A common misconception with rotator cuff exercises is that if you go too heavy, you’ll use less cuff and more of the bigger muscles like the deltoid.
This really isn’t true at all.
Can you go up too fast and compensate? Sure. But that doesn’t mean we shouldn’t load the cuff more.
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#AskMikeReinold Episode 274: Using Higher Loads with Rotator Cuff Exercises
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Show Notes
Transcript
Eric Deutch:
All right. We got Corey from Pittsburgh X. What are your thoughts on never using higher loads for rotator cuff exercises? Because it anatomically recruits the wrong muscles?
Mike Reinold:
Okay. I like that. Let me see. So Cory from Pittsburgh says, all right. We still get this question every now and then, but I feel like this is one of those questions that kind of faded a little bit. I remember 20 years ago, it was, I don’t want to say common fact, I don’t think it was a fact, I think a lot of people doubted it, but it was very commonly stated that you only do rotator cuff exercises up to set amount. And then once you go higher, if you go one ounce higher, all of a sudden the rotator cuff turns off and the big muscles take over and the big one at the time was five pounds. You can’t do more than five pounds with rotator cuff exercises or the deltoid, the pec, the lat, that’ll take over and you’re just using the wrong muscles.
Mike Reinold:
And it’s funny, every now and then, I guess that still happens, right. Because we’ll have like a baseball player come in and they’re like 6’5, 240, right. And I’m like, all right, let’s go through your shoulder program. They go grab like the two pound weights. And you’re like, what on earth are you doing? That’s 0.08% your body weight, right. With a two pound weight. That’s what we would do with a rotator cuff repair patient, right after surgery. Right. And it’s still amazing to believe that some people kind of still think that. So who wants to talk about this first and kind of start with this concept, but I guess the question is, is do we think that we should limit the amount of load we do with rotator cuff exercises? Maybe we start with that. Maybe I’ll kind of start the discussion. Anybody want to talk about working the rotator cuff in that fashion? What do you got Dave?
Dave Tilley:
Yeah, I think this is also one very, very common in the aesthetic sports world. So like gymnastics and ballet and dance and stuff like that. It happens to a lot people. I think the myth that we have is their endurance muscles, so you should only do lightweight for 15 to 25 reps. And that’s how the cuff should work. And I think something I’ve learned from you and Lenny and some other researchers is, you have to push these cuff muscles and more of a high perch-fee type set and rep range and load because they’re combating sport forces, which are very, very high. Right.
Dave Tilley:
So you’re going to need to push yourself a little bit harder if you want to try to tolerate some of the demands. And obviously gymnastics is probably the best one, baseball also as well as, when you look at the research on the biomechanical forces on the shoulder, I don’t know the stats off the top of my head, but your arm’s trying to get ripped off your body, right. By how hard you’re doing sports. So, obviously the natural progression to combat that is doing strength-based exercises to grow the cuff and grow the musculature to be tolerating that. So that’s usually a big light bulb moment for a lot of the patients that I work with, is kind of explaining, you’re doing things that are really, really challenging on your shoulder. So it probably makes sense when need to train them as if we were doing strength exercises.
Mike Reinold:
I like that. That makes sense. And I like that how you, even though it’s maybe a postural or a muscle group that maybe prefers endurance. Right. But remember, no muscle is just one thing, right. They all have type one, type two fibers. I think again, the stronger you can make a muscle, the more fatigue resistant they’re probably going to be too, to an extent, with loads and forces. So yeah, that’s a great perspective, Dave. It’s not just that once you go from five to six pounds, the rotator cuff turns off and it goes deltoid, it’s also that maybe we want to focus on strength and an endurance based muscle too. So I like that. What do you got Dan?
Dan Pope:
Oh, Mike, I’m kind of bring it back to, to my world. Right. I work with a bunch of meatheads in the gym and there’s two studies that kind of pop into mind. I mean, they’ve looked at how the rotator cuff works to where in a bench press type exercise, and in the study was a machine chest press and then a machine row, and just looking at what happens to the rotator cuff during those movements. And it makes sense. And kind of the theory is that if you’re doing, let’s say a bench press, your pecs are active, the delts are active and they’re going to be pulling the anterior delt, pulling the ball anteriorly forward in the socket, right. And let’s say your subscapularis lies on the front part of the shoulder joint, that fires aggressively too. That’s also pulling the ball forward in the socket, right.
Dan Pope:
And that’s not good because we want to try to pull the ball into the socket. So, the research shows your infraspinatus is working like crazy and it’s probably helping to pull the ball posteriorly. So if I’m doing something like a bench press, yeah, if I’m using my pecs more, that has to be countered somehow, right. So in theory, it makes sense if I’m going to be pressing more weight, I have to use my infraspinatus even more to center the ball into the socket. Whereas, let’s say the subscapular is relatively calm and not doing much because it would be interfering with the motion and if I do a row, it’s kind of the opposite. The subscap is working aggressively to make sure the ball’s not being pulled posteriorly in the socket. Right. When the prime movers are definitely doing a lot of work, but the cuff has to work equally as hard. So.
Mike Reinold:
Yeah, and it makes sense. I mean the more force and or velocity that you put, so either the faster you’re using your upper half, right. Or the more aggressive with, say a bench press or something like that, then the more the rotator cuff has to contract, has to contract harder. EMG goes up the faster and the more volume and load you have for an exercise. So it makes sense that those have to contract harder to counteract that force, to keep that humeral head centered. That’s amazing, right. So, that’s a good example, the stronger you are, it shows you that the stronger your rotator cuff probably needs to be, to be able to do these big, crazy advanced exercises. It’s not just endurance, right. So that’s awesome. So what do you got, Lisa?
Lisa Lowe:
What’s been interesting as the more rowers that are kind of starting to trickle into the clinic, I’ve been teaching a lot of them that their rotator cuff is an important aspect of their rowing stroke for the first time, regardless of their 15 or 60. And what’s really cool is using the manuals that we do for cuff strength and teaching them what that is supposed to feel like and what muscles they’re supposed to be using for those movements. Their ability to connect to the water and their ability to maintain proper shoulder positioning for a rowing stroke, changes very quickly because they just actually feel and understand how to use their cuff and not just their deltoids or just their upper traps. And then thinking in terms of the amount of load that you allow someone to use for cuff work, right?
Lisa Lowe:
When we’re doing those manuals, my goodness, I’m not putting a two pound dumbbells worth of force into this person’s arm, right. And as long as they understand what muscles they’re supposed to be trying to feel, there’s so much more force they’re able to create with those, then you would, like a three pound dumbbell wouldn’t do anything for that at that point. Once you understand how to connect to those muscles, but it’s hard to find them properly if you’ve had a movement pattern for so many years where you haven’t felt your infraspinatus work before.
Mike Reinold:
Right.
Lisa Lowe:
So, I think taking that time to make sure that whether it’s home dumbbell exercises or hands-on work, like teaching rowers that proper feeling of what they’re supposed to get out of their cuff, has gone a really, really long way in a very quick, a month is a humongous difference typically, which is really cool. [crosstalk 00:09:03] Even just strength test in the beginning and then strength test in a month later, they gain eight to 10 pounds and it’s not because they just added that much muscle bulk. It’s they actually figured out how to use those muscles.
Mike Reinold:
And you could argue too, that I don’t think they would’ve had that much progress if you just did light Thera-Band or just two pound weights. Right. So.
Lisa Lowe:
Because they’ve all done that, right. They’ve all done that, but they’ve not known what they’re supposed to be feeling.
Mike Reinold:
Right.
Lisa Lowe:
And it hasn’t been enough force for the, you don’t row for 60 plus minutes on the water and have two pounds worth of sideline, external rotation. Dumbbell work is not going to support that.
Mike Reinold:
Right. You know, it’s funny. So I actually did an EMG study on this. We never published it. I got so burnt out with EMG studies. When we were publishing all those, 15 years ago. They’re really hard to conduct and really hard to do well and publish, it’s a big deal. But we actually did a small study. We didn’t have a ton of people, but we had enough people. I consider the results fine. And we looked at the EMG of the rotator cuff and the deltoid, for example, as you go up in weight, right. And guess what happened as you went up with weight? Both muscle groups went up linearly, right? Of course it does, right. But at the time we were trying to combat that concept that your rotator cuff EMG will go up, but then once you hit five pounds, it stops going up and the deltoid takes over.
Mike Reinold:
That really makes no sense, bio mechanically and anatomically. No muscle works that way, right. I think Dan just said it, a great example. Imagine if that happened and then his guy’s trying to bench 300 pounds. Right. And his rotator cuff can only handle five pounds of load. Right. Then that’s going to be really challenging for that person.
Dan Pope:
After a certain weight.
Mike Reinold:
Yeah, exactly. Right. I mean, it doesn’t make a lot of sense for us here. So, I like how we hit this. I like how Dave kind of brought up endurance a little bit with this, which is a good approach. I like how Lisa brought up a little bit of some of the benefits she sees from doing that. I think it’s very clear out there.
Mike Reinold:
So I have some unpublished EMG research, if you still don’t believe us, just trust me on that. That shows that, they both, both the cuff and the deltoid, go up linearly with the more load that you put. So, that is a myth that the rotator cuff shuts down. Now, don’t get me wrong. I think this probably started in 1985, one person was probably trying to do too much weight and they were just compensating and slinging that weight around. But that’s not the real issue here. That’s just poor coaching on that part, right. We can have them do that exercise a little bit better.
Mike Reinold:
So, so awesome. Great question, Corey. Hopefully we helped kind of break through a little bit on that concept there for you and not just give you a simple answer, like a yes-no, but actually kind explain a little bit of it. So hopefully that help, Corey. If you have a question like that, head to mikereinold.com, click on that podcast link and be sure to go to iTunes, Spotify. Subscribe, rate, and review, and we’ll see you on the next episode. Thank you so much.
