MEET THE ROTATOR CUFF
Introducing the rotator cuff muscle group.
Muscles you ask? That is right! The rotator cuff is a fancy way to describe a group of four muscles and associated tendons that attach the humerus (upper arm bone) to the scapula (shoulder blade) and create what is commonly referred to as the shoulder joint.
Many clients come in seeking bodywork after their doctor diagnoses them with a rotator cuff injury. Often when I inquire if the doctor took the time to explain what the rotator cuff was, they sadly say no. Taking the time to learn about the body you live is a helpful tool allowing you to become an active part of the healing process.
So let us take a deeper look.
The shoulder joint also known as the glenohumeral joint makes it possible for us to do many of the activities we love, such as playing a musical instrument, climbing, walking our dogs and so on. It is made up of four muscles which work with together to stabilize the shoulder and allow for a large range of motion. Three of these muscles – supraspinatus, infraspinatus, teres minor – are located on the posterior aspect of the scapula,thereby laterally rotating the shoulder away from the midline and one muscle – the subscapularis is on the anterior aspect, on the underside, of the bone; internally rotating/moving the humerus forward and inward.The top rotator cuff muscle known as the supraspinatus also works with the deltoid muscle to lift the arm up and to the side.
To understand why so many of us have upper back pain it can be helpful to explore deeper into how these rotator cuff muscles work. Muscles work in opposing pairs so that when one muscle or group shortens the opposite group are pulled long. Pain is most commonly felt in the group that is pulled long, yet the shorten muscle is typically the culprit and it is helpful to release and lengthen that muscle.
The infraspinatus and teres minor located below the spine of the scapula both laterally rotate the shoulder and arm where as the subscapularis, in front, medially rotates the arm. Medial rotation is used when we are on computers, texting, driving and other front facing activities. Because we use it so often this muscle is often over contracted and tight due to the rotation. When the subscapularis is pulled tight the infraspinatus and teres minor are pulled long potentially causing pain and weakening of the muscles in the upper back, where so many people complain of discomfort. By opening the front body the subscapularis can be lengthened releasing the tension of the posterior muscles. It is also helpful to strengthten the muscles that are being pulled long. In this case the infraspinatus. There are many external rotator exercises that can be performed and gomukhasa is a wonderful yoga asana to help balance the muscle groups.
There are many common injuries of the rotator cuff that come from repetitive use. A few examples are; tendonitis, bursitis and tears in the rotator cuff tendons. We have many tools in the world of bodywork to assist the healing and improve function of injuries in this area. A skilled yoga teacher will have an understanding of the relationship between these muscles in order to safely guide students through beneficial asana practices. A skilled massage therapist will be able to help release the tension necessary to bring the muscles into balance to improve performance and reduce pain.