5 Essential Tips for Lifting with a Rotator Cuff Injury
As I’m sure most of us have at least heard of our rotator cuff before, what exactly is it and what does it do?
The rotator cuff is a group of muscles and tendons in the shoulder that play a crucial role in stabilizing the joint and facilitating movement. Unfortunately, injuries to the rotator cuff are not uncommon and they can significantly impact your ability to lift weights comfortably and safely. We don’t realize how much we use it in our daily lives as well often until it is injured. However, with the right approach and precautions, it's possible to continue lifting while managing a rotator cuff injury. I’ve seen mulitple clients with rotator cuff and shoulder injures, I would say it’s the most common for my business so far, and you are not incapable of doing the same movements everyone else can.
The Rotator Cuff muscles include the supraspinatus, infraspinatus, teres minor, and subscapularis. Easily remembered by the “SITS” acronym. All four rotator cuff muscles originate from areas of the scapula and insert onto the humeral head. The glenohumeral (GH) joint is highly mobile, allowing a large range of movement, but this comes at the cost of stability.
Together, they work to stabilize the shoulder, allowing for a wide range of motion and facilitating movements such as lifting, reaching, and rotating the arm. The rotator cuff also plays a crucial role in maintaining the integrity of the shoulder joint by providing dynamic stability and controlling the positioning of the humeral head within the socket of the shoulder blade. Injuries to the rotator cuff, such as strains, tears, or tendonitis, can result in pain, weakness, and limited mobility in the shoulder, impacting everyday activities and physical performance.
“Rotator cuff related disorders (RCRD) are common, 40% of individuals report symptoms persisting longer than 12 months,1 including significant pain, disturbed sleep, and a loss of function.2 RCRD includes a spectrum of conditions such as tendinopathy, subacromial bursitis and acute and chronic tears”…(Current Concepts, NLM).
Understand Your Injury:
Before engaging in any weightlifting routine with a rotator cuff injury, it's essential to understand the nature and severity of your injury. Rotator cuff injuries can range from mild strains to more severe tears, and the recommended exercises and modifications may vary accordingly. Rotator cuff injuries can vary in severity and may include:
Rotator cuff tears: Partial or complete tears in one or more of the rotator cuff tendons.
Rotator cuff strains: Overstretching or tearing of the rotator cuff muscles or tendons due to repetitive motions or sudden trauma.
Tendonitis: Inflammation of the rotator cuff tendons, often caused by overuse or repetitive overhead movements.
Common Causes: Rotator cuff injuries can result from various factors, including:
Overuse: Repeatedly performing overhead activities or lifting heavy weights can strain the rotator cuff muscles and tendons over time.
Trauma: Sudden impact or force to the shoulder, such as a fall or direct blow, can cause acute rotator cuff injuries.
Age-related degeneration: As we age, the rotator cuff tendons may degenerate and become more prone to injury.
2. Focus on Range of Motion:
When lifting with a rotator cuff injury, prioritize exercises that focus on improving and maintaining your shoulder's range of motion. Avoid movements that involve excessive overhead reaching or rotating the shoulder joint, as these can exacerbate pain and inflammation in the injured area. Instead, opt for exercises that target the rotator cuff muscles while keeping the shoulder in a neutral and stable position, such as band work to start including movements like external rotations and pull aparts, then progressing to lateral raises, and modified shoulder presses.
3. Strengthen Supporting Muscles:
In addition to targeting the rotator cuff muscles directly, it's essential to strengthen the surrounding muscles that provide support and stability to the shoulder joint. Incorporate exercises that target the muscles of the upper back, scapula, and core, as well as the muscles of the unaffected arm, to help compensate for any weaknesses or imbalances caused by the injury. Strengthening these supporting muscles can help alleviate stress on the rotator cuff and improve overall shoulder function.
Let’s dive into this point a little more…
Scapular Retraction and Depression:
Scapular Retraction: Stand or sit with good posture, shoulders relaxed. Squeeze your shoulder blades together while keeping your arms at your sides. Hold for a few seconds, then release. Repeat for several repetitions.
Scapular Depression: Hang from a pull-up bar or use a lat pulldown machine with your arms fully extended. Engage your shoulder blades by pulling them down and back, away from your ears. Hold for a few seconds, then relax. Repeat for several repetitions.
External Rotation Exercises:External Rotation with Resistance Band: Anchor a resistance band at waist height. Hold one end of the band with the hand of the affected shoulder and stand with your side facing the anchor point. Keep your elbow bent at 90 degrees and your forearm parallel to the ground. Rotate your forearm away from your body against the resistance of the band. Slowly return to the starting position. Repeat for several repetitions.
Prone External Rotation: Lie face down on a bench or a stability ball with your arms hanging down towards the floor, holding light dumbbells. Keeping your elbows bent at 90 degrees, externally rotate your arms by squeezing your shoulder blades together. Lower the weights back down and repeat for several repetitions.
Rotator Cuff Strengthening:
Side-Lying External Rotation: Lie on your unaffected side with a rolled-up towel or small pillow under your head for support. Hold a light dumbbell in your hand on the affected side, keeping your elbow bent at 90 degrees and your upper arm against your side. Slowly rotate your forearm upward while keeping your elbow against your side. Lower the weight back down and repeat for several repetitions.
Internal Rotation with Resistance Band: Attach a resistance band to a sturdy object at elbow height. Stand perpendicular to the band's attachment point with the affected shoulder closest to the anchor. Hold the band with your affected hand, keeping your elbow bent at 90 degrees and your forearm across your abdomen. Rotate your forearm inward against the resistance of the band. Slowly return to the starting position and repeat for several repetitions.
Core and Upper Back Exercises:
Plank Variations: Planks, side planks, and other core stabilization exercises can indirectly support the shoulder joint by improving overall core strength and stability.
Rowing Exercises: Bent-over rows, seated rows, and cable rows target the upper back muscles, which play a significant role in shoulder stability.
Overhead Pressing Variations:
Landmine Press: Stand with one end of a barbell secured in a landmine attachment or corner of a room. Grasp the other end with one hand at shoulder height. Press the barbell overhead while maintaining a stable core and controlled movement. Lower the barbell back down and repeat for several repetitions.
Dumbbell YTWL Raises:
Lie face down on an incline bench with a light dumbbell in each hand. With your thumbs facing upward, lift the dumbbells in a Y motion (arms angled slightly above your head), then a T motion (arms straight out to the sides), then a W motion (elbows bent and close to your sides), and finally, an L motion (elbows bent at 90 degrees, palms facing down). Repeat for several repetitions, focusing on maintaining proper shoulder blade positioning throughout the movements.
Use Proper Equipment and Modifications:
When lifting with a rotator cuff injury, it's crucial to use proper equipment and modifications to minimize strain on the affected shoulder. Consider using supportive gear such as wrist wraps, lifting straps, or braces to provide additional stability and reduce stress on the injured area. Additionally, modify your lifting technique as needed to accommodate your injury, such as using lighter weights, adjusting your grip or stance, or reducing the range of motion for certain exercises (as mentioned with shoulder press, this can be done with any exercise).
Listen to Your Body and Rest as Needed:
Above all, listen to your body and prioritize rest and recovery as needed when lifting with a rotator cuff injury (or just in general really ;P). Pay attention to any signs of pain, discomfort, or fatigue during your workouts, and adjust your routine accordingly. It's essential to strike a balance between challenging yourself to progress while avoiding activities that exacerbate your symptoms or hinder the healing process. If you experience persistent or worsening pain, consider consulting with a healthcare professional to reassess your treatment plan and make any necessary adjustments.
Lifting weights with a rotator cuff injury requires a cautious and strategic approach to ensure both safety and effectiveness. By understanding your injury, focusing on range of motion, strengthening supporting muscles, using proper equipment and modifications, and listening to your body, you can continue to pursue your fitness goals while managing and rehabilitating. Remember to prioritize proper technique, consistency, and patience in your workouts!
Happy Exercising,
Robyn
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285972/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082254/