Rotator cuff injuries are extremely common. While the average prevalence of rotator cuff tears in the general population is around 20%, as we age this increases to over 40% by the time we reach 70. Exercise rehabilitation programs for rotator cuff tears almost always include theraband rotation exercises, but when we look at the purpose of the rotator cuff muscles in the body, we realize that their stabilization role far outweighs their role in rotation. Let’s take a look at some of the important functions of the rotator cuff muscles that your exercise program should include.
The shoulder joint
The shoulder joint is extremely mobile and has a shallow socket making it much less stable than the hip joint. The rotator cuff consists of 4 muscles that as their name indicates, create a cuff around the shoulder joint. They work together to keep the ball and socket of the shoulder together as the arm moves into and through its various positions. Unlike some of the other shoulder muscles, such as the deltoid, the rotator cuff muscles are much smaller and are not designed to generate large forces. Most sporting activities such as tennis and throwing sports, recruit muscles such as the pectorals, deltoid and latissimus dorsi to produce rotational power, with some assistance from the rotator cuff muscles.
They never work alone
It is also important to note that the rotator cuff muscles never work in isolation. In fact, the function of the shoulder depends largely on the ability of the muscles to work together, somewhat like a piece of music relies on the different instruments working in synchrony. Problems often occur where there are imbalances in the muscles around the shoulder. This can place additional strain on the rotator cuff muscles as they need to counteract the pull of any overly dominant muscles.
How should we train the rotator cuff muscles effectively?
- If we use rotation to train these muscles in isolation, it should be to encourage activation of the muscles and is usually best when paired with another movement rather than in isolation
- We need to make sure that we train all muscles around the shoulder to create balance between opposing muscles
- We need to train the reactivity and position sense of the rotator cuff muscles by using unstable loads, and training in positions that force us to “feel” what is happening and make necessary adjustments based on this “feeling”