Physiotherapeutic intervention
The rotator cuff can be trained through certain exercises in physiotherapy. These include training in external rotation for the teres major, infraspinatus and supraspinatus muscles, and training in internal rotation for the subscapularis muscle. In addition, support exercises are well suited for strengthening the rotator cuff.
There are certain coordinative exercises that promote and improve targeted activation of the shoulder joint fixation muscles in the event of instability. Training for external rotation is often more important than that for internal rotation, since in everyday life we often find ourselves in a more prostrate posture in which the shoulders are pulled forward and external rotation is restricted. Support exercises such as forearm support, the four-footed position or even the push-up position also train the rotator cuff.
It is always important to maintain a good posture during the exercise, and not to put excessive strain on the passive joint structures, but to really strengthen the muscles in a targeted manner. The exercises can be varied and made more difficult by lifting support pillars or shifting weight. Support exercises can be found in the article physiotherapy exercises back.
Coordination exercises are also often helpful. Through manual stimuli and resistance directly on the shoulder head by the therapist, the patient can learn to activate his rotator cuff in a targeted manner and possible joint instability can be improved. Later, such exercises can be made more difficult by adding a ball or other aids that disturb the concentration on the joint until a secure fixation is also given in everyday life.
Further mobilization exercises for the shoulder can be found in the article Physiotherapy Coordination and Balance Training. The muscles of the rotator cuff help to move the upper arm in various directions of movement, but are also particularly important for fixing the shoulder head in the socket and thus perform coordinative work. Common clinical pictures of the rotator cuff are rotator cuff rupture or impingement.
In young people, the former is usually due to an injury, while in older people, wear and tear can also cause the tendons of the rotator cuff to tear. Impingement is also known as shoulder stenosis. The head of the shoulder is displaced upwards in the socket under the so-called acromion, resulting in a narrowing of the structures running there.
These include the attachment tendon of the supraspinatus and infraspinatus muscles. In this disease, the spreading of the arm is often particularly painful and limited. Here, too, inflammatory changes in the joint can occur, ultimately leading to shoulder arthrosis.
