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Beyond Mirror Muscles: Rotator Cuff 1

Posted on 10.24.12

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A balanced shoulder maintains stability of the joint and neutralizes undesirable joint movement. When the rotator cuff is fit and healthy, it helps serve both of these functions.

The muscles we don’t necessarily see in the mirror, but which should probably be working.

The Rotator Cuff (RTC)

  • Supraspinatus (most commonly affected in RTC tears 4,5)
  • Infraspinatus
  • Teres Minor
  • Subscapularis

Scapular Stabilizers (Muscles that help stabilize the shoulder blades)

  • Levator Scapulae (Typically need stretching)
  • Rhomboids
  • Serratus Anterior
  • Upper, Middle, and Lower Trapezius
When trained, these muscles can help provide stability to the shoulder. The following are two exercises that can help address shoulder muscles needing attention in a strength program.
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Standing Shoulder External Rotation At Side
C.J. Eberley

Standing External Rotation: Start

Standing External Rotation: Finish

Using a band or cable, rotate the shoulder out away from the body.  Imagine rotating the shoulder as if a steel rod is going through the shoulder and out of the elbow.
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Good for working:1
Infraspinatus
Teres Minor
Subscapularis (co-contract)
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No Money

No Money

No Money is very similar to the first exercise.  The exception is that both arms are rotated out while the shoulder blades are squeezed together and down. This may be performed in a door-frame so the shoulder blades are squeezing in toward the frame while the arms rotate out.
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Good for working:1,6
The shoulder blades
Lower trapezius
Infraspinatus
Teres Minor
Subscapularis (co-contract)
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These exercises are typically performed with light weights for high repetitions. For example, 2-3 sets of 20 reps would be appropriate. I think an argument can be made with heavier weights, but I believe this needs to be worked into a program very purposefully.
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In the future, I will highlight more exercises to address the RTC and scapular stabilizers.
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Author: Christopher (C.J.) Eberley, PT, DPT
Board Certified Orthopedic Physical Therapist
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Disclaimer: The views discussed on this website are for educational purposes only. Should you have any questions please consult your physician or physical therapist. Copyright© Kinesis Physical Therapy. All Rights Reserved.
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References
1. Escamilla R, Yamashiro K, Paulos L, Andrews J. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med 2009;39:663-85.
2. Armfield D, Stickle RL, Robertson DD, Towers JD, Debski RE. Biomechanical basis of common shoulder problems. Semin Musculoskelet Radiol 2003;7:5–18
3. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80:276–91.
4.Clark JM, Harryman DT, 2nd. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am. 1992;74:713-725.
5. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop. 1990;64-74.
6. Reinold, M.M., Escamilla, R., & Wilk, K.E. (2009). Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature.Journal of Orthopaedic & Sports Physical Therapy, 39(2), 105-117.

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