The Rotator Cuff

No, it’s not your rotor cuff, rotator cup, or rotor cup. The rotator cuff is a small but mighty group of muscles that weave and wrap their way through and around your shoulder. These four little muscles hold the potential to keep your shoulder healthy, swing efficient, and will even do your taxes - okay maybe not your taxes. But, a healthy rotator cuff will give you a great chance at having a healthy shoulder joint, and usually means your upper body won’t be limiting your swing. 


There are four muscles grouped into this generic term. They are your S.I.T.S. muscles: Supraspinatus, Infraspinatus, Teres minor, and Subscapularis. These are the muscles that connect your shoulder blade to your humerous (a.k.a. your upper arm bone). Although these muscles are generally thought of as the rotator cuff, the shoulder is a crazy junction box where many muscles meet up. Your latissimus dorsi, biceps brachii, pecs, and deltoids all control and stabilize the shoulder However, these other muscles have not been shown to be as crucial as the rotator cuff  in providing dynamic control of the arm bone in the shoulder socket. This includes distracting the arm bone slightly out of the joint, so the tendons and labrum that are within the shoulder do not impinge. 


As stated before, the muscles of the rotator cuff are small, but play a huge role in any movement of the arm. Any time you move your arm, your rotator cuff is working to stabilize, position, and provide rotation at the shoulder. Because these muscles are constantly being used, they are often being impinged because of our progressively worsening postures. As our shoulders round forward and our shoulder blades shrug, the joint space within the shoulder has been shown to decrease, leading to increased impingement on the tendons of the rotator cuff, and biceps. The muscles are not large and robust like the quads, and neither are their tendons. Because of this, there is a high prevalence of tendonitis and tears within the rotator cuff. 


Rotator cuff tears are prevalent in over 20% of the general population[1]. The general idea is that the older you are the greater the chance is that you will have a rotator cuff tear. This sounds like discouraging news, unless you take a deeper look into these numbers. Just because something shows up on diagnostic imaging does not mean that it will limit you or provide you pain. In fact, only about 34% of all tears are symptomatic, meaning 66% of the people with rotator cuff tears don’t actually feel pain associated with their tear. They most likely don’t even know they have one!


Despite this, rotator cuff health is crucial for an efficient, powerful, and painless golf swing. The shoulder may seem like a simple joint—a ball and a socket. But the connections to and from this joint and its ability to function effortlessly will have massive implications for your golf swing. A shoulder that works well also means that you have a thoracic spine that is in working order. This area of your spine, from the top of your shoulders to below your shoulder blades, can make or break your golf swing. For our upper bodies to transmit all that power that we produce in our legs into the ball, we need to have a stable shoulder and a mobile thoracic spine. If our thoracic spines are rigid, the positioning of the shoulder blade will be compromised and there will be a greater chance at injuring your cuff. Because the shoulder joint is formed like a golf ball sitting on a tee, it inherently has tons of play. Therefore, to move it quickly and athletically, we need to have lots of stability/control. But the rotator cuff muscles connect your arm bone, which moves a lot during the golf swing, to the shoulder blade which also moves a lot during the golf swing. There is a lot of potential for problems here with the parts of the body that control the shoulder blade are not working well. 


The thoracic spine is one of the linchpins of the golf swing. If there is a problem here, likely with mobility, there will be an issue with your swing. Stiffness in the thoracic spine can lead to compensatory movements in the shoulders, including protraction and elevation (shrugging). These two movements will ultimately lead to a tight neck and chest, as well as a decrease in the amount of space in your shoulder joint resulting in fraying of your biceps tendon and labrum, and possibly impinging your rotator cuff. These are just the issues with the body. When a shoulder and thoracic spine are not healthy and moving well, detrimental swing characteristics will likely follow.


Below, you will see the average ranges of motion the human shoulder can produce.  External rotation - think trail shoulder during the backswing. Internal rotation - think trail shoulder during the follow through. As well as flexion. To achieve these ranges of motion, there must be synchronous interactions of the shoulder joint as well as thoracic spine and shoulder blade. If one or more of these areas have restrictions, our golf swings will show it. 


Movement

ROM

External Rotation

90 degrees

Internal Rotation

70-90 degrees

Flexion

180 degrees



Despite a significant portion of the population having rotator cuff tears, and most of those people not knowing they even have this condition, rotator cuff maintenance should be part of your training regimen. The rotator cuff will help you get your arms into a consistent, and leveraged position in your backswing, as well as efficiently put force from your legs and trunk into the club. A healthy rotator cuff reduces the likelihood that you chickenwing, have a flying elbow, or even lose your posture in your backswing. But how do you keep these muscles healthy? You have to maintain a mobile thoracic spine, a flexible chest, and be sure that these four little muscles have strength and endurance and can work collectively with the other muscles of the shoulder girdle. 


Below you will find 5 exercises to help you maintain a healthy rotator cuff, or even help you if you are currently experiencing some shoulder pain. Sure, these drills don’t all focus on the shoulder, but that is because the shoulder has so many connections to other parts of your body. As stated before, a mobile thoracic spine and flexible chest muscles will also help maintain a healthy rotator cuff. 


Doorway chest stretch

 

 2-4 sets of 60 sec each side

  • Stand in a doorway.
  • Place your right elbow on the doorway at approximately ear high. 
  • Step through the doorway with your right foot and rotate to the left, while keep your right elbow and hand where you started. 
  • You should feel a stretch through your chest and bicep on the right.
  • Remember to keep your ribs down to prevent arching your lower back.

Thoracic spine FR

Roll up and down your spine (staying off of your neck and lower back) for 60 seconds or so. This should feel great on your back and is awesome before and after golf. But, it is also amazing to break up the sitting that you do during the day. Rolling your thoracic spine will not only help restore function to your thoracic spine so you can make a great turn into your backswing and through impact, but it will also make it possible for you to get your shoulders in a better position at the top of your backswing. If you are limited in your ability to move your thoracic spine, it is common to destabilize your shoulder to find the motion that is missing from the spine. 


Side plank with rotation

2-4 sets of 10 turns each side)

  • Lay on your right side with your elbow underneath your armpit. Your knees will be together with your knees slightly in front of your hips, knees bent to a 90 degree angle. 
  • Push your hips forward and up off the ground, so now you are balanced on your right forearm and lower leg. Your body should be a straight line from your ears to your knees. 
  • Pull your right arm down into the ground and toward your body. Feel your shoulder pulled down and back; engage the muscles in the back of your armpit. 
  • Rotate your torso toward the floor with your left arm by your side elbow bent at 90 degrees. 
  • Rotate back to starting position and repeat for the specified number of reps. 

Wall open books

2-4 sets of 8 turns each side)

  • Take a knee next to a wall inside knee down, outside knee forward
  • Place your inside arm on the wall with both palms together
  • Keeping your inside forearm and hand on the wall, make a big turn toward the outside knee all the way around to the other side of the wall. 
  • You may or may not get there, but make sure you stay tall, squeeze your glute on the inside leg
  • Return to the starting position and repeat for reps. 
  • Keep both shoulders off the wall as you make you turn

Crawling

2-4 sets of 25 steps each way

  • Setup on your hands and knees
  • Tuck your toes under your feet and lift your knees two inches off the ground
  • As you move your right hand forward, move your left leg forwards as well
  • Alternate moving with a reciprocal pattern (left arm and right leg, and right arm and left leg)
  • Keep your knees close to the ground 
  • Keep your hips and torso square to the floor so there is no rotation
  • Crawl forward and then return to where you started by going backwards

If you consistently add these exercises to your workout routine and feel the benefits in your shoulder and your swing, check out Supple Shoulders for Golf. This 8 week program takes you through progressions of flexibility, stability, and mobility drills with 3 unique 20 minute sessions per week. 


Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768248/


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