How to Strengthen with Pilates for Rotator Cuff Health

The rotator cuff is a group of tendons and muscles in the shoulder. Rotator cuff disorders occur when tissues in the shoulder get irritated or damaged. Keeping the muscles of the rotator cuff strong and healthy will help prevent injuries. Strengthening is necessary when recovering from rotator cuff injuries. Pilates, both on the mat and reformer can be beneficial. There are many exercises on the reformer that can help strengthen and stabilize the rotator cuff muscles. All exercises in Pilates, mat or on equipment, requires stabilization of the shoulder girdle which in turn requires activation of the rotator cuff muscles.  We’ll look more at how we can strengthen with Pilates for the rotator cuff health.

What does the rotator cuff do?

The shoulder joint is a ball and socket joint made up of three main bones, upper arm bone (humerus), collarbone (clavicle) and the shoulder blade (scapula). The ball, top or head of the humerus fits into the socket of the shoulder blade. This socket is shallow which allows the arm to move through a wide range of motion. But this also means that the muscles and tendons of the rotator cuff have to work hard to hold the bones in place. As a result they are easily injured and prone to wear and tear. These bones are held together by muscles, tendons and ligaments. The rotator cuff keeps the humerus in the shoulder socket and allows you to raise and twist the arm. Disorders 

• Inflammation of the tendons or a bursa (bursitis). 
• Impingement, tendon is squeezed and rubs against bone. 
• Calcium builds up in tendons causing a painful condition called calcific tendinitis. 
• Partial or complete tears of the rotator cuff tendons. 

Causes

• Normal wear and tear. 
• Overuse. Activities where the arm is used above your head a lot can lead to rotator cuff problems. i.e. tennis, swimming, house painting 
• Both wear and tear and overuse can lead to impingement when a tendon rubs against bone. This damages and irritates the tendon causing bleeding and inflammation. Over time damage to the tendon can build up leading to easier injury of the tendon. 
• Great force is required to tear a healthy rotator cuff tendon. This usually happens during sports, an accident or a severe fall. A simple movement like lifting a suitcase can cause a rotator cuff tear in some people. 

Symptoms

• Pain and weakness in the shoulder. Pain is usually on the side and front of the upper arm and shoulder. May hurt or be unable to do everyday things i.e. comb hair, tuck in your shirt, reach for something.
• There may be pain at night and trouble sleeping. 

Treatment

• Rest the shoulder. Use the arm but carefully. Don’t keep your shoulder still with a sling or brace. This can cause the joint to become stiff (frozen shoulder). 
• Use ice or heat on the shoulder, whichever feels better. 
• Take anti-inflammatory drugs to relieve pain and reduce swelling. 
• Avoid uncomfortable positions and activities. i.e. lifting, reaching overhead.
• Physical therapy may be needed. Here exercises will be taught to stretch and strengthen the shoulder.

 It may take anywhere from a couple of weeks to several months to get good results from any treatment. 

Shots of steroid medicine may be given if other treatments don’t help. This probably won’t cure the problem but it will relieve pain and inflammation allowing you to do exercises to strengthen the shoulder. 

Surgery isn’t usually done for rotator cuff problems. When is surgery an option? It may be done if a rotator cuff tendon is torn or if several months of other treatments haven’t helped. When you are young and the rotator cuff is in good shape. Surgery is not a substitute for physical therapy or regulary Pilates for rotator cuff health. Even after surgery, months of physical therapy may be needed for a full recovery.