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The Injury: Rotator Cuff Inflammation or Tear
The rotator cuff is a group of four muscles that stabilizes the upper arm bone in the shoulder socket and allows the shoulder to rotate. The tendons of these muscles often become irritated, or they can be torn due to a traumatic injury or repetitive motion, especially in combination with weakness in the muscles that stabilize the shoulder blade and anchor the rotator cuff.
Common in: Swimmers, yoga practitioners, rock climbers, golfers, and tennis players.
Symptoms: Because the rotator cuff involves four muscles and their tendons, a wide range of symptoms can be associated with it. Generally, pain is felt over the top of the shoulder, but it can extend to almost anywhere around the shoulder joint itself, including the shoulder blade or the armpit.
Poses for Prevention and Healing: By strengthening the muscles around the shoulder joint and restoring range of motion to the rotator cuff, you can create a stronger, more supportive structure to move from and decrease your chance of injury—or facilitate your recovery.
Cow Face Pose, variation (Gomukhasana)
What it Does: Stretches the entire rotator cuff with a combination of internal and external rotation of the arms. (If your shoulders are tight, you can do this pose in a warm shower or grab on to a strap or towel if you can't reach your hands.)
How to: From a seated or standing position, reach your left arm straight out to the left, parallel to the floor. Rotate your arm inwardly; the thumb will turn first toward the floor, then point toward the wall behind you, with the palm facing the ceiling. This movement will roll your left shoulder slightly up and forward, and will round your upper back. With a full exhalation, sweep the arm behind your torso and tuck the forearm in the hollow of your lower back, parallel to your waist, with the left elbow against the left side of your torso. Roll the shoulder back and down; then work the forearm up your back until it feels parallel to your spine. The back of your hand will be between your shoulder blades.
Inhale and stretch your right arm straight forward, parallel to the floor. Turn the palm up, inhale, and stretch your arm straight up toward the ceiling, palm turned back. Bend your elbow and reach down for the left hand. If you can, clasp your hands. If you can't reach, start over with a towel or strap in your overhead hand. Hold for 1 minute, and then repeat on the other side.
Plank Pose, variation
What it Does: Strengthens the muscles that stabilize the shoulder blade, which will provide a strong foundation for the rotator cuff.
How to: Come into tabletop position. As you exhale, without bending your elbows, lower your rib cage toward the floor and draw your shoulder blades toward each other. As you inhale, push the floor away, pull your rib cage away from the floor, and, without rounding the spine, spread your shoulder blades apart. Once you have the motion, come into Plank Pose and try the same movement there. Visualize your shoulder blades gliding toward and away from each other around your rib cage. Repeat 10 times, rest for a few breaths, and repeat. As your muscles grow stronger, work your way up to 15 or 20 repetitions.
Side Plank Pose, variation (Vasisthasana)
What it Does: Strengthens the muscles of the rotator cuff and teaches them to work as an integrated unit.
How to: Come onto your forearms, with your elbows under your shoulders and your feet together. Roll onto the edge of your right foot and turn your right forearm in 45 degrees. Hug your right arm bone into the socket and press the base of your right index finger into the floor. Lift and lengthen the sides of the rib cage and extend your left arm up. Hold for 30 to 60 seconds; then repeat this variation of Side Plank on the left side.
It's All in the IT Band
Focus on hip openers as well as quadricep and hamstring stretches in your yoga practice to reduce the pull on the IT band.
Use a foam roller to release tension in the IT band. To reach the high-friction zone between the quadriceps and the IT band, imagine that your thigh is a shoe box: The outside of the thigh is one side of the box, and the front of the thigh is another side. Roll where the corner of the box would be, about halfway between the front and the outer thigh.
Relax: It's the Best Medicine.
In yoga practice and throughout the day, focus on relaxing your shoulder blades down the back. Tension in the upper back can hike the humeral head higher in the socket and cause wear on the top of the rotator cuff.
If you sit at a computer all day, take regular stretching breaks to reduce tension in the muscles of the shoulders, neck, and chest.
Simple Tips for Better Performance and Fewer Injuries:
Warm Up and Cool Down. Warming up allows the blood to move into the muscles slowly so the fascia can expand to accommodate the demands of the upcoming activity. Walk for a few minutes or take a short, dynamic online yoga class aimed at pre-sport warm-ups before you train or play. Afterward, stretch for at least 20 minutes.
Soothe. Soak in a warm Epsom salt bath after exercise to relax tired muscles and absorb magnesium sulfate, which can help alleviate soreness.
Rest Easy. Muscle tissue heals and rebuilds during sleep, so don't skimp on the shuteye, especially on hard workout days.
Mind Your Minerals. Look for a sports drink that replaces minerals (especially calcium, magnesium, and potassium) that are lost through sweat, contributing to muscle soreness and cramping. Postworkout, refuel with foods high in magnesium and potassium, such as chard, kale, and cantaloupe.
Tiffany Cruikshank is the acupuncturist and yoga teacher at the Nike World Headquarters in Portland, Oregon, and is trained in sports medicine, acupuncture, and holistic health as well as in Chinese medicine.
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