Advancing Your Health

In part one of my rotator cuff blog series, I discussed how the rotator cuff works and what happens when it is injured. The good news is that many rotator cuff injuries can be treated with physical therapy alone, particularly if you seek care at Emory Sports Medicine at the first sign of an injury. So let’s now look at the treatment options available to you if you injure your rotator cuff, and how you can prevent a rotator cuff injury from occurring in the first place.

Rotator Cuff Treatment

Every rotator cuff injury has its own unique cause, its own particular damage, and its own best path to recovery. It’s like detective work, figuring out which rotator cuff muscles and tendons are causing the problem, whether the problem is weakness, stiffness or inappropriate mechanics, and then deciding which treatments will be most effective. At Emory Sports Medicine, we first want to figure out why you’re experiencing rotator cuff pain. Is your problem caused by an underdeveloped muscle or one that has poor flexibility? Are you moving with poor mechanics? Is an anatomical abnormality to blame?

Once we know what’s causing the problem, we create a custom physical therapy program that may include targeted strengthening exercises, stretches, manual therapy and reeducation of the muscle.

For example, if a patient comes to Emory Sports Medicine with a rotator cuff problem but he seems to have good strength in his shoulders, we may stand him in front of a mirror and ask him to raise his arms. Maybe we’ll notice that his whole shoulder is lifting up along with the arm, a “shoulder shrug.” If he’s just lifting his arm to wave at someone, it probably doesn’t matter, but when he applies force in that position – say pitching a baseball – he’s putting a lot of unnecessary strain on his rotator cuff. So we’ll work with him to reeducate his muscles, keeping his shoulders down and engaged correctly when he raises his arm. This approach often fixes bad mechanics and the problem goes away.

Rotator Cuff Injury Prevention

Of course the very best strategy is to prevent a rotator cuff injury from happening in the first place. Major league pitchers make rotator cuff training one of their top priorities in the off-season, not because they want to go around flexing their rotator cuff to impress people, but because they know they’ll have longer, more successful careers if they do. Any qualified coach, athletic trainer, or physical therapist should be able to guide you in developing a rotator cuff training program, and anyone at risk for rotator cuff injuries should strongly consider starting and sticking to such training.

Developing strong and flexible pectorals, deltoids, lats, biceps, triceps and other upper body muscles is all good, but if you want to put all that strength to good use, don’t neglect developing your rotator cuff. It matters more than you think.

Do you have questions or comments about rotator cuff injuries? If so, I welcome you to leave them for me in the comments section below.

Michael Biller is the director of physical therapy for Emory Physical Therapy’s Perimeter and Sugarloaf locations and currently treats patients at the Perimeter location. He graduated from the University of North Carolina at Chapel Hill with his physical therapy degree in 1992. He is a board certified clinical specialist in orthopedics and is a McKenzie credentialed practitioner. Biller is a guest lecturer on many topics, including the spine and extremities, and serves as a book reviewer for the Journal of Orthopedic & Sports Physical Therapy. He is also Emory Physical Therapy’s clinical coordinator for student education. He is married to his lovely bride, Rachel, who is also a physical therapist, and has two children. Biller enjoys getting outdoors on the weekends, especially to go mountain biking and hiking.