT: If your goal is to improve the strength of the muscle it is important to fatigue the muscle. Adding these exercises to the end of a workout is a nice way of making sure that you have included some exercises that specifically address the rotator cuff muscles, in addition to making sure that you have properly fatigued the muscle. 

WHEN SHOULDERS ARE FEELING “STICKY” DURING WORKOUT: Motion is Lotion - moving improves the mobility of the joints and soft tissues. “Sticky” areas in movements can be caused by a number of things - poor joint mobility which can be caused by insufficient joint lubrication (synovial fluid), stiff ligaments, or tightness or stiffness of the muscles, tendons, or fascia. Movement can help in all of these cases: increases the synovial fluid in the joints, increases the temperature and therefore the elasticity of the muscles, tendons, and fascia by increasing blood flow.

Fascia is a thin sheet of connective tissue running throughout the body between the muscle and the skin. The fascia allows the skin to be able to glide effortlessly over the muscle (you can feel this by taking your fingers and gently moving the skin over the underlying muscles. Sometimes you get restrictions in the fascia where it no longer glides smoothly with movement (frequently happens around scars). Tendons run in sheaths of connective tissue and are surrounded by a layer of fluid, sometimes the tendon can get hung up somewhere in the sheath and feel caught or stuck, movement can help to loosen this restriction. By warming up with larger, fluid, movements that combine many directions of motion you “floss” the tendons in the sheath and improve the ability to glide these soft tissues. Leading to freer, unrestricted movement. 

HOW FREQUENTLY CAN THESE EXERCISES BE DONE?

Exercises that work the endurance muscles can be done daily. This includes core exercises, balance and stability training. The muscles work at a low level for a long period of time every day. The reason for giving a rest to the larger power muscles is that in order to strengthen those muscles you need to use heavy weights and push them to the point of failure - actually causing small tears in the tissue. The muscle needs a day to make the repairs to the tissues. The endurance muscles are worked at a low level for an extended period of time, the training is more focused on form and muscle re-education as opposed to muscle failure.