Importance of the Rotator Cuff

The rotator cuff is of paramount importance for athletes that perform overhead activities. This is any sport that requires the hand to go above the shoulder and/or head level i.e. baseball, swimming, volleyball, weight lifting, golf and many more.

The shoulder is a complex ball and socket joint that allows for great multi-directional mobility, but also allows for an unstable joint. Unlike the knee (a hinge joint) which mainly goes front to back with minimal rotation, the shoulder can go in various directions at any one time during activity. This is where the importance of the rotator cuff comes into play. The rotator cuff is made up of a group of four muscles (supraspinatus, infraspinatus, teres minor and subscapularis) that attach from the scapula (shoulder blade) to the head of the humerus ball. The function is to lift the ball of the humerus into the socket to increase function and stability and rotate the upper arm. It is also important in decelerating the forward motion and rotation of the arm when performing throwing, spiking and free style swimming motions.

Strength deficits in the rotator cuff result in reduced efficiency during performance and the shoulder can be put in jeopardy and predisposed to injury. Much of the stress caused by these activities can be prevented or minimized by proper rotator cuff strength and function. Typical rehabilitation exercises for the rotator cuff patient in physical therapy can also be utilized as a preventative measure prior to dysfunction.

There are basic exercises that can be performed during off season and prior to your activity. These exercises can be done anywhere, anytime using light weight (1lb – 5 lbs) or with resistance bands. For instance, to work your right rotator cuff with weights, lie on your left side hold your elbow in a fixed 90 degree angle with your right elbow stabilized on your right hip. Starting with your hand on your belly button lift your hand slowly to just above hip level and pause then lower slowly to the starting position. Generally 3 sets of 10 repetitions without an overexertion on the last few repetitions is adequate. Resistance bands use the same body position and arm motion from a standing position with the band fixed at waist height to a stable fixture. These exercises can be performed 3 – 5 days per week and prior to your activity as a warm up.

Posture remains one of the most overlooked and simplest means to improve the function and reduce stress on the rotator cuff. Forward shoulders, slouched posture and muscle imbalances can contribute to decrease the amount of space the rotator cuff tendons have to glide under the acromion process (the bony tip of the shoulder) leading to inflammation.

In essence, maintaining good strength and health of the rotator cuff incorporated with proper posture will keep athletes at optimal performance and diminish lost competition time in season.

Mark Hornick, P.T. graduated from The University of Texas Southwestern in Dallas, Texas with a B.A. in Physical Therapy. Mark has been working in the outpatient orthopedic clinical setting for over 20 years. Mark is the Lead Therapist at the Atascocita Physical Therapy Clinic and the Fall Creek Physical Therapy Clinics associated with Fondren Orthopedic Group LLP. Mark and his staff provide Physical Therapy for patients referred from Physicians throughout the Houston area including, Dr. Ken Korthauer, Dr. Jay Muscat, Dr. Scott Stanislaw, Dr. Razvan Scobercea and Dr. Matthew Jordan.