The acromioclavicular joint (AC Joint or Rotator Cuff) of the shoulder facilitates the largest range of motion of any joint in the body. It is comprised of muscles, ligaments and tendons that work in harmony to coordinate movement in both the scapulae (shoulder blade) and arm. When functioning optimally, the rotator cuff allows an extremely wide range of motion, accounting for more than 1600 different positions, providing function for multiple activities, from work to recreation. When the rotator cuff is injured, the associated pain and dysfunction can completely disable a person's ability to perform normal activities.
A variety of injuries can occur that result in symptoms ranging from a general ache to dehabilitating pain and dysfunction of the shoulder joint. The most acute form of injury usually results from direct force trauma that occurs from impact on the shoulder joint. This can occur from a car accident, football tackle or fall, and generally results in at least one or more ligaments being detached as well as tendons being torn.
Another from of serious shoulder injury occurs from a muscle imbalance resulting from repetitive overuse. Unidirectional (one way) movement patterns cause the muscles that are controlling the movement direction to become stronger, larger and shorter than the opposing muscle groups, resulting in imbalanced muscles and therefore an imbalanced joint. Most often, the muscle imbalance results from excessive over utilization of the anterior (front) portion of the shoulder, resulting in the humerus riding forward in the joint capsule, which in turn, causes Impingement Syndrome or Thoracic Outlet Syndrome to occur. Although there are a number of shoulder injuries, these two are very common and are associated with overuse.
Impingement syndrome occurs from the anterior shoulder muscles pinching the supraspinatus muscle, resulting in severe pain when trying to reach above the hard or across the body towards the opposite shoulder. Thoracic Outlet Syndrome results from compression of the Brachial Plexus, the main branch consisting of the Radial, Median and Ulnar nerves, which control feeling and function of the entire extremity. Symptoms usually consist of the entire hand falling asleep when the hands are out in front of the body at chest level or above the head, as raising the arms causes increased pressure on the anterior shoulder/ upper pectoral region where the Brachial Plexus lies.
With this in mind, many physicians and therapists recommend exercises to strengthen the musculature in and around the shoulder joint in order to eliminate or prevent muscle imbalances, while simultaneously increasing overall shoulder strength and joint integrity. When properly devised, an exercise regimen can build strength and provide flexibility for both muscles and tendons. This in turn prevents undue stress and strain on the acromioclavicular joint and its ligaments and tendons.
Rotator cuff exercises provide a safe, easy way to both prevent and rehabilitate shoulder injuries. Creating more strength and integrity in the shoulder joint than is going to be used by a particular activity can greatly protect the area from injury. If the joint is made to withstand 400lbs of pressure and it is only asked to use 300 lbs, it is going to be less prone to injury as it is stronger than the force that it is being subjected to. This is such an important key in preventing injuries. Prepare the body for the activity; do not perform the activity in order to prepare the body for that activity. And if an injury does occur and rehabilitation is necessary, it is again important to realize that the injured muscles will never regain their original strength unless specifically isolated and subjected to resistance training to bring them up to pre-injury levels and beyond. Research suggests that within as little as 4-6 weeks, performing a regular strengthening routine using free weights, resistance bands and/or flextend, most patients report substantial improvement.
Remember to always consult your primary care physician about an injury that may have occurred so that you receive a correct diagnosis.
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