Rotator cuff – Prevention of injury

Rotator Cuff – Prevention of Injury Part 2 of 3

Hello fanatics of pickleball!

Most people injure their rotator cuff muscles due to chronic misuse or due to a sudden traumatic force to the shoulder joint. To help prevent injury, three specific exercises can be incorporated into a regular workout that isolate the four muscles of the rotator cuff. The exercises consist of shoulder external rotation, internal rotation, and scaption(abduction in the scapular plane).

To perform internal and external rotation, I prefer using a theraband, theratube, or a gym machine with a cable/pulley system that can be moved up and down to the correct height. The exercises can also be performed with free weights, but it can be difficult getting into the correct position(on your side in bed) to perform them. Performing scaption is best performed with a free weight and is less effective using a machine or theraband.

Before you begin the three exercises, remember that the rotator cuff muscles are small and do not typically tolerate a heavy force. For this reason, it is more important to perform more repetitions of each exercise versus using a heavy load. Therefore, you should be able to complete thirty repetitions of each exercise. I would not recommend increasing weight or band resistance before thirty consecutive repetitions can be completed easily. It’s important to know that theraband/theratube resistance/thickness is usually easiest with the color yellow, and then follows with red, green, blue, black, silver and finally gold. They can be purchased online, at sporting goods store, or possibly at a physical therapy outpatient clinic.

To perform external rotation, start with your upper arm at your side with the elbow bent at a 90 degree angle and your hand at your abdomen. The theraband should be tied to something sturdy at the same level of the abdomen and opposite to the arm being exercised. Grip the other end of the theraband tightly in your hand. Pull your hand away from your abdomen and rotate it away from your body as far as possible. Do not let your upper arm move away from your side(see illustration). It is important to hold the end position of the external rotation for two seconds before slowly returning to the starting position for the next repetition.

To perform internal rotation, follow the same instructions given for external rotation except that the starting/finishing positions are reversed(see illustration). The tied off portion of the theraband is on the same side of the arm being exercised. The internal rotators are stronger, thus this exercise should be easier to perform than external rotation. For this reason, a heavier weight/theraband color will likely be used compared to the one used for external rotation.

To perform scaption, start with your arm at your side with a weight in your hand. I would recommend starting with one or two pounds to begin and increase to tolerance for the 30 repetitions. It is important to isolate the rotator cuff muscle(supraspinatus) versus the deltoid muscle when raising the arm. To do so, the arm should be raised to the side of the body and slightly towards the front of the body(approximately 30 degrees forward). The shoulder should be internally rotated, which causes the thumb to face the ground during the lift(see illustration). Stop the motion no higher than shoulder height. Again, hold this position for two seconds before slowly returning to the starting position.

Perform these three exercises on a regular basis and you will be amazed at how much stronger your shoulder becomes. More importantly, you will help prevent injury which means more pickleball play!

The third and final rotator cuff segment will discuss treatment options for both chronic and acute injuries. Until then, have fun on the pickleball courts!

To check out part one, click:  Rotator cuff pain – What is it?