By Dr. Mark Cheng
The rotator cuff is one of the most constantly used muscle groups in the human body. Every movement of your hand requires some involvement of it. So when you're working on lifts like heavy bench presses or lat pull downs, those muscles can decide your limits.
Traditionally, the rotator cuff is thought of as the muscles that start on the scapula (shoulder blade) and attach to points in the humerus (upper arm). The supraspinatus, infraspinatus, teres (major & minor), and the subscapularis are the major players in this league. Of these, the infraspinatus and subscapularis are often the most knotted up with trigger points. That, in turn, can cause the workload to shift towards the smaller, thinner teres and supraspinatus muscles, making them more prone to strain.
When the rotator cuff muscles start getting locked up, they affect everything that the shoulder blade is attached to. Thus, the elbow, the neck, and even the thoracic spine (mid back) can suffer because of a dysfunctional rotator cuff. Your grip can also give out because of rotator cuff problems. Since the levator scapulae muscles start on the shoulder blade and attach to the vertebrae of the neck, a over-tightened rotator cuff can mean that you're putting uneven strain on your neck every time you simply move your arm.
Do I have your attention yet?
Now that we've identified the importance of the rotator cuff, how to address those trigger points is even more important.
RULE #1 OF FUNCTIONAL MEDICINE - We don't just treat the site of pain. That means that you shouldn't just blindly roll or put pressure on what hurts. If the front of your shoulder is aching, that's probably not where the root problem is unless you just got punched in the front of your shoulder. Non-contact injuries are almost always rooted ELSEWHERE. Now we have to go on a search & destroy mission to find those hidden trigger points.
While the bulk of the subscapularis muscle lies between the shoulder blade and the ribs, the infraspinatus sits readily available to outside pressure, making it ideal for rolling. As you go through this vidclip, pay special attention to the set-up position. If you angle your body such that you can get pressure with the nubs of a Rumble Roller into the trigger points of backside of the shoulder blade, hang out there and train yourself to relax into it, moving back & forth gently, allowing the roller to penetrate deeper & deeper from one position to another. The 3 S's (presented in the previous installment of the Rehab Prehab series) should also be kept in mind as you work on unlocking the rotator cuff.
The muscles that span the shoulder are like a team. When any one muscle is overactive, it gets pumped up, occupying more space, but it can also become less functional if it's not trained properly to relax. When the infraspinatus becomes triggered up, it forces the other muscles to pick up the slack. But when you de-trigger an overactive muscle, you allow it to develop greater elastic strength. Something that's already tightened can't get much tighter.
Thus, a buff muscle isn't always a useful muscle. This is the kind of insight that set Arnold Schwarzenegger head & shoulders (no pun intended) above his competition. Instead of lifting to the point where he would make his muscles locked up and immobile, he also spent time working on fine motor skills and mobility training that allowed him to move like an athlete instead of waddling around like a brick with legs. Schwarzenegger knew how to achieve hypertrophy without stiffness.
For those of us who want to achieve that same sort of strength without being rigid, proper foam rolling practices can make a big difference. The shoulders and hips are the "four knots" where the limbs tie into the torso. Keeping them tied at just the right level of tension gives you extra resilience, strength, and durability!
Needless to say, if you're having shoulder problems that are stubborn and painful, don't gun the gas pedal if you're driving on the rims. Get a doctor to check it out!
Read part two of this series on the finer points of foam rolling!
ABOUT THE AUTHOR
Dr. Mark Cheng, L.Ac., Ph.D., Sr SFG Instructor, FMS faculty, TRX Sports Med, & Tai Cheng creator.
Dr. Cheng is a speaker/lecturer on optimum human performance & orthopedic medicine through the lenses of Pavel Tsatsouline's kettlebell training methods, FMS Functional Movement patterning, TRX Sports Medicine rehabilitative & strength training, traditional martial arts/combative systems, & Chinese manual medicine.