Let’s
examine the components of the rotator
cuff. The humerus (upperarm
bone) Chart 1, has a rounded head.
The outer side of the head forms the greater
turberosity and the inner side is rounded
and fits into the dish-like joint called the glenoid
cavity of the scapula
bones (scapulae are
the wing-like bones in the upper back).
There
are 4 muscles which comprise the Rotator cuff:
The
supraspinatus, which keeps the head
of the humorus from sliding down and out of the shallow
joint of the glenoid cavity. It originates on top of
the scapula. It makes abduction possible. [An
example of abduction is moving the arm from Mountain
Pose to Warrior II Pose.]
The infraspinatus and
teres minor (Chart
2) work together
to keep the ball of the humerus from
impinging on the
acromium (Chart 5) when lifting
your arms from Warrior II to overhead. When you slump,
the shoulder heads sink forward and cause the head of
the humorus to
squeeze up against the acromium
process.
This habitual squeezing from a slumping
habit causes exaggerated curvature and over lengthening
of the back muscles.
The back muscles, rhomboids, lats, trapezius, erector
spinae, serratus posterior, and levator scapula become
weaker and more likely to tear. If the teres
minor and
the infraspinatus are not strong enough
to hold the humerus firmly
in place, and the scapulae are not in
proper alignment, then the tissue between the acromium
process and the head of the humerus compress (Impingement
Syndrome). (Chart 5)
The subscapularis (Chart
3) is
an extremely strong external rotator and its actions
oppose those of the infraspinatus and teres
minor. [Opposing muscles
help each other keep proper alignment and protect against
movement into unsafe ranges of motion.] Pockets of spacer pads called bursa run
between
bones and the tendons (tendons
connect your muscle to bone).
If the pinching in the rotator cuff is
creating damage to the bursa,
it’s
called bursitis and if it affects the tendon,
its called tendonitis or RCT
(rotator cuff tendonitis). There are
groups of tendons, ligaments (ligaments
connect bone to bone) and muscles that
work as an elaborate strapping system, holding the head
of the humerus in place while at the same time allowing
for the most complex ranges of motion required by the
shoulder joint.
There should be a balance between the flexibility/openness
of the chest and the strength of the back muscles.
If
you are beginning your yoga journey with weak, pre-injured
or deconditioned shoulders remember to work in all ranges
of motion with your shoulders. Allow your body to slowly
re-learn proper alignment and postural balance. If a
yoga asana that requires bearing the weight of your whole
body on your arms, practice at the wall first. You can
do wall plank, wall chaturanga,
wall downward dog and
wall push-ups (puppy-dog pose) to strengthen
the upper arms and shoulder girdle area. Work gradually
into full arm balances such as crow and handstand.
The important muscles to stretch: pec
major and minor (Chart
3), lat dorsi, teres
major, subscapularis, and
anterior deltoids (Chart 2). Fish
posture is a good pose to stretch the anterior delts.
It is necessary to maintain a 3:2
ratio between the strength
of the external rotator and the internal rotator muscles.
Practice standing at a wall in mountain pose, pressing
your scapula into the wall while letting the inside
crease of your elbow face forward (in
the same direction as your nose), while lifting
your sternum (Chart
3) upward without lifting
your clavicle bones (Chart 5) or shoulder
heads.
General guidelines
for strength are rapid, controlled repetitions with lighter
weights. Due to the slow twitch type 1 fibers of the SITS muscle
group, external rotators have lower endurance
and fatigue quickly. HGH (human growth hormone) levels
are activated with higher reps with shorter rest periods
between sets with much lighter weight.
Do shorter lever movement in the beginning stages of
rehabilitation as it requires only moderate strength
(i.e., use a narrow grip while doing a supine chest press).
Avoid upright rows, tricep dips and supine tricep pullovers
if you are working with an injured rotator cuff.
You may do rehabilitative work with your
shoulders, such as is shown in these websites:
Orthopaedic
Associates of Portland Familydoctor.org
PreventDisease.com
NJSportsDoc.com
The Training Station, Inc.
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