Rotator Cuff Tendonitis

The shoulder is the most mobile joint in the body. A compromise for this mobility however, is a lack of stability. The mechanisms contributing to shoulder stability are complex and varied.

Cervical dysfunction or neck pain, for example, can cause impingement on nerve roots supplying the shoulder musculature. There are fifteen muscles which move and stabilize the scapula; nine muscles stabilizing the glenohumeral (shoulder joint); and six muscles supporting the scapula on the thorax. When there is insufficient strength in any one of these muscles, there is an imbalance created with a resulting change in position of the scapula and shoulder joint. This change in neutral position at rest or with activities in particular, produces overuse problems or tendinitis pain.

Rotator cuff tendinitis is one of the most frequent diagnoses of shoulder pain seen in a physiotherapy clinic. Treatment is directed toward correcting any cervical dysfunction, modalities to relieve pain, as well as stretching and strengthening exercises for the muscles of the shoulder girdle. Listed below are a few exercises which can be followed for prevention of injuries.

Stretching for internal rotation:
Reach behind your back with one arm. Use your other arm to assist in a stretch by pulling your forearm.
Stretching for external rotation:
Reach behind your head with one arm. Use your other hand on the elbow to assist in gently pulling the arm further.
  rotator1.jpgStrengthening for internal rotation:
Your elbow must be held at your side at 90 degrees of flexion. Pull on the theraband towards your body slowly, keeping the forearm parallel to the floor and your wrist locked. Be sure to return to your starting position slowly for strengthening in both directions.
  rotator2.jpgStrengthening for external rotation:
Use the same position as outlined in #3. Pull on the theraband away from your body. Keep your elbow in by your side and return to your starting position slowly.
  rotator3.jpgStrengthening in diagonal pull-downs:
Attach the theraband around something high such as a shower rod or railing. Grasp the theraband or pulley in your hand with the starting position for the shoulder joint above shoulder height. Pull your arm downward across your body towards you opposite hip. Hold the position for 5-10 seconds and slowly return to the starting position.
  rotator4.jpgStrengthening in diagonal pull-ups:
Attach the theraband to the leg of a couch. Grasp the theraband or pulley in your hand with the starting position for the shoulder by your side. Keeping the elbow slightly bent, slowly pull upward across your body bringing your hand towards the opposite shoulder. Hold for 5-10 seconds and slowly return to the starting position.

The diagonal strengthening exercises can be performed from all four corners for each arm.

Conditioning of the shoulder girdle is essential to continuing in a pain-free fitness program.