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Rotator Cuff Related Pain

The rotator cuff (RC) muscles are a group of four muscles which stabilise the shoulder. These four muscles include supraspinatus, infraspinatus, subscapularis and teres minor. These muscles emerge from the shoulder blade and connect to the head of the humerus forming a cuff around the shoulder joint. These muscles have many different functions. The main known function is stabilising and rotation of the shoulder joint. However, these muscles are also involved in flexion and abduction of the shoulder joint. They are more or less involved in every movement the shoulder performs. 

The rotator cuff muscles are associated with many different injuries of the shoulder joint. The most common injuries are tears, tendinopathies and impingement syndrome. These injuries can occur at all ages. In the younger individual these injuries are related to trauma or overuse secondary to sport related activities. In the older individual it is usually related to degenerative changes or overuse. 

Most rehabilitation programmes tend to heavily emphasise shoulder rotation exercises. While these exercises hold significance, incorporating a variety of shoulder joint movements across different planes is essential to diversify the effectiveness of the programme. Lateral raises have been shown to strengthen all four RC muscles to a high degree when appropriately performed. During pushing and pulling exercises the RC muscles can act as both agonists and antagonists. Pushing movements primarily engage the supraspinatus and infraspinatus muscles, whereas pulling movements predominately target the subscapularis muscles. Including an appropriate combination of horizontal and vertical pushing and pulling exercises, lateral raises and rotation work in a RC strengthening programme is the most effective way to train the shoulder joint. It is important that exercise selection is specific to the individual. This is why it is important to book in with a qualified physiotherapist to find a programme specific to your individual needs. 

Struggling with shoulder pain? Book a consultation to get some help.


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Wattanaprakornkul D, Halaki M, Cathers I, Ginn KA. Direction-specific recruitment of rotator cuff muscles during bench press and row. J Electromyogr Kinesiol. 2011 Dec;21(6):1041-9. doi: 10.1016/j.jelekin.2011.09.002. Epub 2011 Oct 5. PMID: 21978788.

Reed D, Cathers I, Halaki M, Ginn KA. Does changing the plane of abduction influence shoulder muscle recruitment patterns in healthy individuals? Man Ther. 2016 Feb;21:63-8. doi: 10.1016/j.math.2015.04.014. Epub 2015 Apr 16. PMID: 25920341.



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