Severe pain around the top, front, and side of the shoulder is quite common and can often be traced to problems in the Rotator Cuff, the group of muscles surrounding the shoulder joint. In this article, you will learn about this delicate muscular collection and discover important steps toward healing your shoulder pain.
The shoulders are perhaps the most overused and under-cared-for joints in the body. They are essential in the performance of everyday activities such as typing, driving, reaching, lifting, etc, but also take a lot of strain in more strenuous activities like tennis, weight lifting, rowing and other sports.
Rotator Cuff Basics
The four muscles of the rotator cuff wrap around the arm bone, attaching it to the bones of the shoulder and holding it in the hollow of the joint.
The rotator cuff plays a key role in all movements at the head of the arm bone. It helps lift the arm forward, pull it back, lift it to the side, and circle it all the way around. When a pitcher winds up to send the ball over the plate, the rotator cuff is what gives him the control to follow through with force.
The repetition of daily tasks can cause limited range of motion, as well as a hardening and shortening of the muscles in the complex structure of the shoulder. This can lead to damage and inflammation. Going from everyday repetition to the demands of sports takes an even greater toll on the rotator cuff.
Think of these muscles like the cuff of your shirt. Ideally, the rotator cuff muscles should be supple and pliable, allowing the arm to move in the socket with ease. However, these muscles are often either over-used or tight from inactivity and the cuff becomes more like a stiff t-shirt.
In this condition, the rotator muscles can easily become frayed or even torn through repetitive motions or sudden movements. They can also become irritated by rubbing against the bones of the shoulder. In these conditions, inflammation is virtually inevitable, which can severely inhibit motion, even to the point of preventing it altogether, causing a condition known as Frozen Shoulder.
Solutions for the Rotator Cuff
The first step is to give your shoulder a break — playing or working through the pain will only lead to further injury. Your first priority is to remove inflammation from the muscles of the rotator cuff by applying the RICE treatment (Rest, Ice, Compression, Elevation) along with pain and/or anti-inflammatory medications. Removing inflammation will help relax the muscle, which accomplishes three objectives:
- Relaxed muscles occupy less space and therefore there is less chance of abrasion of the tendons and muscles on the bones of the shoulder joint.
- The relaxed muscle exerts less pull on the irritated tendons and therefore causes less pain.
- Relaxed muscles allow greater circulation of blood and nutrients and therefore give the damaged tissues greater efficiency in healing and a speedy recovery.
Although the treatment options following this vary, the most important thing is to restore resiliency to the muscles and keep them from pulling the rotator cuff into further damage. Self-massage of the rotator cuff muscles using Yoga Tune Up® Therapy Balls and the accompanying Rotator Cuff Series can be a great help. For strengthening and stretching exercises check out the Yoga Tune Up® Shoulder Quick-Fix Video.
The muscles of the Rotator Cuff are delicate, complex and prone to injury. However with a little maintenance, and a regular exercise and massage routine, you can have healthy shoulders for life!
The intricacies of the rotator cuff and the reality of how we can overuse it is unfortunately so common.
I like this article a lot; it’s very informative. And I love the three objectives to achieve through rest. It reminds me of the space we must have in our bodies in order for our automated bodily functions to do its job! Thank you!
This page and many others on your site link to “Shoulder Quick-Fix Video” page. However, there is no video on that page, nor a link to a video. Please help!
Thank you for this very helpful summary and not only covering the cause of rotator cuff dysfunction but also pointing out a treatment consisting of both relaxing and strengthening the affected muscles.
This is a fantastic article and very good advice for anyone and everyone who spends time hunched over a keyboard, curled over a smart phone or slouched on the couch. Shoulder pain is a part of the modern condition, but it shouldn’t be. Now, we have the tools and techniques to address these issues. Thanks!
I agree that it is so important to let shoulders rest before these stressed out muscles can heal. I did that when my shoulder was frozen. However, in addition, I began a years-long process of strengthening my serratus anterior, which becomes an awesome buddy for your shoulder and supports it as it heals and increases range of motion.
So often I have blamed my anterior deltoids for my limited ROM in my shoulders. I certainly feel their tension when I extend my shoulder all the way back. I think strengthening these rotators… Particularly the infraspinatus, and teres minor will help extend my shoulder more, in the sense that they can create more tensoion, and help the antagonist deltoid release in this case. Thanks!
As a yoga instructor on the North Shore of Oahu I see many surfer bodies who lack a range of lateral flexion in the shoulder joint. A ROM necessary for any safe down dog, chaturanga, forearm stand, arm balance and much more. When paddling (the foundation of any surf practice) the shoulder joints do experience a full ROM, but the majority of the resistance happens underwater when the arm is in internal rotation and extension. To increase the stability and mobility of the shoulders, the joints must be exercised in all fashions of movement to decrease imbalances and floss out the stuck junk. Fluid like motion at the shoulder joint helps enable the shoulder joints to breech the water and return as quickly as possible to the water, propelling on!
I have found the Yoga Tune Up Shoulder Quick Fix video and other exercises to be very effective with myself and students.
These Yoga Tune Up ROM exercises assist the surfer in making a clean fluid stroke, with less stress and more power.
It wasn’t until I experienced my own shoulder pain that I could completely understand my students’ pain. The thought of further injury can be terrifying! The good news is that healing and strengthening is possible with the right information and action.
great write up about the rotator cuff. The shoulders are a part of the body i really have a hard time remember all the muscles and how they work. Hips are so much easier to memorize!
Thanks so much for helping me understand the rotator cuff’s muscles and direction of movement. I teach fitness classes and one of the most common areas of pain/injury participants complain about is in the shoulder in the rotator cuff. Next time a participant asks what they can do for it in terms of strengthening, I will definitely refer them to Yoga Tune Up- Shoulder Quick Fix video.
Thanks for the thorough description. The rotator cuffs were my first yoga stress area
Thanks for posting the quick fix video link! Courtney & I have decided to practice handstands every day so this will be our new warm up.
Thanks for this information. So many of us suffer shoulder pain and are not clear on how to heal ourselves. Rest assured, I will be using the many tools/informaiton you shared down the road to help heal others and your truly.
Thank you so much for sharing this, it’s so informative and well explained. I love the examples and the way you explain the healing process. Taking care of our shoulders it is SO IMPORTANT to avoid injury. The Yoga Tune Up shoulder exercices are a wonderful way to bring awarenes to the shoulder gridle.
Great information on (those darned) rotator cuff muscles and tendons. As i learned during the first day of the training this week, the balls must be applied gingerly in this area if it’s been inflamed before — in my case, a couple of months ago. Otherwise, you “awaken the beast”, which is why i’m writing this with a bag of frozen peas sitting on my shoulder. Now i know and hopefully, this too shall pass….
I have been nursing a left wrist injury for a few challenging months now, and having recently begun yet another yoga training, I found myself back in planks and chatturangas again after weeks of following orders to give my wrist a rest. I noticed a few (sore) days into the training, that I was basically compensating by over-using my right arm, and by the week’s end, my rotator cuff was inflamed and very cranky. I gave it a rest this weekend, and I am hoping the inflammation was temporary, but I will indeed be using my yoga tune up balls and letting the shoulder rest if it flares up again. Jeffrey’s point that a relaxed muscle takes up less room may seem obvious, but it hadn’t occurred to me…and the sensation of tugged-on tendons is not one I want to revisit. Thanks for the reminder that rest can prevent further damage.
As another responder stated, Rotator Cuff injuries are pervasive. I have more students with shoulder injuries and a majority of those students are over 50. Overuse with little attention to carefully strengthening the joint seems to be a common thread. I find Yoga Tune Up exercises and therapy to be very helpful at isolating muscles in a complex joint and working on them individually, layer by layer. That not only serves to relieve pain and stiffness but isolate areas that require strengthening in order to stabilize the joint which decreases wear and tear going forward. This is particularly true when it comes to the Rotater Cuff and the balls as well as the exercises in the YTU tapes are excellent for personal body work as well as assisting students.
Great picture of the muscles of the rotator cuff. I think that most people think that the rotator cuff is one muscle that they might find when they look for the origin of their pain. Many people have shoulder issues and this is one of the most misunderstood areas of the body. Regaining range of motion and strengthing these muscles is something that we all can benefit from.
I liked that you reminded us to rest this area when inflamed. I have had a rotator cuff injury and it took me over a year of diligent work to help heal it.
Your blog is very well-written, and I have a personal affinity for your topic, as I have a rotator cuff injury. It’s so important to take care of your shoulders. Better to prevent than have to manage injury (I’ve stabilized mine through modification of my practice and YTU, but the only true fix is surgery, as a tendon is torn). Someone once described the shoulder socket to me as being a basketball and a plunger. The tiny muscles and tendons of the shoulder have big jobs to do and a lot of things to work around in that small space. It’s so important to remember this in our yoga practices.
Thank you! I have been using the therapy balls on my injured shoulder and have seen a great improvement. I still feel I have limited range of motion, but the daily pain is gone and my strength is returning.
Thank you for this post! I have massage clients and yoga students with shoulder injuries and this was very helpful!
After yesterday’s YTU therapy ball sessions working the shoulder and arm, I have new found respect and knowledge of the musculature of the shoulder cuff and surrounding areas. This is an area of the body that has eluded my understanding to my regret I only wish I’d found YTU sooner. The hands on work we are doing is giving me mental picutres of intricate details I have never been able to call upon. And my classmates amaze me with their knowledge and creativity. I am learning so much from them, an huge bonus to this training. Thanks to all.
i love this picture of the rotator cuff muscles, i keep thinking of them as encapsulating the shoulder blade but of course, there are attachments to the humeral head as well and this picture shows this clearly. thanks for sharing, and also explaining why its so important to release and relax this area. i haven’t been spending enough time on the shoulders with my YTU balls!
I wish I had read this post a few months ago when my mother injured her shoulder moving something that was about a third of her weight. After many years of habitual internal rotation of her shoulders (from working at desks, writing, needlework, etc.) the sudden compression and force forced on the inflamed muscles of her rotator cuff was one insult too many. She decided to power through the pain by assaulting her shoulder with more activity like aggressive gardening and swinging golf clubs. The pain got worse and range of motion in the shoulder smaller. After 6 weeks, she finally went to see a specialist who said surgery might be needed to reattach torn tendons and ordered her to stop treating her poor shoulder like a drill sergeant. After the observation of RICE and a few weeks with a physical therapist, the shoulder will not need surgery and is healing nicely. YTU therapy balls are next. Your explanation of why working an inflamed muscle is unwise makes a lot of sense. Thank you.
I really appreciate the breakdown of the rotator cuff mechanics and the advice for self-massage. Having had both shoulders injured (one many years ago, and one relatively recently), I feel the adhesions/scar tissue in both, and the differences between the older injured shoulder and the more recently injured shoulder in all type of activities (yogic and ADLs). I particularly love the YTU quick fix videos (5 and 10 minutes), and have especially come to appreciate the Pranic Bath for its gentle awakening of the entire shoulder girdle. The therapy balls are also excellent in the rotator cuff sequence, but I agree with Dinneen and Dilshad that a gentle exploration is called for, at least until those areas have more oomph to experience opening.
very helpful! and the therapy balls are an amazing tool for pinpointing this area. thanks!
Thanks Jeffrey for this and the related articles on rotator cuff injury and the process of healing. The article is very informative and I enjoyed reading it. Your explanation of the objectives of relaxed muscle is so crucial to understand. I certainly believe that Yoga Therapy balls are effective once the R.I.C.E is done. However one has to work through the surrounding area a little further away, first and then explore very gently around the area.
R.I.C.E! YAAAY! It’s sooo easy. And cheap too! 🙂
When aggravated or moderately injured, the body will heal itself if given the proper environment. Practicing the first Astanga series or doing vinyasa flow while ignoring pain signals from the shoulder is not so great for joint longevity. Ice and rest and conscientiously limiting arm movement while the area is inflamed will exponentially increase the body’s ability to heal itself.
As a Health and Nutrition Coach who specializes in reducing chronic inflammation in the body, it is a joyous moment to hear the old R.I.C.E. get trotted out in a rotator cuff injury discussion! Many of us have heard the acronym but perhaps can’t recall that it simply means Rest Ice Compress and Elevate the injured area. I really appreciate how you give the reasons WHY reducing inflammation is important to the rotator cuff joint.
It’s also important to add the YTU balls should be used very, very gently and in an “exploratory” manner on mildly inflamed tissue, The flip side is that digging the balls into red, angry tissue may exacerbate the condition.
You will always met someone who has a rotator cuff problem. After experiencing the YTU Balls and the rotator cuff series, I this would truly be a great way to correct problems and aid in the healing process.
about a year ago i injured my shoulder… my practice has b=since changed dramatically. thanks for the info!
Helpful article it seems every other person I’ve met over the age of 40 has some experience with rotater cuff injury,
and I think creating flexibilty and strength is the key… too many times people are doing one or the other , the weight lifter who
builds his biceps and pecs and turns around yet cant extend his elbow and develops adhesions around the elbow joint
or the yogi who does vinyasa focusing on flow and extension with out eccentric strenghtening
This is important information about the biomechanics of the shoulder and how to treat a rotator cuff injury. I find that I don’t want to wait with RICE and other anti-inflamation techniques. And yet when my shoulder injury gets cranky it is exactly what I need to do before I start to move again or even to use therapy balls. Thanks for the thorough description of how this works. PS After the inflamation is down, YTU® and the therapy balls are the very best remedy for me.
Having had a fantastic scoliosis, dislocated shoulder (no, not Yoga – diving), I have been working those shoulders (and still am).
Use it or loose it. Good to see and encouragement to work the shoulders intelligently. Many opt of just waiting…. and waiting, and waiting… and gathering more and more fuzz in their fascia.
I had frozen shoulder for 2 years. And I still hadn’t regained the full range of motion. I realize now that my joints are hyper mobile and lacks stability. That is why doing the daily routine of exercise is crucial for maintaining the shoulder health. I use Yoga Tune UP Shoulder shape up DVD all the time. I am confident that I will soon regain full range of motion. But the best part of all this is, I gained so much awareness and intelligence because of my injury.
I learned a lot from watching the shoulder quick-fix video. I will be adding these moves to my life.
I had my right shoulder scoped 4 years ago and am always interested in reading informative articles on how to keep my shoulders heatlhy and active.
I found this to be extremely helpful in the contraction of the infraspinatus and in the triceps. I often compress my rotator cuff in chaterunga and this article helps me to create space and be more aware of my body. I feel that as I relaxed the muscle in these poses it exerts less pull on the irritated tendons and i suffer less from pain. Informative!!
Yoga Tune Up Shoulder Link video is incredibly helpful in this regard. I am particularly interested in how things get more complicated when the usual DOMs in the shoulders are compounded by a torque or twisted motion in bad movement, which is the problem I’m having.
good information and reminder of how important it is to to create awareness for your Rotator Cuff wether it is in poses like Downward dog or through the use of your Yoga tune up balls.
Following the thread for rotator cuffs. Another, very informative blog. Thanks, Jeffrey.
A great window into the everyday actions that impact our rotator cuff. Even as I type, I can bring conscious awareness to the suprasipinatus, originating from the ventral surface of the scapula, inserting at the lesser tuberosity of the humeral head. No longer can I shrug my shoulders without realizing its interconnectness to accessory muscles, like the trapezius and deltoids. Really good reminder to use the Yoga Tune Up (R) balls to massage this part of the body.
My godfather is in his 60s and has cleaned pools for a living for many many years. Thus, he has chronic and acute pains in his shoulders. I’m excited to show him this site, as it will provide him with more tools for healing.
Do you have videos showing where to place the massage balls to heal the injured rotator cuff muscles?
I must say, I enjoy reading your site. Maybe you could let me know how I can bookmark it ? Also just thought I would tell you I found your page through yahoo.
Extremely interesting blog post thank you for sharing I have added your site to my bookmarks and will be back.
thank you for sharing this!
thanks !! very helpful post!
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