Rotator cuff issues

**Traceur** · Posted On: 7/24/2011 9:20am

About 18 months back I messed up my shoulder with a combo of training, rock climbing, poor form in pull ups and kettlebell snatches.

A referral to a physio diagnosed minor tears to the infraspinatus and supraspinatus. Side/contributing issues were a winging scapula and over tight pectoralis minor.

So I diligently did the physio exercises, sucked up the training lay off and once I started again paid careful attention to form along with way. A few days ago I was doing a KB circuit for time mixed in with push ups and now the whole area is sore as hell, just like it was before I got to physio in the first place.

I've got to accept this is going to be a problem area from here on in but does anyone have good tips for looking after this area? Other than paying attention to form (when I am not being stupid and going too fast) I use an ice pack and resistance bands to work the rotator cuff muscles. I would love to figure out how to make this area less vulnerable to injury.

Thanks in advance.

**ChenPengFi** · Posted On: 7/24/2011 1:09pm

Take your time with rehab, sounds like you aren't quite ready for intensity yet.
Remember that the steps of rehab need to be completed in sequence:
* Decrease initial pain and inflammation.
* Improve flexibility.
* Improve the strength of the joint.
* Re-establish neural control and co-ordination.
* Return to full fitness.

Prudence dictates to keep up the physio for a while more.
I assume you're doing band work with internal/external rotation, shrugs etc?
Pay particular attention to the eccentric movements.

If your scapula is winging, you haven't completed the second, third and fourth steps up there^.
Winging scapula usually also involves a tight serratus anterior, subscapularis is probably shortened too i'd guess.
Some type of massage could really help with that issue.

Finally DO NOT resign yourself to this being a chronic/lifetime issue.
Just be smart about it.
"Argue for your limitations long enough, and sure enough they're yours."
Good luck.

**Traceur** · Posted On: 7/25/2011 2:33am

Thanks a lot for your reply, that's pretty comprehensive. You must be a physio yourself or you have been through something similar.

I carried on the physio exercises for a good while and the sports masseuse I go to (who recommended her own physio) said everything was as it should be and I was engaging the right postural muscles. Oddly enough she detecting scapular winging on the other side but as I'd been doing pull ups again (keeping the shoulders tight instead a dead dead hang) I thought I was probably good to go again.

I guess this is what happens when you are closer to 40 than 30 and expect to heal like you are still in your 20s. I guess I need to keep doing the band exercises in perpetuity. I know I will still be able to train, it just means some things like full on grappling will be a no-no from now on unless I want to emergency tap whenever someone grabs my left arm.

My physio used to work for the UK karate team and a load of boxers. She doesn't like the strains martial arts put on the body but I told her I'd be going back anyway. :D

**ChenPengFi** · Posted On: 7/25/2011 2:51pm

You should be able to make full recovery from the sounds of the injury you described.
It just takes time and patience.
I have a small private clinic specializing in sports injuries and rehab and have injured my shoulder much worse than you.
I can share a great massage sequence that addresses the winging.
You can try that with your therapist if you'd like.
Share your concerns with your therapists, they should be able to fine tune your program to meet your goals.

PS, I looove my MA and crazy, athletically-addicted clients. It's called job security. :)

edit: Here's a pretty good resource: http://www.sportsinjuryclinic.net/cy...otatorehab.php

**Traceur** · Posted On: 7/26/2011 2:24am

That's a great link. Many thanks for that.

Ha - one thing my physio did say is she likes to treat people who are athletic or have physical pasttimes they want to get back to because they go and so they put they hours in with the rehab exercises.

I was getting up an hour earlier to go through all the knee and leg exercises and stretches she gave me (at the same time I tore the rotator cuff I also tore a hamstring - I was a bit of a wreck for a while.)