The Rotator Cuff
The rotator cuff is a group of four muscles which surround the shoulder joint, holding the shoulder securely in place.
Injuries to the rotator cuff are quite common, particularly in people who do a lot of repetitive over-head work such as painters who have painted ceilings, boxers, window cleaners and even people who throw a ball over and over for their pet dog.
Supraspinatus is the muscle that sits in the top groove of the shoulder blade and its action is to lift the shoulder at the side. If this muscle is completely torn, the shoulder cannot lift up to a horizonal level without help. Once the shoulder gets to horizontal (with help), other muscles help it to lift all the way up.
Subacromial impingement is a condition which affects the rotator cuff muscle tendons. Tendons are the white section of connective tissue which joints muscles to bone. In subacromial impingement there is not enough subacromial space, for the tendons to move because they are being squashed by something such as the acromion (part of the scapular bone) or inflammation of the subacromial bursa (a fluid filled sac which protects the tendon).
Treatment for subacromial impingement varies depending upon the cause and severity of symptoms. It is therefore beneficial to get a diagnosis, so that treatment can be more effective. In cases of a completely ruptured supraspinatus tendon, surgery is normally performed to re-attach the tendon especially in younger patients. For older patients, supraspinatus tendon surgery tends to not be as successful as the muscles surrounding the shoulder tend to be weaker.
Subscapularis is a muscle which sits directly underneath the scapula (shoulder blade), its function is to turn the arm inwards (internal rotation), such as the motion of touching your low back. Symptoms of subscapularis injury include pain and clicking in the shoulder. To strengthen your subscapularis, you can fix your elbow to your side, and with the elbow bent to 90 degrees, press your hand inwards against a doorframe. Hold this for 7 seconds and repeat 3 times per day.
Teres minor and infraspinatus externally rotate the shoulder, so to strengthen these muscles stand beside a wall with your shoulder relaxed and elbow bent up to 90 degrees. Press outwards with your hand, whilst keeping your upper body still. As above, hold this for 7 seconds and repeat three times per day.