Rotator cuff injuries are one of the more common injuries that people who regularly go the gym will complain of.

Men - in particular - who work out regularly tend to ignore this problem often causing irreparable damage.

What is the Rotator Cuff?

The four rotator cuff muscles are primarily stabilisers of the shoulder joint and help to keep the upper arm in place against the shoulder blade. The four muscles are supraspinatus, infraspinatus, teres minor and subscapularis.

A rotator cuff injury is a condition where one of the four muscles in the shoulder becomes injured

Causes of Injury

Rotator cuff injuries can occur from a fall or a specific activity, become progressively worse from a chronic postural condition, or become hurt by rolling over in bed or brushing your hair. The pain can range from the odd twinge or ‘catch’ to that of being acute. Either way the range of movement is always impaired.

The most common causes of rotator cuff pain in gym goers are chronic tears caused by excessive shoulder activity (usually without optimal body mechanics to begin with), or Tendonitis caused by repetitive trauma to the muscle with everyday wear and tear caused by poor posture.

The ranges of injury types to the shoulder are quite vast, from inflammatory tendonitis type conditions, to torn rotator cuffs that require surgery.

Symptoms

The symptoms of rotator cuff injuries include pain (usually in the dominant arm), a decrease in ability to move the arm especially out to the side, a deep ache in the shoulder but also felt on the outside upper arm and pressure point tenderness.

Shoulder pain can also be a symptom of other illnesses, such as heart conditions.

What Makes It Worse?

Rotator cuff problems are typically worsened with movement or the onset of exercises that involve the arms and shoulders. If your pain is not affected by movement you should call your doctor. If you are unable to move your arm or shoulder it would also be wise to refer to your doctor regarding a possible tear that may require specific treatment.

Rehabilitation and Self Care

Most people will not have torn their rotator cuffs and can rehabilitate their shoulder themselves or with the help of an experienced osteopath and corrective exercise specialist.

Self care of an injured shoulder will typically involve resting the injury at first and applying ice and heat intermittently to reduce any inflammation and swelling.

Once pain is decreased to the point that exercise may be undertaken then it is essential to get the person into optimal alignment of posture as quickly as possible, and to improve their movement patterns so that the shoulders are not taking any more excess load than they should.

The Importance of Posture

Alignment

Aligning posture should be the foundational part of any exercise programme, for without optimal posture then the body will function by increasing wear and tear on joint structures that are not designed by nature to operate in that way. Many people do this every day without any pain, but the likelihood is that you will have problems at some point in the future, especially with increased movement such as exercise.

Improving posture is quite an individual thing, however. The basic tenet is that you should stretch the tight muscles, and strengthen the loose muscles. As you can imagine, there are as many different tight/loose muscle combinations as there are people. This is why a proper biomechanical assessment is crucial. Typical findings from an assessment such as these in clients with rotator cuff injuries are protracted shoulder blades, elevated shoulder blades often unilaterally, and forward head posture.

Pectorals

These postural findings are accompanied by tightness in the pectorals, the scalenes in the front of the neck and the upper fibres of the trapezius muscle. This would also indicate that the person is then relatively loose and weak in the opposing muscles: the middle and lower trapezius muscles and the deep cervical neck flexors.

Forward Head Posture

Forward head posture can be seen as one of the major causative factors in rotator cuff injuries because it is as a result of the head coming forward from the mid-line of the body that the muscles in the sides of the neck and shoulders increase their tension as a coping mechanism and this then throws out the alignment in other areas.

Whilst this article is focusing on rotator cuff injuries, it is just as likely that forward head posture could contort a person’s whole posture enough that as a chain reaction their pelvic tilt increases, their knees drop inwards more, and they develop a lower extremity injury.

Holistic Factors

So what holistic factors can we implement to correct forward head posture?

Breathing

Very simply, we need to learn how to breathe again. I say this because most people that come for biomechanical assessments with forward head carriage are also chronic mouth and chest breathers – an inverted pattern of breathing where the chest rises first on inhalation through the mouth, instead of the nose.

Breathing should be done through the nose as breathing through the mouth promotes the head coming forward in an effort to open up the windpipe and bring in more oxygen. Obviously there are biomechanical factors at work here too that are causing certain muscles to become tight and others to not work, but the cause is the breathing through the mouth in the first place. Practicing your breathing on a daily basis is very beneficial then for improving a persons posture, so find time to lie or sit down and breathing solely through the nose allow your abdomen to inflate on inhalation and then to drop down on exhalation. Breathing in this way will relax your neck muscles and allow you to work the muscles in the reverse of your neck and upper back.

Nutrition

Another factor of a person’s lifestyle that will affect their rotator cuffs is their nutrition. If a person is eating poor quality foods that are processed and full of additives that are aggravating their system then this will leave them with systemic inflammation that will compound and make a tendonitis injury much worse. There are also many foods that will block the nasal passages from being fully open and will contribute to a person’s forward head posture by forcing them to breathe through the mouth as their only way of getting oxygen in.

Once again, much like exercise prescription, diet is also entirely unique based on the individual, however there are some general rules you can follow to improve the health of your rotator cuffs by changing some of the foods you eat.

Eliminatinating all sugar, dairy and gluten containing grains from your diet for a period of time and increasing your intake of water will calm your whole system down. All of these foods have been shown to increase inflammation, and dairy is particularly associated with blocking the nose with a mucus-type build up for sensitive people.

Alternative Therapies

Soft tissue manipulation, Homeopathy and Acupuncture are particularly effective in speeding up the process of repair. At Lifesmart we have had tremendous success with elite sports people and stunt men and women in using Homeopathy to speed up the healing of injuries.

This feature was sponsored by Lifesmart at the Albany (www.lifesmart.co.uk)