Todd Kuslikis

Todd Kuslikis

MMT, MPA
Knee Pain Specialist and Injury Prevention Expert

Rotator Cuff Injury? Put Resistance Bands to Work

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The rotator cuff is a group of muscles and tendons that surround the shoulder joint. Together, they work to stabilize the ball-shaped head of your humerus in it’s socket just below your collarbone. 

A rotator cuff injury can be hard to diagnose because it often causes no pain or weakness until after an incident has occurred. This means that by the time you notice something is wrong, your injury may have become more severe.

Never fear!  Shoulder resistance band exercises may be an option for people with rotator cuff injuries who want to improve strength and endurance without aggravating their condition. In other words, you can get through this!

 

Anatomy

Rotator Cuff Anatomy

More specifically, the rotator cuff is a group of four muscles that attach from the shoulder blade to different parts of your upper arm. These muscles help keep your shoulder in place and provide mobility for various motions such as lifting or throwing objects.  

These are the four, muscles in your rotator cuff:

 

Supraspinatus:

The supraspinatus produces the first 15 degrees or so of motion when you lift your arms, or move them away from your body (abduction). After that, your deltoid and trapezius muscles take over for up to 90° on each side.

 

Infraspinatus:

The infraspinatus is a triangular muscle that covers the back of your shoulder blade deep below the skin. It’s responsible for lateral rotation. 

Think about when you are playing tennis and swing your racquet back to prepare to hit the ball.  You rotate away from the centerline of your body.  

If you stop to think about it, you’ll realize that’s a very common motion not only in sports but in daily life. Because of this, the infraspinatus plays an important role in injury prevention and sports performance.

 

Teres Minor:

The teres minor muscle is a small, narrow muscle located on the back of your shoulder blade just below infraspinatus.  It also assists when you’re trying to rotate your arm outward, aka lateral rotation. 

Remember, the body is a well-oiled machine, and the muscles of the rotator cuff work together!


Subscapularis:

The subscapularis is the largest of the four rotator cuff muscles. It helps rotate your arm towards the midline of your body–internal rotation–making  it especially important for activities like throwing a ball or rotating your body to look behind you while driving. 

It attaches to the front of the upper arm instead of the back.

 

Types of Rotator Cuff Injuries

Partial Tear :

Sometimes a tendon in the rotator cuff can be torn but not completely separated. This is called a partial tear.

 

Complete Tear : 

In this case, the tendons tear away from where they attach at the humerus and break off completely. In a complete tear, the tendon must be stitched back together by medical professionals.

 

Acute Tear: 

These are sudden tears that are caused by an injury or trauma, like a fall or lifting something too heavy too quickly.

 

Degenerative Tear:

Rotator cuff tears can also be caused by repetitive stress over time from.  Some degeneration also occurs naturally with age and increases your chance of injury later on in life.

 

Rotator Cuff Tear Symptoms

Symptoms of a rotator cuff injury can vary widely depending on the type and severity, but some of the most common ones are as follows:

  1. Pain in the shoulder area that may come and go.
  2. Loss of mobility or range of motion.
  3. Pain when lifting or rotating the arm.
  4. Stiffness in the shoulder area.

The sensation of grating or crackling when you move your shoulder in certain positions. We all crackle and pop a bit as we age, but this would be more significant than a few pain free pops.  

Keep track of what you are doing when you hear a new crack.  Look for a pattern.

 

Causes and Factors That Contribute to Rotator Cuff Tears

  • Some of the causes and factors that contribute to rotator cuff tears include overuse, falls, lifting a heavy object too quickly, or repetitive stress. 

  • People who have held jobs that require repetitive stress are often at risk here.  One example is someone who works in construction who consistently lifts heavy boards overhead and hammer in nails.  Or movers who pick up heavy things on a daily basis.
     
  • The most common cause is wear and tear from years of use or favored use of one arm over the other. 

  • Another cause can be trauma-related injuriesSomeone who falls on their shoulder or lifts something too heavy or someone who has diabetes who isn’t being as cautious as they need to be. 

  • Genetics can also play a role in injuries, because sometimes it’s just inevitable that one shoulder would work more than the other.  We all have a favored hand that is attached to a favored shoulder.  It’s normal.
     
  • Bone spurs on the joint could also be a reason that people experience a rotator cuff injury. 

  • It could even be caused by a lack of blood supply. The rotator cuff is notorious for having a poor blood supply. When the rotator cuff muscles don’t receive enough oxygen and nutrients, they become stressed. This, in turn, causes the muscle fibers to degrade which causes weakness, eventually leading to tearing.
 

How to Know if You Have a Torn Rotator Cuff

When to use Knee Compression Sleeves ?Some aches and pains are normal, but how do you know if you have a torn rotator cuff?  If you’re not sure, there are a few things you can check that may indicate that it’s time for an evaluation.

When does it hurt?  If your arm is stiff and sore in the morning or when first waking up, that could be a sign of a tear. Do you have pain when you have consistent pain when you rotate your shoulder out or in?

Another thing to look out for is tingling or numbness when you move your shoulder. There are sometimes pressure points in the area or irritation from scar tissue, but if this symptom persists more than a day or two, it could be a sign of more serious damage.  Call your doctor to find out for sure.

 

What to do When You’re Diagnosed With a Rotator Cuff Injury

If you’re diagnosed with a rotator cuff injury, there are several things you can do to stop the pain and protect your muscles. 

First, try to avoid any activity that might put pressure on your arm or shoulder

Second, do something light and comfortable when you get up in the morning to give your muscles room to loosen up. Save the tight shirts for later!  

Third, ice the area of your shoulder which is hurting after exercising. 

Finally, try to add more protein into your diet so that your body has all the substances needed for muscle growth and repair.  This could be as easy as mixing a supplement into a smoothie in the morning.  Enjoy!

 

Rotator Cuff Injury Treatment Options

A prevalent treatment for a rotator cuff injury is a corticosteroid injection. Doctors inject medication into the shoulder to help decrease the pain and inflammation.

Not only do these injections reduce the amount of time you’ll need to take off from work or school for recovery, but they can drastically reduce discomfort.  

A rotator cuff exercise regimen can be helpful to build strength and prevent future injuries. This also helps stave off the degeneration that occurs naturally with age.  As with all muscles, there is a “use them or lose them” mentality.

Your physician may also recommend physical therapy. There you will have trained specialists who can help guide your strengthening plan

 

Signs You Should Consider Surgical Treatment

Rotator Cuff Surgery CheckSurgery is sometimes necessary, but it can be approached as a last resort.  If you have pain that is always there or that lasts for more than 3 months, it’s definitely an option.

You should also see a doctor if you have any of the following:

  • Narrowing of the space in the shoulder joint.
  • Difficulty in using your arm or shoulder.
  • Persistent clicking or grating sound when you move your shoulder
  • Pain during specific activities, such as lifting your arm over your head, lying on your side to sleep.
 

Rotator Cuff Therapy Exercises That Aid in Recovery 

Rotator Cuff Exercise | Feel Good LifeFor many people, the best type of exercise for rotator cuff injuries is a light warm-up followed by light exercises.

Light exercises such as lifting your arm from different angles and positions are safe, because they’re unlikely to over-strain the shoulder. Heavy weight lifting is not recommended during the recovery period.

The types of exercises that helps rotator cuff injuries include:

  • Weight-free, active, range of motion exercises: performing exercises without weights or resistance bands.
  • Stretching.
  • Shoulder resistance band exercises to increase strength.
 

Relieve Shoulder Pain With Shoulder Resistance Band Exercises 

If you’re experiencing pain from rotator cuff injury, try out some resistance band exercises. Start off slow, because these exercises require stability and strength. Always build stability before adding more resistance.

Try the following exercises with a resistance band to help relieve shoulder pain.  

 

  • Row

One of the best exercises for a rotator cuff injury is a row. This exercise builds muscle and strength in the biceps, deltoids, and back muscles. It can also stimulate circulation and relieve pain.

  1. Loop a resistance band around a door knob and close the door. Be careful to make sure the door is secure and won’t open on you. 

  2. Hold the ends of the resistance band, draw elbows back–keep them close to your body–while also pulling shoulder blades down and back. You should feel this in your back. Then reach forward.
 
  • Internal Rotation with a Resistance Band

The IR is a great exercise for strengthening subscapularis:

  1. Loop a resistance band around a door knob and close the door. Be careful to make sure the door is secure and won’t open on you. Place a rolled up towel under your armpit.

  2. Stand sideways to the door with your painful shoulder closest to it. Keeping your elbow bent 90°, grasp the resistance band with your palm up. Draw your hand to your belly button, rotating internally.  If you’re holding the towel, your elbow should naturally stay tucked tightly in towards your body.  Relax and repeat.

  • External Rotation with a Resistance Band

ER with a resistance band is the great exercise for the remaining three rotator cuff muscles.  

  1. Loop a resistance band around a door knob and close the door. Be careful to make sure the door is secure and won’t open on you. Place a rolled up towel under your armpit.

  2. Stand sideways to the door with your non-painful shoulder furthest from it.

  3. Grasp the resistance band with your palm up.  Then, draw your hand away from your belly button.  Relax. Be careful to keep your elbow tucked close to your body and rotate your arm out keeping your elbow bent vs extending your elbow.
 

How Long Does it Take to Heal a Rotator Cuff Injury?

The rehabilitation process can vary in time depending on the severity and scope of the injury. Most people experience improvements in their pain level within 6-12 weeks, but it can take up to 12 months to fully heal. 

If the rotator cuff is torn at a tendon, it will most likely take about six months for that area of damage to fully heal. Tendons take much longer, because unlike the muscles, they don’t have a significant blood supply delivering the nutrients necessary for repair. The less blood flow there is, the longer it takes.  

If the tear in your shoulder increases, surgery may be necessary and can mean up to 12 months of recovery time.

 

Dos and Don’ts in Managing Rotator Cuff Pain

If you have a rotator cuff injury you should avoid following activities:

  • First, avoid heavy weight lifting, because it can risk increasing damage to the rotator cuff muscles. That is opposite to what you should be aiming for during recovery.

  • Second, be careful not to sleep on your injured side with your arm overhead, because this will cause pain. You should also refrain from carrying too many items in one hand and pulling on an object that is overhead with the injured arm. 

  • Third, wear a sling when resting for a few hours to alleviate pressure and pain on the rotator cuff. 

  • Finally, try not to stretch or ice your arm for more than 20 minutes at a time, because this can cause more inflammation or swelling.
 

How can a Rotator Cuff Injury be Prevented?

In order to prevent a rotator cuff injury, regular exercises should be performed to strengthen the shoulder and encourage range of motion. Weak, inflexible muscles are more susceptible to tears.

Throw in a warm up prior to any task that will stress the joint.  This reduces the chance of microtrauma or injury later on during the activity. 

Finally, repetitive motions with a high risk of causing damage must be avoided as much as possible since they contribute towards injuries/microtrauma over time if repeated often enough without rest periods between sets. 

If you have a job or hobby that involves repetitive movements, be sure to take breaks.  And as always, consciously strengthen muscles involved in the movement.

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