Preventing and Managing Rotator Cuff Injuries

By Jay Vincent

If you or your child is involved in sports, either recreationally or competitively, or you are just an avid baseball fan, you are probably familiar with the term “rotator cuff.” This term is usually associated with an injury that is keeping an athlete out of the game. Athletes can drastically reduce the likelihood of suffering a rotator cuff injury with some very simple steps in the offseason through proper training and then managing the stress placed on the rotator cuff during the season.

The rotator cuff is a well-known term, but few people actually know the physiology behind the body part. The rotator cuff is a group of muscles that support the shoulder joint. These muscles include the Subscapularis, Infraspinatus, Supraspinatus, and Teres Minor. The 4 muscles and their supporting tendons surround the glenohumeral joint of the shoulder, which is a ball-and-socket type joint that allows for a wide range of motion. Unfortunately, a wide range of motion is often accompanied by a large amount of instability. This range is what makes this joint and its supporting musculature prone to injury.

The primary function of the rotator cuff is to stabilize the glenohumeral joint by compressing the humeral head (ball at top of upper arm) against the glenoid (socket on upper torso). The 4 muscles originate at the scapula (shoulder blade) and insert into the humerus (upper arm). The muscles also provide internal rotation of the arm, abduction of the arm, external rotation of the shoulder, and internal rotation of the shoulder.

Now that we understand the basic physiology of the joint and the muscles of the rotator cuff, we can identify the common cause of injury. The answer is simple: throwing.

The muscles are heavily involved in ANY type of throwing motion and the glenohumeral joint is heavily stressed providing adequate range of motion for a throwing movement. As described earlier, the shoulder is a ball-and-socket type joint. During a throwing motion, the ball and socket structure moves around a fair amount and loses a large amount of stability. The high peak forces generated during a throwing movement are largely responsible for causing the multiple tendons and ligaments to fail. High peak forces in ANY movement make ligaments and tendons prone to fail and tear, ultimately resulting in injury. Unfortunately, there is no way to perform a throwing movement effectively without generating high peak forces. This is why, over time, it is extremely likely that a rotator cuff injury will be sustained.

This doesn’t have to be a self-sacrificing scenario. To achieve athletic-level throwing capabilities, there will be wear and tear on the glenohumeral joint that can result in rotator cuff injury. However, there ARE things we can do with our athletes to DRASTICALLY reduce both the chance of and severity of injury to this important joint.

 Strength training using low impact methods.

  1. Strength training will strengthen the muscles of the rotator cuff AND the supporting tendons and ligaments of the shoulder joint. Stronger muscles, tendons, and ligaments result in a reduction in likelihood of injury for ANY part of the body.
  2. Using low impact training methods, such as a slow speed of movement while weight training or using static or isometric contractions, will allow the rotator cuff to grow stronger without producing wear and tear in the process. Since wear and tear is inevitable with sports, reducing wear and tear during training is CRUCIAL to the length of an athlete’s career.

 Limit practice time.

  1. Obviously, practice is necessary to improve the skill of throwing in any sport. But many coaches have their athletes practice WAY too much. There is a point of diminishing returns with repetition and practice. Hypothetically, if 100 practice pitches in baseball improve the athletes skill by 10%, an additional 100 pitches might improve his or her skill by an additional 0.5%. In this case, it is NOT worth the additional wear and tear for an additional 0.5% in skill improvement. The athlete is better off stopping after 100 pitches, taking the rest of the day off to recover his or her body, and resuming practice the next day.
  2. The athlete should use the offseason to recover his or her body and build strength.
    • They should reserve a period of time in the offseason where NO practice takes place to allow his or her body to recover.
    • Then, once adequate recovery time has taken place, resume practice with a healthy body.

Western culture is indoctrinated into the “more is better” frame of thinking. The truth is, more is not better. There is always a point of diminishing returns and a point where too much of something produces adverse effects. Unfortunately, many of our coaches operate on superstition and folklore, which is leaving our athletes injured for life. Rather, they should be using critical thinking and following advice by the sports medicine community that relies on a proven evidence base and endorsed by such national organizations as the National Athletic Trainers’ Association and the American Orthopedic Society for Sports Medicine. As a parent, if you implement the strategy explained in this article to your young athletes training and preparation regime, your young athlete will undoubtedly have a more fulfilling sports career with less pain, if any at all.

Jay Vincent is an exercise expert and fitness entrepreneur with two training studios in Upstate New York. Jay’s goal is to teach the proper science behind exercise to help people train more efficiently, safely, and effectively.

Western culture is indoctrinated into the “more is better” frame of thinking. The truth is, more is not better. There is always a point of diminishing returns and a point where too much of something produces adverse effects. Unfortunately, many of our coaches operate on superstition and folklore, which is leaving our athletes injured for life.

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