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Exercises for Rotator Cuff Problems

The rotator cuff is composed of four muscles that assist in elevating your arm over your head and rotating it toward and away from your body. Because these are common movements, the rotator cuff is often subject to either injury or conditions that cause chronic pain. These include rotator cuff tendinitis, rotator cuff tears and instability impingement. Rotator cuff tendinitis and instability impingement can be considered warning signs. If properly treated, they will not lead to rotator cuff tears.

Rotator Cuff Problems Described
Rotator cuff tendinitis is an inflammation of the bursa. Symptoms include pain on top of the shoulder, a popping sensation and an inability to sleep on the shoulder. There are two forms of instability impingement. A dislocation occurs when the upper arm bone pops out of the socket. A subluxation occurs when the shoulder temporarily slips out of socket, and then comes back to place. Rotator cuff tears often occur when someone has had tendinitis for a long period of time, or when lifting overly heavy objects. Once the rotator cuff is torn, exercise can alleviate the symptoms. However, it will not heal the injury.

Choosing the Right Rotator Cuff Exercise
The American College of Sports Medicine recommends a multi-faceted approach to rotator cuff exercise. This includes muscle strengthening, stretching and sensorimotor training. However, it's important to choose the right exercises for the right problem. For example, instability impingement is often the result of hypermobility and often occurs in people who practice contortion-type stretching exercise without performing strength training. Other types of problems may be caused either by muscle weakness, which requires strength training, or muscle overuse, which requires flexibility exercise. Sufferers of all types of rotator cuff problems can benefit from sensorimotor training or movement re-education.

Hand Walking on a Treadmill or Stair Stepper
This sensorimotor exercise is recommended by the American College of Sports Medicine as a means of proprioceptive training. Because your hands will be in a fixed position, it is considered a closed-chain exercise, which will create compression as opposed to shearing forces of the joints. In most cases, compression forces are healthier for the joints. You might want to wear a pair of work gloves to avoid dirtying your hands. Kneel in front of the machine, and walk one hand over the other. Notice that it's difficult to perform this if your shoulders are hiked up by your ears, which is why this is an effective exercise for movement re-education.

Side-lying External Rotation
This exercise is performed with a light weight of usually no more than 5 pounds. It is designed to strengthen the rotator cuff muscles, which makes it an effective exercise for anyone with instability impingement. Lie on your side and hold a weight in your top hand. Attach your elbow to your waist, and make sure that it stays in that position. Lower your forearm, so that your wrist is aligned with your navel. Inhale to prepare. As you exhale, rotate your shoulder and lift your forearm, so that your hand faces the ceiling. Do three sets of 8 to 12 repetitions.

Side-lying Internal Rotation
This strengthening exercise also uses a weight and is also performed in a side-lying position, but the weight is held in the bottom hand and the exercise is performed on a bench. Lower your forearm so that it is parallel to the floor. Your elbow should maintain contact with the edge of the bench. Inhale to prepare. As you exhale, raise your forearm so that your hand reaches toward your top elbow. Perform three sets of 8 to 12 repetitions.

Shoulder Shrugs
Some popular stretches may over-stretch the shoulder muscles, which can exacerbate the problem. As such, static shoulder stretches should be performed only under the guidance of a physical therapist. However, dynamic, also known as functional flexibility exercises, can be performed. The shoulder shrug is an effective exercise for teaching the shoulder muscles to relax. As such, it is also an effective movement re-education exercise. Lie on your back with your knees bent and your hands by your side. Inhale as you slide your shoulders toward your ears. Allow your hands to slide along the floor. As you exhale, slide the shoulders downward.

Scapula Isolation
Overuse of the shoulder muscles and under-use of the rhomboids are reasons for rotator cuff problems. The scapula isolation exercise teaches you to activate the muscles of your upper back while relaxing your shoulders. It should be performed after the shoulder shrugs. Lie on your back with your knees bent. Raise your arms so that your palms face each other and your fingers are reaching toward the ceiling. Inhale as you lift your shoulder blades from the floor. Keep your head on the mat. As you exhale, return your shoulder blades to the floor and squeeze them together, as if you were trying to catch a pencil between them.