Vickie...need help strengthening my rotator cuffs

I'm only 23 but i've played sports since i was 7. I'm a natural left hander however i have played certain sports the other way (righty) which has placed the bulk of the strain throughout my sporting career to my left shoulder/rotator cuff.

For instance:

-Baseball threw left handed, i was a pitcher and/or outfielder
-Batted right-handed (left arm went across the chest)
-Basketball shot left handed
-Hockey, played lefty. Power shoulder is your left, i had one hell of a slap shot for a teenee-weenee nobody, 3 fastest shot in the league thank you very much!
-Golf, i play righty...again left shoulder

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Due to all of this i have worn out some of the "stuff" (i forgot what they said at the doctors) that the ball (in the shoulder) sits in. I had a certain MRI where they inject die in the joints and they found that nothing is torn, but it was worn out some by the "tip."

So due to all of this when my left arm reaches an extreme angle during my golf swing, i get a "pop." Sometimes its louder than others.

I had physical therapy and we changed my posture some to help distribute the shock of impcat better and it seemed to help some but it still is coming back some and i can't afford to keep going.

Anything you can reccomend?

The main things i was doing were:

arm raises that activiated the muscle right under the traps, i think the lat? He had me doing arm raises 3 different ways. Palm down, up, and in between.

We also put my elbow at my side and put my forearm at a 90* angle to the upper arm and used a cable to pull outward and inward.

We also worked on balance moves with it.....kneeling posiiton (like a dog) and balanced on just my left arm, then switch.

Those were the main ones....

Anything you could suggest would be very helpful

Not addressed to me , but I thought I'd chime in.

You'd want to ensure that you have adequate range of motion for the golf swing. It's not clear which "extreme angle" of the golf swing gives you the "pop." Key movements would include internal and external rotation of the shoulder, but in your case (and as a fellow lefthander who plays righty), you also need good flexibility of the posterior capsule of the left shoulder.

Sounds as if you might have some rotator cuff irritation/degeneration due to "impingement." You will want to ensure that your scapula (shoulder blade) is free to move and help make your shoulder successful. The shoulder blade very much depends on the muscles attached to it, as it's only direct connection to the skeleton is to the sternum through the collarbone. [And, if we really want to clear you, we'd check the mobility of your upper thoracic spine] So, we need adequate flexibility of the chest muscles, lats, upper traps, and the muscles between the shoulder blades.

The exercises you were given sound like traditional shoulder rehab exercises. Um... you might want to try exercises that look and smell a little more like golf. What does your left arm do during a golf swing? Try some exercises that replicate those movements, particularly on the loading aspect (i.e. backswing) and the deceleration aspect (follow-through).

One last tip (and possibly the biggest one) - is your buttock and hips helping your left shoulder to be successful? This is a serious question.

Not sure why...but my legs and lower body is the strongest part on my body. Even when i was a puny 150lbs in high school i out leg pressed half the football team.

So i would say my lower body is strong.

Thank you for your help

1st let's just appreciate that physioguy is chiming in. His information is not only accurate and valuable but interesting and entertainintg Sounds like your glenoid fascia is wearing out. Ok lets look systemically, just like the physio-master suggested. If your whole spine is not aligned, yea you guessed it Jim, it is not going to all work just right. I don't use the tech terms but if your 1st and 2nd cervical vertebrae don't balance your head just right with your sacrum then you can't hit a ball well much less without pain. So you have to look at the whole system. Having great leg strength can be a plus unless it isn't balanced with your chest strength which by the way is connected to your scapula (yea, that's the shoulder bone) by way of many muscles including the biceps and triceps. Now you know that Homer Kelly talks about the triceps . . .

I once trained a guy that was only 15 and had been scouted by the pro baseball people ( he was also a high level soccer player BTW) but had lost his game; why you ask? He was a pitcher / short stop but he couldn't stretch his left leg forward (without pain) so he couldn't throw his fast (right) ball. His trainer wouldn't work on his lunge because "it hurt him". Duh! He had lost his 'balance' so we worked from the most elementary point. [This will kill tongzilla, we worked almost exclusively with the therapy ball and increased is abdominal strength by 80%; you don't want to know how we measured it]. We started at the core, I hate that term for the record, we just said let's work the abdomen. But we did do some Pilates which means you look at the transverse muscle. We also isolated the right and left side of his rectus abdominus ( it is 2:30 in atlanta, give me a break on my key stroke until I see this at 4:00 pm tomorrow) Stand in the mirror and tighten one side, without dropping you shoulder and then tighten the other. I do a lot of work with neuroligically challenged people and it works for them. My healthy people are always shocked ,aND challenged and enhanced by the work.

Next, don't so do much to strengthen your shoulders as work on your ability to move through the full range of motion with some resistence. Yes, this means you increase the weight slowly (the traditional, sissy and safe way, is 5%) and avoid injury but you also avoid thickened (excessive) soft tissue development; for those of us that want to maintain range of motion . . that means . . well. . ., range of motion. See how strong and simultaneously flexible your joint functions can develop, . . . think turtle.

Finally, see if your highly powerful hip muscles are more compensatory during your swing than you anticipated. Seems like a strong anchor would make for a better swing foundation except, like the song says, it really is all connected so . . . if you are swinging a weaker, less balanced 'upper' relative to a "lower" . . . you got problems.

Remember that flexibility is the other side of the strength coin. What is your whole workout? Chest? Back? Legs? Abs? Shoulders? (your traps are back by the way - BTW for those of us that are not so computer literate) what do you stretch and when and do you do abs. Youth is great but . . . I have to tell you I have less pain at 48 than I had at 25 since I learned about balanced training. Oh yea, I play everytning better, too.

Let's keep talking. And physioguy, Jim only addressed me caz I'm the moderator. Everyone should please chime in. I will feel free to put in my two cents, fear not; it's a woman thing.

Vik

First learn to do trigger point therapy on yourself with a large super ball.

Buy a speedchain and start swinging it with your bad arm. Cirlces, figure eights, tennis back hands, forehands and any other motion you want to try.

Having come out second best in an unfortunate meeting of car and train in the early 80's, I was told that my left arm would be useless and my golf was over. There weren't any pieces of my shoulder big enough to wire together. I worked like a dog in physio for a lot of years and I've developed a few exercises that allow me to play some decent golf.

Whenever I hit the fridge for a snack or a beverage, I pay for it by leaning into the kitchen counter, my hands on the counter edge, my elbows at my
sides. I then slide my feet back to the point where I feel my heels wanting to rise. Then, I do what amounts to a modified push-up, my chest lowering to the counter, then pushing away with my arms until they are
fully extended. I lean into one arm then the other then both take the weight equally. 45 reps done several times each day (depending on your snacking frequency) will result in a good stretch for the back of the legs and stronger shoulders and triceps.

Then it's the rotator cuffs that I want to work on. I have found that washing the back, neck and shoulders with a soapy washcloth does the job well.
While bathing or showering, use a circular motion in each direction, 10 times, first by putting the soapy cloth behind your back to the same side`s lower back then do the opposite side lower back and then do the opposite side shoulder blade. Finally, reach behind your neck and wash in circular motions toward your shoulder blades to the left and right. Repeat this for the other hand reaching around and you not only have a clean neck and back but you have also stretched and strengthened your rotator cuffs. I find that the circular motion works best and the 10 reps in each direction is sufficient, and you will notice that these motions becomes easier as the muscles strengthen.

My range of motion aint great and I still deal with chronic pain but I can play and shoot in the 70's as many times as not, hitting or swinging.

Hi Jim,

The good news is that your MRI gave you the go ahead to rehab. Even though you shared your rehab protocols, and they helped, I can't be sure they were executed with enough precision to bring the joint back into it maximal capacity; as opposed to being an exercise in temporary pain relief.

Rotator Cuff problems are always and forever an indication that your shoulders are out of alignment. This includes the position of the shoulder blades which indicates inappropriate application of the rhomboid, latissimus, and pectoralis muscles on the primary level and many smaller muscles on the secondary level; as you can imaagine that is where the evaluation comes into play.

Since I have worked in a physical therapy facility, in gyms with 'professional' trainers, and witnessed the 'experts' on TV (yes that includes the golf channel) I must tell you that more often than not I have seen perfectly effective rehabilitative movements applied without the benefit of alignment. This translates into limited positive outcome and an opportunity to strengthen in the disfunction.

Your goal in your training should focus on creating a balance of tension in the shoulder girdle. If one primary system is faulty then the whole system functions poorly.

First things first. Overuse of your dominant arm is inherent in every sport. The only solution to avoiding eventual damage (whether it is pain or just loss of full use of funtion that translates into loss of accuracy or strength) is to re-establish balance at the end of 'play'. If you continually realign your structure then you avoid the residual deterioration of the soft tissue. This actually holds true for even non athletic endeavors. I will tell you that the aches and pains we call old age are nothing more than loosing our alignment over time and suffering the slow deterioration (as opposed the the more rapid deterioration we see in overuse for sport endeavors) of a perfectly designed frame we call the skeleton due completely to mismanagement of the muscular system. The bones go where the muscles take them. Period.

So what do you do?

1. Realize that the muscle has two functions: contract for power and elongate with proper counter tension to keep the joints from collapsing into the contraction. This includes the spine which is nothing more than a series of intricately connected joints.

2. For the above reason you must have a flexability program and a strength program. You must bring at least as much intention and concentration in your stretch positions as to pushing against resistance for strength. In fact possibly more since we like to measure our workouts in distance, quantity of weight and range of motion. Flexibility is measured, literally, in millimeters so most of us feel impatient with the process. Maybe this will help; there is only a 3 degree range of motion between the spinal joints. Accomplishing (over time) a 1 degree increase means a 33 percent increase in function. Weights force you to breath but the same amount of oxygen must be created within your cells to give you the energy to create the work of stretching muscle fibers, so you have to think about it. The reason most people have more success in yoga than traditional stretching is simply because breathing is emphasized from day one.

3. Learn to perfectly execute the exercises that address the core muscles of your body. This is not, as is popularly misunderstood, just the abdominal wall but includes the neck and thigh muscles. You don't have to become a body builder but must use a level of resistance that challenges your natural strength threshhold (level). You don't have to be in the gym an hour or do 'so many' sets but address the primary muscles in their entirety and with complete focus on execution of the movements.

4. Since your bicep and tricep and a secondary pec muscle all connect the shoulder blades make sure you can create full extension with absolute alignment.

5. I don't often suggest other peoples material because it still requires learning to set your body in proper alignment before you apply even the best effort but . . . this is a very useful book. The 7-minute Rotator Cuff Solution by Joseph Horrigan, D.C. & Jerry Robinson. There is a lot of information about the function of the joint and I think their illustrations are pretty close albiet not as refined as I instruct.

Would be easier to be more specific with an evaluation in real time but alas . . . In closing just remember, as long as you play gold, or any athletic activity, you must bring your body back to balance so it will not suffer from the necessary adjustments you make to load-up maximal power for your drive.

Best of luck, Vik

P.S. It will also help in refining your short game

Good Stuff VL.

UPP in rainy Ohio