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22.12.2012

Anterior deltoid exercises for rotator cuff tears, broscience store - For Begninners

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Factors Influencing DurationThe size of the tear, the individual's age, occupation, and overall health, dominant side involvement, the need for surgery, and the effectiveness of rehabilitation may affect the length of disability.
Overview © Reed GroupA rotator cuff tear occurs when the tendons that form the rotator cuff weaken and tear. Tears are described as either partial-thickness tears or full-thickness, depending on the amount of tissue damage. The rotator cuff functions straightforwardly in the internal and external rotation of the arm.
While athletes can suffer an acute rotator cuff tear as a result of a traumatic event, chronic rotator cuff conditions usually start with a tendonitis of the supraspinatus muscle.
Physicians in Canada have divided the spectrum of rotator cuff disease into three stages(3).
In swimmers with shoulder pain, the subscapularis may fatigue earlier, or diminish function to avoid pain during internal rotation at pull-through. Greek researchers sought to find the most effective way to train the rotator cuff muscles and restore strength balance around the shoulder joint(3). Seeking a more practical method of training, researchers at the University of Pittsburgh examined on-field, resistance-tubing exercises for throwing athletes(4). While studies conclude that any programme to strengthen the shoulder will yield positive results, researchers at Northeastern University in Boston, sought the most specific exercise for the supraspinatus muscle(5).
Of course, the key to any training programme is doing the exercises correctly and in a focused manner.
Sign up to receive our e-mailings with state-of-the-art info on training for sports and martial arts and with answers to questions on sports training. Information on this Web page is for educational use only, and is not intended as medical advice. Balanced rotator cuff strength and function are necessary to prevent upward migration of the humeral head and subacromial impingement of the rotator cuff tendons.
Other causes of injury and rotator cuff dysfunction include kyphotic posture with rounded shoulders and abducted shoulder blades, as well as fatigue and weakness of periscapular (shoulder-blade-moving) muscles and rotator cuff muscles. Exercises for strengthening and conditioning both the periscapular muscles and the rotator cuff muscles, for joint mobility, for sensorimotor training, and for postural awareness are essential components of both a rehabilitation and injury prevention program. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. It attaches the humerus to the scapula, and forms a ring or cuff around the joint that helps prevent the bone from slipping out of its shallow socket called the glenoid fossa. It is the only rotator cuff muscle to be located on the anterior portion of the shoulder joint and resists motion of the humeral head in the forwards direction. The supraspinatus tendon is the most commonly involved tendon in rotator cuff pathology and understanding the anatomical placement of this tendon is important(1). The infraspinatus and the teres minor function to externally rotate the arm and, along with the supraspinatus, draw the humeral head inward and down, thus clearing the acromion and allowing the arm to abduct to 120 degrees (see figure 2).
The first stage, which usually affects athletes aged 25 and under, is bruising and swelling in the rotator cuff tendons as a result of microtrauma from overuse.
Scapular stabilising muscles may also be weak, interrupting the normal scapular-humeral rhythm required for full shoulder range of motion.
The combination of years of overuse, as well as the degenerative changes associated with age leave the rotator cuff more vulnerable. When comparing training methods of multi-joint dynamic resistance exercises, isolated dumbbell training, and isokinetic exercises, they found all interventions improved the muscle balance around the joint when compared to controls. After evaluating EMG data from the shoulder muscles of athletes performing 12 different exercises, they concluded that performing seven of the exercises activated all the important muscles for throwing. As already mentioned, one of the main functions of the rotator cuff muscles is to compress and depress (to pull in and down) the humeral head within the glenoid cavity, to prevent it from spinning, sliding, and rolling off the top of the glenoid cavity and striking up against the undersurface of the acromion process. The supraspinatus and teres minor are considered the most efficient abductors and humeral head depressors in the rotator cuff group, respectively.
Normal scapular motions against the rib cage provide the stable yet mobile supporting base from which the rotator cuff muscles work. Many arm and shoulder movements, especially the overhead movements, are made possible by the concerted actions of four small muscles in the rotator cuff group and the structure of the shoulder joint. Vahl, joint capsule tear, levator scapulae, pectoralis minor, rhomboideus major, rhomboideus minor, Richard J. As gravity pulls us forward and things in our life that demand our attention pull us forward, the muscles on the front of our chest and shoulders shorten.


The larger the tear, and the longer the interval from injury to surgery, the more likely that there will be some residual permanent weakness of the rotator cuff (Safran). The muscles of the rotator cuff, the subscapularis, the infraspinatus, the teres minor, and the supraspinatus, are often referred to by the acronym SITS muscles (see figure 1). The role of these muscles working together is to externally rotate the arm and assist the supraspinatus in stabilising the humeral head during arm elevation. At that point, the scapula begins to rotate away from the spine, effectively extending the position of the shoulder in space, moving the acromion away from the head of the humerus, and allowing the arm to abduct the remaining 60 degrees(2). As the anatomy in this region is very precise, the presence of a bone spur, anomaly in the shape of the acromion, or weakness in one of the rotator cuff muscles, can easily result in an impingement of the tendon when the arm is raised overhead. This is the position after release in throwing, when the rotator muscles are contracting eccentrically, and at the beginning of pull-through phase in freestyle swimming, when the rotator cuff muscles are working concentrically. This increased range of motion affects the length-tension relationship of the rotator muscles, impairing their ability to stabilise the humeral head in the socket(1). While rotator cuff injuries are degenerative in nature and their incidence increases with age, the sustained overuse of the shoulder in athletes seems to speed up the process.
Partial tears can occur in the tendons and a seemingly minor incident can result in a complete tear. Rotator cuff impingement, tendonitis (tendon inflammation) or tendonosis (tendon weakening), joint capsule tears, and structural injuries are all common in athletes, both male and female. Such uncontrolled movements of the humeral head cause injury to the joint’s surface, rotator cuff tendons, and all other structures that are between the humeral head and the acromion. Its function is to work closely with the deltoid muscle to raise the arm in flexion and abduction. As a group, the rotator cuff directs and stabilizes the humeral head within the glenoid cavity, while the larger extrinsic muscles, such as the latissimus dorsi, pectoralis major, and deltoid produce the forces necessary for gross arm and shoulder movements. It enables the rotator cuff tendons and their lubricating bursae to glide unscathed beneath the acromion. During normal or proper shoulder flexion and abduction, both upward rotation and posterior scapular tilt move the acromion process away from the greater tubercle on the humeral head, allowing the humeral head and rotator cuff muscles and tendons to move freely.
Understanding the biomechanics, anatomical structure, and function of the shoulder and of the rotator cuff muscles can assist health care professionals in establishing a better rationale and understanding for selecting specific techniques and exercises for patients and clients in both rehabilitation and injury prevention.
These forces cause disc degeneration, head and neck pain, rotator cuff impingement, amongst other problems. The tendons of these muscles come under stress from activities that require lifting and rotation of the arm often in a throwing type motion. This complex architecture leaves little room for variability without one structure affecting its neighbour. Therefore, complete range of motion in the shoulder requires synchronous activation of the rotator cuff with the other shoulder muscles. For instance, estimates suggest the average American collegiate swimmer performs more than one million strokes per year with each arm(1)! Making the front of the shoulder more mobile only increases the vulnerability of the rotator cuff. The shoulder joint complex does sacrifice some of its stability as compared to the hip joint for the sake of extra mobility.
Under normal circumstances, the rotator cuff muscles enable the humeral head to be constrained within a couple millimeters of the center of the glenoid cavity throughout most of the arc of the arm’s motion.
The supraspinatus fibers maintain a horizontal line of pull, much like guide wires, which resolves or modifies the deltoid’s vertical line of pull. Without this stabilization by the rotator cuff, gross movements of the arm would cause irritation, pain, and finally inflammation that would eventually destroy the joint. A reduction in this space can cause impingement or abrasion of the rotator cuff and of the long head of the biceps tendon.
Both the primary impingement and the secondary impingement may lead to more severe injuries, through irritation and resulting inflammation causing bone spurs, weakening of tendons, and rotator cuff tears. This, in turn, enhances glenohumeral stability and maintains optimal length and tension of the rotator cuff and deltoid muscles. Any abnormalities of the shoulder joint can aggravate the stress, especially joint looseness (laxity), muscle imbalance, rubbing of the front edge of the shoulder blade (acromion) on the rotator cuff (impingement syndrome), bone spurs, and bursitis.
As the deltoid muscle abducts the arm, it also elevates the humerus, which butts against the acromion of the scapula and can go no further. Injuries causing damage to the small and delicate rotator cuff muscles are the most common, are often debilitating, and can easily become chronic.


Weakness or extensive damage to the supraspinatus allows the vertical pull of the deltoid to drive the humeral head directly against the undersurface of the acromion process. Rotator cuff tears are generally classified by the extent and depth of the fiber damage as either partial or full thickness tears. He is also a Certified Professional Health and Fitness Specialist by the American College of Sports Medicine (ACSM) and a Certified Physical Trainer by the American Council on Exercise (ACE). For a lot of us stress in our lives is manifested by tightness and hyperactivity of our shoulder muscles. If any of these compensations are noted, a swimmer should be pulled immediately from a workout and tested for shoulder injury.
On the average, up to 40 percent of rotator cuff tears are full thickness tears, and the majority of them are asymptomatic.
The rotator cuff muscles are generally exercised in conjunction with the periscapular muscles. Circulation to the rotator cuff decreases with age and the tendons themselves degenerate over time.
Because of its structural mechanics, the shoulder joint relies heavily on support from the group of relatively small muscles collectively known as the rotator cuff complex.
He has published and lectured both nationally and internationally and is a member of the National Association for Sport and Physical Education (NASPE) and the National Academy of Sports Medicine (NASM). The rotator cuff complex enables the shoulder joint to produce its numerous movements while still maintaining a balance between shoulder mobility and stability.
One of the major functions of the four rotator cuff muscles is to work in concert with each other to stabilize the humeral head as the arm moves. Shoulder blade stability secured by proper function of the periscapular muscles, balanced rotator cuff muscle strength, and adequate flexibility help maintain normal, healthy shoulder function. He has been a team doctor for many state, national, and international sporting and martial arts events and has been the team doctor and medical advisor for the USA Kendo Team and Team Miletich Fighting Arts. Thanks to the diagonal orientation of the infraspinatus fibers, their line of pull produces external rotation of the arm as well as stabilizes the glenohumeral joint by pulling the humeral head down and in. The intrinsic rotator cuff muscles are important and offset some of the potentially destabilizing and damaging forces created by the larger extrinsic muscles. The rotator cuff muscles’ oblique line of pull creates downward and inward compression forces.
The teres minor, like the infraspinatus, attaches to the greater tubercle of the humerus and produces external rotation of the arm.
The forces of the rotator cuff muscles and of periscapular muscles maintain the humeral head’s center of rotation. It occupies the subscapular fossa on the anterior surface of the scapula and attaches to the lesser tubercle of the humerus. Force couples of the subscapularis, supraspinatus, infraspinatus, teres minor, and long head of the biceps brachii muscles create a concavity compression mechanism that pulls the humeral head into the glenoid cavity during all movements of the arm. In other words, rotator cuff muscles plus the long head of the biceps (which presses on the humeral head) keep together the joint surface of the shoulder. As you can see on the diagram the rotator cuff will function to rotate the humerus medially (subscapularis) and laterally (infraspinatus, teres minor) and through abduction (supraspinatus). Functionally they are relatively insignificant rotators compared to the more superficial muscles. The force vector angles are much too close the the joint resulting in a poor moment arm to cause rotation. Over stretching the glenohumeral ligaments and anterior joint capsule leads to excessive translation of the humeral head anteriorly which can cause inpingement. For this reason it is important not to bounce into these stretches or apply excessive force.
It is an exercise prescribed to help maintain mobility, relax the shoulder muscles, and by stimulating nerve endings within the joint helps block pain.
Hold this position for the appropriate time Upper Fibres of Trapezius Sit upright on the edge of a chair and hold onto the chair with your right hand. Hold this position for the appropriate time Latissimus Dorsi, Teres Major Stand with feet shoulder width apart, chest up and head back over your shoulders.




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