Hello, I’m Bob Lujano, Paralympic athlete. Over the last twenty years I have been
involved in wheelchair sports and over the last thirty years I have been a
wheelchair user. A rotator cuff injury is an injury that many wheel chair users are
very of. It could sideline you for several weeks. Jim Murdock, who has been an
athletic trainer for over thirty-seven years will explain what a rotator cuff injury is,
the symptoms of a rotator cuff injury, and hopefully it will bring you awareness and
insight to the seriousness of a rotator cuff injury.
So, the four rotator cuff muscles or, S.I.T.S., are: supraspinatus, which is on
top of the scapula, infraspinatus between teres minor, and on the front surface is
subscapularis. So, these four muscles in conjunction control the head of the
humerus in place and allow rotation to occur in a synchronous smooth motion.
And their function is to stabilize the upper-arm in place. So, these muscles
attach onto the arm bone, or the humerus, and keep it in place during
motion. So, technically they don’t rotate the arm they help the arm in rotation. It’s
the other muscles, the larger muscles in the shoulder, that create the rotation were
the rotator cuff creates stability.
Like we said the four rotator cuffs are small muscles, but they come underneath
the collarbone and then attach onto the arm. So, again usually what’s happening
is that those tendons are getting pinched between the collarbone, the scapula, and
the humerus. So, it is a very small little tunnel that they go through. So those
tendons get irritated. And this is where that impingement occurs. So, when the
humerus rides up it pinches between the head of the humerus and the subcromion
process and this is where we get impingement. And you can actually get
wearing away and tearing of the rotator there.
The strength, or what we call, the stabilization of the scapula or the
shoulder blade. Because these four muscles of the rotator cuff all come from
the scapula onto the humerus. So, if the shoulder blade is not strong, stable that’s
when you are going to start seeing rotator cuff issues because you get more motion.
Obviously if there is any physical deformity or injury in the shoulder itself,
whether it’s the ligament, cartilage, or the bone it can create a lot of other
components. So, like any injury it’s really finding out what the mechanism is before
we can really determine what we are going to do. And I think a lot of times with
shoulder injuries people will jump to, “Oh it’s got to be rotator cuff because it hurts
when I do this,” really there might be underlying pathology. A lot of it is
scapular stabilization. It’s either the muscles are too tight or they’re weaker.
Pushing a wheelchair is actually like a throwing sport. So, you’re doing a lot of
this motion, where as in upper body activity you’re doing here. So, what you’ll
start seeing is a forward motion or rounding of the shoulders. Which may feel stronger, but it
actually widens or makes the back muscles weaker. So that changes that
stabilization, sometimes referred to as scapulothoracic rotation. So, the scapula
doesn’t move as well and you’ll have defused pain. Again, if that happens then
the rotator cuff tends to get involved. So, primarily it’s trying to get them back into
a more upright or neutral position by stretching and strengthening.