If you go to any rugby club across the country, you’ll undoubtedly stumble upon someone who has at some point in their playing career “done their rotator cuff”. This rather ominous prognosis is rather deceptive: what is it exactly they have “done”? To shed some light on that let’s look at exactly what the rotator cuff is…
The rotator cuff in its simplest form is a group of four muscles that stabilise the head of the humerus in the glenoid fossa. These muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis. Don’t worry – we won’t be testing you on those names. Each one of these muscles plays a key role in the stability of the arm in movement.
Here’s an analogy to explain what’s going on: imagine the top of your upper arm is a golf ball and where it sits on your shoulder being a golf tee. While this setup provides a wealth of movement, this freedom comes at the cost of the shoulder being inherently unstable, say in comparison to a joint such as the knee. So, in essence, these four small muscles have the tremendous job of “pulling” the head of the humerus (golfball) into the glenoid fossa (golf tee) when the arm begins to move upwards.
In a perfect world, no-one would get injured, and these four muscles would do their respective roles in stabilising the head of the humerus all day long. That would be it. However, as you’re aware, we don’t live in such a world. I seemed to sprain my ankle getting out of bed the other week and I have a degree in Sports Therapy! It just goes to show that these things can happen to anyone!
Smaller muscles tend to get fatigued more quickly than larger muscles. This is why your arms get tired quicker than your legs when you’re carrying too much shopping in from the car because you don’t want to do more than two trips! And when muscles delve into the realm of fatigue they are at greater risk of injury (whether acutely or due to chronic issues). So, in essence, what we have going on with the shoulder when we’re tired is that we’re putting it at a greater risk of injury, when there is already inherent risk. Sounds a bit scary, doesn’t it?
But all hope should not be lost, as the human body is wonderfully resilient. Generally, pain is elicited to stop us worsening any damage which may have occurred. However we’re all guilty of ignoring said pain and thinking we can “work through it”. Additionally, the stresses of modern life mean we often don’t listen to our bodies. Although this presents the case for compensatory patterns to arise in our movement, this still showcases the magnificent manner in which the human body can adapt.
So, what can you do if you “do your rotator cuff”? Well firstly, you need to stop whatever activity you’ve been doing that’s overloaded it. Secondly, you need to let it rest and heal in that first 24 to 48 hours of injury. The inflammatory process is also our friend, much like pain; a perfectly natural response our bodies have developed over the last 200,000 years. Most importantly, you need to see a therapist. Not only will they be able to assess what’s happened, but they’ll be able to offer treatment and rehab techniques that won’t only get you on the road to recovery, through strengthening and re-education, but also hopefully help you to avoid re-injuring yourself in the future.
So, there you have it, the rotator cuff is not the flashiest group of muscles but they certainly punch above their weight in worth.