Are You Isolating the Rotator Cuffs?
Reference:Personal Experience. The full article is available complimentary on www.aptei.com in the section ‘clinical articles’
Training the rotator cuff (RC) muscles by resisted lateral rotation is one of the most common exercises provided to patients with impingement syndromes.
It is however my personal opinion that most patients are doing little RC training but primarily needless deltoid strengthening! How you may ask?
The Challenge: Many individuals with impingement syndrome are likely to also have insufficient RC muscles. During uncontrolled resisted lateral rotation many will inevitably compensate and utilize their relatively ‘powerful’ deltoid muscle. This results in the patients doing a pretty good job of strengthening the unaffected and likely already overactive deltoids, and little activation of the much-needed RC muscles.
The Solution: Place a thick towel roll or a folded pillow in the arm pit and request the patient to lightly ADDUCT the shoulder during the entire lateral rotation exercise. The PT should simultaneously palpate the posterior fibres of the deltoid muscle to note unwanted compensation.
Ensure that the focus of the exercise is in the eccentric phase taking at least 10 seconds…yes, I said 10 seconds, as too often patients totally skip the eccentric phase and simply jerk back!
I can guarantee that your patients will feel a much more local RC muscle fatigue when you incorporate the above two concepts!
Posted on: June 22, 2006