Thursday, April 14, 2005

Relief for the Rotator Cuff

I know I promised in my last message I'd talk about pain. And I said I'd pass along remarks made by Mark Jenkins in his recent Outside magazine article. But...

I want to talk about something else today.

Not pain in general, but rotator cuff pain. Ask anyone who's had it and they will tell you about their misery--in vivid, excruciating detail. Someone with rotator cuff pain will point to the front of his shoulder when you ask where it hurts. Most people say that they can't sleep lying on the affected side, because of pain.

Megan Sappington, one of my teacher training program participants from a few years ago, asked me just yesterday about one of her students who hurt her shoulder. Should she be doing yoga with rotator cuff pain? And, is there a way to do yoga that will aid in healing her rotator cuff?

Yes. In general, yes. You can do yoga with rotator cuff pain. And my experience is that yoga can help with rotator cuff pain. But it's easier said than done. [This entire message and everything on this web page do not constitute medical advice. This material is not given for the purpose of diagnosis or treatment. For diagnosis or treatment, you should consult a licensed medical professional.]

If you'd like to understand the rotator cuff and typical rotator cuff problems, see this excellent patient guide.

The rotator cuff is a set of tendons associated with the muscles that attach your shoulder blade (scapula) to your upper arm bone (humerus). Tendons attach muscle to bone. When those tendons are worn, torn, inflamed, or entirely ruptured, it hurts.

For most of the people I work with, I can teach them one thing that makes rotator cuff pain go away. It's surprisingly simple: move your upper arms toward your back body. That's it. When you do this, you bring your shoulder into a more ideal alignment. Your own natural healing energy begins to flow through the shoulder girdle. Then pain goes away as the the tendons are healed and inflammation goes down.

That simple, eh? Yes. It's that simple.

It usually doesn't work in two instances: 1) when the person I'm working with doesn't actually do it, and 2) when there's a complete rupture of one of the tendons. How do you know if your tendon is ruptured? You won't be able to lift your arm. A doctor will tell you this not-so-wonderful news after a physical exam that may include an MRI study. If you're tendon is ruptured, it won't heal. Surgery is in your future.

But let's get back to the technique. Move your upper arm bones back, towards your back body. When you do it, you'll feel two things: 1) your shoulder blades will feel snug up against your back ribs, and 2) you'll feel a hollow "trough" between your shoulder blades.

So, you can do yoga AND you can do particular yoga poses, as long as your upper arm bones are back and the space between your shouder blades is concave. The same rule applies to daily activities. Do them as long as you can keep your upper arm bones back. (Good luck with driving and eating soup. And good luck with bearing weight on your arms. Hard to do, but with practice, YOU CAN DO IT.)

Here's a little tidbit of news: since we slouch a lot, almost everyone I know has his or her upper arm bones in a forward position.

Check out this cover girl. With few exceptions, women pictured on magazine covers have their upper arm bones hunched forward. See how the front of her shoulder points forward? I call that steer-horning the shoulders.


Upper arms are forward. Posted by Hello

People who like to lift weights typically have their upper arm bones in a forward position, especially when they're bench pressing. Ask someone who bench presses regularly if he or she has sore tender spots on the fronts of the shoulders. Or just watch. If he can't raise his arm to comb his hair, suspect rotator cuff pain.

I love this old posture poster. Almost everyone with problem posture presses his or her arms forward.


An old posture poster. Except for the woman at the far left, they all have their upper arm bones forward. Posted by Hello

Can you see how sending your kids to school with one of those 25-pound book bags is a recipe for future shoulder pain?

But you don't have to live with shoulder pain. Practice yoga poses with your upper arm bones retracted back into the shoulder joints. As you work with more challenging poses, those in which more weight is borne in the arms, the healing power of this action becomes magnified. So don't be surprised if one day while you're doing a hard yoga pose, with humeri retracted, the pain in your shoulders leaves you for good.

Not a believer? Ask me a question. Click on the word comment below and speak your mind. I'll to my best to address your concerns.

Don't just read about it. Get up. Experience it. Experience yoga!

Kevin Perry
www.ExperienceYoga.org

p.s., Megan is a great teacher. You should check out her classes on Wednesday and Saturday mornings in California, MO. She teaches in the beautiful space above Dr. Vanderfeltz's office on North Street. Email her at m.sappington@mchsi.com for details. She also teaches a yoga class for teens at Show Me Yoga Center in Jefferson City on Thursday evenings.


Megan Sappington Posted by Hello

p.p.s., Just about everything I know about "yoga therapeutics" I've learned from John Friend or one of his students. He is a gifted teacher and healer. And he's the founder of Anusara yoga. Check out the Teachers Directory at www.Anusara.com to find a teacher near you.

p.p.p.s., Do you want to participate in our next Teacher Training Program in St. Louis? We'll meet one weekend each month for a year. You'll finish with all the hours you need to be a Yoga Alliance Registered Yoga Teacher. The focus of this training is on Teaching Yoga, not learning to do yoga poses. Send me an email at info@experienceyoga.org to find out more about the Experience Yoga Teacher Training Program, taught by me and Sallie Keeney.

Copyright 2005. All rights reserved, Mo Yoga LLC.
Kevin Perry
Mo Yoga LLC
1305 Elmerine Ave
Jefferson City, MO 65101

(573) 680-6737

16 Comments:

Anonymous Anonymous said...

Hi there, just read the article on ' Relief for the Rotator Cuff'. Seems very helpful. Could you some examples of postures where the upper arms are moved towards the back body?
Maybe some pics or the names of the asanas will do.

Thank you,
Grungean

5:54 AM  
Anonymous Anonymous said...

Hi, thanks for the insightful information! I just found out I have frozen shoulder and tore my rotator cuff. Not enough for surgery but enough to keep me in pain! I want to keep up my yoga practice, but the doc said not to lift my arms over my head and so many poses require that. Is there a guide for doing yoga with a serious injury such as this?

12:57 PM  
Anonymous Anonymous said...

Great article! I think that most rotator cuff problems start because the front and middle deltoids get more exercise during the activities of daily life than do the rear deltoids, the result of which, is an imbalance in the supportive structures of the shoulder joint. are there any gentle excercises that strengthen the rear deltoids, that do not aggravate the pain and inflamation that I am experiencing, while I am trying to continuue my "three times a week tennis?" Lol. Thanks again for your conservative and practical advice. Lee

10:30 PM  
Anonymous Anonymous said...

I googled this article because I myself am having rotator cuff pain during yoga and afterward. As I read your post I was currently experiencing said pain and noticed my shoulders were slouched, sure enough moving them back and together made the pain lessen immediatly, thanks for the great advice.

5:45 PM  
Blogger Teresa said...

Thank you for this information, my rotator cuff has been hurting for sometime now, and I attribute it to driving a stick shift. I am a yoga teacher myself and I have found that practicing Iyengar has taught me how to do all the poses correctly, and yes, you are right, bringing your shoulder blades together while extending your back sideways and widening your collar bone is the recipe for all yoga poses.
Poses such as: upward facing dog, cobra and sphinx, adho uttanasana (half-way fold), dancers pose, camel pose, fish pose, cow pose, cow-face pose, will help you rotate your shoulders towards the back, bring your shoulder blades together and open your collar bone, or heart chakra better.
namaste!

6:58 PM  
Anonymous Marybelle Perrigan said...

Yoga is totally useful for people who are recovering from injuries, due to its low impact exercises that are fit for young and old alike. When I was in rehabilitation due to an injury caused by a motor accident, I was totally lucky that I had myself a back-up plan on getting my medicare insurance quote, or else, the financial burden will take a toll on me.

With the medicare supplement insurance quote, I can rest assured that my hospital bills will be lighter and the quality of service won't be compromised.

10:02 PM  
Anonymous Anonymous said...

Wow Marybelle, way to spam.

1:10 PM  
Anonymous Anonymous said...

I have read the article.I am going through lots of pain because of partial Rotator cuff tear,inflamation,frozen shoulder.Would you please add more exercises and tips to help me recover.Thanks.

10:16 PM  
Anonymous Anonymous said...

I really appreciate the insight in this blog. I have a student who has torn her rotator cuff and i trying to build a practice for her. Thank you again

Namaste
Vanessa

http://www.otraola.com

12:57 PM  
Anonymous Anonymous said...

Thank you - this has brought me immediate relief

6:08 PM  
Anonymous Anonymous said...

Thank you for your wonderful post! I have been suffering from inflammation in my rotator cuff for months now after over working myself as a pizza chef. Your tips really gives relief for the pain in the upper shoulder. But I also have immense pain in the back stretch muscle (the one behind the right shoulder blade, and it's killing me. Do you have any tips to release the pain there aswell? Thank you again, much love and peace, Fanny

8:57 AM  
Anonymous Janine K. said...

And.... Any suggestions on what poses one should avoid to keep from further injuring the shoulders?

7:21 PM  
Anonymous Anonymous said...

Hi. I have never had shoulder problems before, but managed to injure my shoulder/rotator cuff while doing yoga on a hot summer day. I was sweating and my mat was wet, and when I went into downward dog my right arm slid forward off the mat suddenly and I jammed my shoulder joint. I have had pain ever since, better with ice etc but i don't want to give up my yoga practice. I foolishly attempted some arm balance poses and headstand prep which aggravated the situation. Are there some poses that should just NOT BE DONE while you are waiting for the soff tissues to heal? I have a normal range of motion so I think my cuff is inflamed, not completely torn (my phsyio agrees, but she says to stop doing yoga entirely and I don't want to do that...) Thanks

2:01 PM  
Blogger RazorShark said...

my shoulders are not level
the scapulla of right side is down
plus the collar bone is bit shiffted on right side
what yoga pose should i do
i'm doing right now
dho Mukha Svanasana

8:47 AM  
Blogger jack johnson said...

This comment has been removed by the author.

12:38 AM  
Anonymous Anonymous said...

This article us helpful, but as the author is aware, it's easier said than done! If u r a student, I think it's important to inform your instructor about your injury and ask for modifications for any dangerous poses. For instance chaturanga dandasana can frequently hurt a strained shoulder if not modified.

10:07 PM  

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