Ask The Trainer #73 – Rotator Cuff Injury

Ask The Trainer #73 - Rotator Cuff Injury

QUESTION: 

Hi Chad,

I am 46 years old and I’ve been training for the past 26 years. I’m all natural and train because I love to do it. Yes, it is nice when people give you compliments, but the fact that I love it is the main reason I do it. I like to read all of your advice. That is why I have a question myself. The past 6 months I’ve been struggling with shoulder pain. My doctor said it’s an injured rotator cuff. Is there a way of training around this injury, because it makes me sick to not be able to train. Thanks much.

TJ


ANSWER:

Hi, TJ. I’m going to proceed with caution giving you an answer here because I’m not sure exactly how severe your injury is. Hopefully, you were able to have this injury evaluated by an orthopedic specialist who could accurately determine the extent of the injury you’re dealing with.

A qualified doctor would typically take you through a series of range of motion and strength tests, then possibly order an MRI to get a more thorough grasp on all the aspects of your injury.

The rotator cuff is composed of small muscles: The Infraspinatus, the Supraspinatus, the Teres minor, and the Subscapularis. These muscles work together to keep the ball part of the humerus bone in the socket.

When you think about it, this small group of muscles doesn’t provide a confident level of stability for the shoulder joint. That is, at least not compared to other joints. This is why rotator cuff injuries are so common. When a doctor says you have a torn rotator cuff, that typically means either one or more of the four rotator cuff muscles, or tendons attaching those muscles to the humorous, have sustained some degree of tearing.

Strength imbalances throughout the shoulder are the primary causes of rotator cuff injuries. Most bodybuilders and weightlifters generally have a tendency to place much more emphasis on exercises that build muscles on the anterior (or front) part of the body, than those on the posterior (back) part of the body. I guess that’s because they focus more on the muscles they can see standing in front of the mirror. In other words, they generally focus more on pushing exercise than pulling exercises.

This can lead to a strength imbalance where the muscles in the front part of your shoulder become more developed than those in the rear part of the shoulder. This causes the shoulder joint to pull forward, placing more strain on the rotator cuff.

Think of your shoulder like a canoe, with 1 person in front and 1 person in the back. The person in front has a 6-foot long paddle and the person in the back has a 3-foot long paddle. As they attempt to paddle the canoe straight, it sways back and forth, never sailing smoothly because of the mechanical differences between the two paddles.

It’s the same type of scenario when it comes to your shoulder joint. Your front deltoid is the long paddle and your rear deltoid is the short paddle. Your shoulder joint cannot function smoothly, leaving you vulnerable to soft tissue injuries.i-KGWwrZS-M

That being said, you’re going to want to CAREFULLY devise a well-balanced strengthening routine, with an emphasis on rear posterior deltoid exercise, such as reverse flyes. This will balance out the strength of your shoulders to help prevent future shoulder injuries.

It is MANDATORY you start with very light weights. Don’t worry about getting a pump, or setting any new PRs, because that’s not going to happen until your shoulder is fully healed. For the time being, avoid ALL movements that cause pain! That means avoid overhead movements or any range of motion that triggers pain. DO NOT work into the pain! Doing so will only exacerbate your injury and delay your recovery.

For now, you should focus on exercises that will help strengthen your rotator cuff, so you’re able to tolerate a regular weightlifting routine sooner than later. You’re going to stick with light weights for these exercises. I mean like 5-10 pounds sort of light!

Perform 3 sets of 15-20 reps on each exercise. If you can’t perform this many reps, you’re using too much weight, and it’s time to lighten up. Since you’re not stressing your shoulders intensely, you can do these exercises 3-4 times per week, or every other day until you’ve regained significant strength and range of motion.

Here Are The Exercises:

Lying Front External Rotation: Begin by lying face down on a bench with a light dumbbell in your hand. Take the 1 arm holding the dumbbell and bend the elbow at 90 degrees, then allow the dumbbell to rotate towards the floor until your knuckles are aiming directly at the floor. Keep you keep your elbow stead at the same height as your shoulder. Rotating your shoulder, slowly raise the dumbbell until your hand is at the same height as your elbow and shoulder. Repeat this motion for 15-20 reps. Pass the dumbbell to your other hand and repeat this same movement with your other arm.

Lying Side External Rotation: Begin by lying down on a bench on your side, with a dumbbell in the hand of the side opposite from which you are lying on. Bend that arm at a 90-degree angle while keeping your arm at your side. The underside of your forearm should be resting against your ribs. Again, the knuckles of the hand holding the dumbbell should be aimed towards the floor. Keeping your elbow bent, use your shoulder to slowly rotate the dumbbell up away from your body until your hand and the weight is level with your shoulder. Slowly lower the dumbbell back into the beginning position. Repeat this motion for 15-20 reps. Pass the dumbbell to your other hand, turn over to your other side, and repeat this same movement with your other arm.


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Lying Side Internal Rotation: Begin by lying down on your side on a bench. This time you will be holding the dumbbell with the same arm as the side you’re laying on. The outside of your shoulder and triceps of the working arm will be on the bench. Roll up a towel and use it as a pillow to support your head. Again, bend the elbow of the side you’re lying on at a 90-degree angle with your knuckles aiming towards the ceiling. Your elbow will be resting on the very edge of the bench. From your elbow down to your hand will be aimed straight up with the underside of your upper forearm resting against your side. The dumbbell will be at about the same height as your opposite shoulder that’s aiming away from the bench. Your arm should look like an “L” turned sideways. Keeping your arm bent, slowly lower the dumbbell down and allow it to descend until your hand and the dumbbell are aligned with the front part of your shoulder that’s against the bench. Your knuckles will be parallel to the floor. Do NOT allow the dumbbell to descend lower than the bench! Next, using your shoulder, slowly rotate the dumbbell up, bringing your forearm to the side of your body, back into the starting position with your knuckles aiming at the ceiling again once again. Repeat this motion for 15-20 reps. Pass the dumbbell to your other hand, turn over to your other side, and repeat this same movement with your other arm.

Depending on the severity of your injury, it may take a couple weeks, or even months, for your injured shoulder to completely regain full strength and range of motion. Also, based on personal experience, I feel confident mentioning that both acupuncture and laser therapy are effective for accelerating the healing time of soft tissue injuries like this.

I hope this advice helps and I wish you a speedy recovery!

Prove ‘Em Wrong,
Chad Shaw

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