The most common shoulder injury is the rotator cuff muscles. The two most common mechanisms of rotator cuff injuries for weight lifters are from behind the neck military presses, and from the bench press. Both of these exercises put strain on the rotator cuff muscles, especially if already weakened and/or performed improperly.
The rotator cuff has clinical importance because subsequent tearing of its tendons is a rather common pathology which results in restriction of the shoulder movement. The cuff is composted of four muscles, known as the SITS muscles: supraspinatus, infraspinatus, teres minor, and subscapularis.
VERY IMPORTANT - If a rupture of the rotator cuff muscle(s) is suspected, please see your primary health care provider or schedule and appointment with an orthopedist to have it properly examined.
If it is a sprain/strain injury, then the following are a few tips on rehabilitating the injured rotator cuff muscle(s). I recommend extremely light weights (surgical tubing/band work being my preference). This is a perfect example of less resistance and higher repetitionss being most beneficial, as these are very small, thin muscles that are not designed to be exercised for size and strength. They are quite vulnerable to injury, so treat them that way and by exercising them for endurance and stability, which is exactly what they are designed for. My recommendation is three sets, ranging between thirty and forty repetitions for the four rotator cuff exercises described below (no breaks or rest period required between sets or exercises). I typically instruct my patients to do one set of each exercise, then start over until three sets of each exercise has been achieved. These exercises should be performed at least every other day, three to four days a week for six weeks.
First, attach a band to fixed point at the approximate height between your waist and your shoulder. Next, stand at a point of tension facing away from the band’s attachment point, arm extended out from the shoulder and forearm flexed at the elbow (90 degree angle) so your fist is pointing straight up. Then internally rotate arm at the shoulder joint against band resistance. This motion should be similar to the forward motion of the arm when throwing a football. The second exercise is the exact opposite, with the arm in the exact same position, but now facing the point of band attachment, you are going to externally rotate the arm at the shoulder joint against band resistance. This motion should be similar to the backwards motion of ****ing back to throw a football. The next two exercises are opposites of each other as well, and can be used without changing the position of the band. With your arm down at your side and your forearm flexed at the elbow (90 degree angle) and facing away from the band’s point of attachment, internally rotate arm at the shoulder joint against band resistance (internal rotation is rotating inward towards the body). For the next exercise, while facing the band’s attachment point with arm in the exact same position, externally rotate arm at the shoulder joint against resistance (external rotation is rotating outward away from the body).
These above mentioned exercises are also very good warm-up exercises for the rotator cuff to prevent injury. If prone to these types of injuries, you should perform these exercises before every chest and shoulder workout. Also, it is quite common to have chronic rotator cuff injuries and pain due to incorrect posture; the most common is a slump or forward shoulder carriage. What makes this so common is the over-working of the chest muscles, without proper stretching, causing them to overpower their protagonist muscles (rear deltoids, rotator cuff, trapezius, rhomboids, & latissimus dorsi muscles). Therefore, proper stretching of the chest muscles, both before and after workouts, is quite important in preventing rotator cuff problems as well.
Sorry for no pictures, I will try to either find some online or scan them in on my computer and add them to later posts. If you have any questions or comments please feel free to share!