The past two shoulder tips have focused on the support structures around the rotator cuff.  First there was the development of the scapula and then the core. As the title states, rotator cuff problems represent something that is worth the time to avoid, rather than spend weeks or months of therapy. If surgery is required, it may take many months to recover.

So, how do you avoid problems?  I’ll break this into four basic topics.

1. Know your flexibility and do not mess with the balance of the shoulder.  This sounds confusing but boils down to the fact that everyone has different natural flexibility. Those who have great flexibility must be particularly careful to maintain muscle balance in the shoulder. Over-stretching and over-development of some muscles compared to others contribute to the loss of this balance. An example of this is the tendency of swimmers to develop large muscle groups in the front (anterior) at the expense of back (posterior) muscles, pulling the shoulders forward (the swimmer slouch).
   
2. Stroke technique is critical. Repetitive poor technique places stress on the smallest muscles of the rotator cuff to result in their failure and injury.
   
3. Perform routine strengthening of the rotator cuff muscles as part of your training.  Several simple examples are given below. Dry land training is not the part of practice that you can miss.
   
4. Early troubleshooting is key. If you are having problems, let your coach know early on, not weeks to months later. An easy way to address problems early is by icing your shoulders as soon as your workout is completed. If there is no residual soreness, keep the icing going for at least a week and let your coach know so a stroke assessment can be made and training schedules adjusted slightly. Long-term pain, lasting hours after practice or into the next practice, may result in your sitting in your medical practitioner’s office reading last year’s magazines.

Now, for some of the basic exercises to strengthen these muscles.

Exercise #1

Ball on the Wall: A ball is supported against the wall with a straight arm that is directly out to the side. Roll the ball back and forth against the wall in all directions with short motions, using these small stabilizing muscles.

Exercise #2

Inward and outward Rotation: Holding the elbow against your side at 90 degrees (a towel held between the elbow and waist assures good alignment) either rotate inward or outward against a pulley resistance that you can control. Do not throw it with your body.

Exercise #3

Shake it Up: Holding a water bottle at least half full, shake it quickly back and forth.  The arm is at 90 degrees forward and bent at 90 degrees, as shown.

So there you have it for now.  We still need to review those stretches that are bad for you, and how to know when you have to see your medical practitioner. Looks like more Medical Briefs to come!