Workout can benefit rotator cuff

     By Mike Springer
     View columnist
      The rotator cuff is a group of muscles in the shoulder that is usually not specifically addressed during a workout program. For most individuals, the rotator cuff is not a concern until it is impinged or torn.
      The four muscles which compose this group are: the supraspinatus, infraspinatus, teres minor and subscapularis. More important than knowing the specific functions and locations of each muscle is to understand that they all work together to tightly hold the ball and socket of the shoulder joint together.
      Since the shoulder joint is mobile in so many directions, there is higher chance of injuring the weaker areas. Overuse, whether it is through sports, exercise or occupation, is the most common cause of impingement in the rotator cuff.
      When the arm is in an upright position, the rotator cuff tendons tend to rub against the bony undersurface of the shoulder blade, causing a slight tearing and inflammation called impingement.
      Once tendinitis starts in the rotator cuff, the inflammation following just makes matters worse as there is even less room for mobility. Picture a rope being pulled back and forth across a jagged rock repeatedly -- it will eventually start to fray. This is what is happening in the shoulder.
      A therapist can easily diagnosis tendinitis by simply touching the patient. By rotating the arm backward and away from the body, the rotator cuff tendons become exposed from under the shoulder blade.
      Touching them usually will make the patient cry out. Of course, diagnosis should always be left to a professional. If there is a more serious underlying problem, an MRI might be the next step to specifically pin-point the extent of the injury.
      Once the severity is understood, treatment can then begin.
      Nonsurgical treatment is, of course, the best and first option for impingement and weakness in the rotator cuff. Athletes who play racquet sports or baseball/softball are most susceptible to these types of injuries as their arms are raised over head.
      The most common exercises for the rotator cuff now being seen more commonly in the gym are internal and external rotation. Whether these exercises are performed with a free weight, machine or resistance tubing, consistency is key to recovery.
      By including these simple exercises into your upper body routine, most individuals will notice marked improvement in strength not only in the shoulder but other areas of the upper body. A regular routine of icing the area inflamed should also be included.
      As chronic irritation of the rotator cuff continues due to impingement, the muscles become thickened and weakened and may result in degenerative tears of the rotator cuff.
      Surgery is always the last option when all other methods are not proving to be effective. The surgery eliminates the mechanical problem in the shoulder.
      If there is a tendon tearing, they are stitched to prevent further damage. Sometimes a bone from the under-surface of the shoulder is sliced to allow more room for the tendon to move.
      Also, the coracoacromial ligament is often removed because it is overly tight, causing the tendons to be pushed down. Of course, each diagnosis and surgery can vary from person to person.
      The one topic not yet discussed regarding the rotator cuff is prevention. Prevention is the best way to stop irritation and tears from occurring in the first place.
      A workout program designed to incorporate the rotator cuff and address weaknesses in the upper body is best. Next, ice and rest can only help to reduce any damage which might already be developing.
      See your doctor at the earliest sign of a problem and exercise smartly.
     
     Mike Springer and his wife, Kim, are certified by ACE, NASM and ACSM as personal trainers. They can be reached at 233-9442, by fax at 233-9446 or by e-mail at springtrain@ netscape.net.