Rotator Cuff Injuries
From Doug Keller’s “The Therapeutic Wisdom of Yoga” (Vol. 1), “The shoulder joints are more mobile than any other joint in the body, and only 2/5 of the head of the armbone is in contact with other bones of the joint – in stark contrast to other joints, such as the head of the thighbone, which is firmly seated in the hip socket. The greater freedom of the shoulder joint allows greater potential to disengage, and even to dislocate. The many strands of myofascial – some powerful and some tiny – are meant to hold everything in place even as the shoulder enjoys great range of motion. This assumes, of course, balanced muscle tone and proper engagement of the muscles around the shoulder joint to maintain the integrity of the joint. This, of course, is rarely the case, and the imbalance is the primary reason for shoulder injuries.”
Rotator cuff injuries are fairly common, especially in Vinyasa Yoga where there is so much emphasis on movements that require the muscles around the shoulder girdle, including the rotator cuff, to be strong and stable. Postures like Adho Mukha Savanasana (Downward Dog), Plank, Chatturanga and forearm balances and inversions like headstand and handstand all require strength and stability of the shoulders, as well as core engagement.
The muscles of the rotator cuff include Infraspinatus, Supraspinatus, Subscapularis and Teres minor. Some of the other muscles often involved in injuries to the shoulder include Trapezius, Pectoralis minor, Serratus, Rhomboids, Levator Scapulae, Latissimus Dorsi, Biceps brachialis and Coracobrachialis.
Weakness in any of these muscles, or overdominance of muscles like the Upper Trapezius, as well as poor posture (ie: cellphone neck) can lead to trigger point pain, inflammation (tendonitis), pinched nerves and even herniated cervical disks.
Therapeutic yoga and Somatic Movement can be part of a recovery program for shoulder injuries and can help increase range of motion and prevent “frozen shoulder” as the shoulder girdle heals. “Frozen shoulder” or adhesive capsulitis is characterized by pain and stiffness in the shoulder joint. Frozen shoulder often develops as you are recovering from a shoulder injury when the shoulder is prevented from moving or held in place for a period of time. Treatment for this condition typically includes range of motion exercises, which may include yoga therapy or Somatics. Healing from an injury can be frustrating and takes time, but can also be an opportunity to slow down, become mindful of behaviors that contribute to shoulder weakness or poor posture and correct them to prevent future injuries. A good yoga therapist can help with shoulder recovery, restoring range of motion, changing postural habits and suggesting alternative ways to participate in yoga without injuring your rotator cuff. Taking restorative yoga classes and Yoga Nidra can also be helpful to the healing process, as our body cannot heal if we do not rest. However, even some restorative postures may need to be modified while you are healing. As always, it is important to be cleared by your doctor or physical therapist before you embark on a yoga therapy program or other movement program if you are recovering from an injury.