The Rotator Cuff Surfing Injury

In the last edition we talked about Surfers’ Elbow.

In this edition I want to give you a quick run down on another common surfing injury, “The Rotator Cuff” (shoulder) injury.

The rotator cuff covers the four main muscles group related to the shoulder joint: Teres Minor, the Infraspinatus, the Supraspinatus and the Subscapularis. These muscles keep the shoulder-joint locked in place and act with your humerous (arm bone) to stabilize the shoulder joint.

  • The supraspinatus causes shoulder abduction (lifting your arm out to the side of your body).
  • The infraspinatus and teres minor cause shoulder external rotation.
  • The subscapularis causes shoulder internal rotation.

Strengthening this group of muscles will assist you to continue surfing for many years. The primary role of these muscles is to stabilize the shoulder capsule, thereby ensuring the joint remains firm and in place.   Of course these muscles also allow the shoulder to be in a position to move freely, without any restriction or pain, which in turn allows you to paddle, lifting and lowering the arms with ease. In a rotator cuff injury your shoulder would be in considerable pain.  After excessive paddling the shoulder joint can pinch at the top resulting in an overuse injury.

Rotator Cuff Injury Symptoms

Inflammation in the shoulder-joint can cause swelling, resulting in pain and decreased range of motion. Because the muscles and tendons of the rotator cuff are often deep, it may be hard to feel the swelling associated with the injury which prevents the normal range of motion of the shoulder joint.

In an acute rotator cuff tear there is often a tearing feeling followed by pain emanating from the front and back of the shoulder. The shoulder will then go into a spasm and a decreased range of movement will occur. The pain can then continue from internal bleeding and further muscle spasm. In severe cases, the arm will not be able to abduct (allow you to lift your arm out to the side of your body).

Pain can be worse at night particularly when lying on the affected side, aggravating the rotator cuff. Weakness will occur and contribute to a decrease in movement.  The affected person is unable to use the injured arm for activities requiring the arm to be lifted as high, or higher than the shoulder, to the front or side.  This is most common in people aged between 35-50 years of age. There will also be tenderness around the posterior head of the deltoid (the back of the shoulder joint).

How to treat

In the onset stage, rest and ice is a necessity. Apply ice for 15-20-minute periods, at least three times a day. A cuff and collar sling can also be useful, but ensure that you do not entirely rely on the sling. Also ensure the sling is not too long, otherwise the joint may become too tight and more effort will be required to re-gain the range of movement.

It is also a good idea to consult with your local pharmacist for suitable anti-inflammatory medication which can help decrease the pain and swelling at the injury site. Just be careful when taking this type of medication if you have any kidney or stomach complaints (such as ulcers), you are taking any thinning blood drugs (such as warfarin) or are asthmatic, as they  can all be affected by these medications.

How to strengthen the Rotator Cuff muscle group

Some tips for avoiding injury whilst performing rotator cuff exercises.

A sports medicine professional or physical therapist should be consulted prior to beginning or changing any exercise program for the rotator cuff.

  • Use light weights – hand-held weights are better than exercise bands.
  • All movements should be slow and controlled.
  • Work through a pain-free range of motion.
  • Keep wrists neutral rather than flexed.

External rotation

  1. Lie on the floor.
  2. Grasp weight with working arm.
  3. Keep elbow by your side and at a 90 degree angle, then flex elbow.
  4. Rotate the arm outward in a smooth controlled motion.
  5. Return to start position.

Internal Rotation

  1. Lie on weight bench.
  2. Grasp weight with working arm.
  3. With elbow at the side, flex elbow at a 90 degree angle.
  4. Rotate the arm upward, keeping movement smooth and steady.
  5. Return to start position.

Start these exercises slowly with light weights and build the repetitions according to the advice of your physiotherapist.

Exercise Source: (Centers for Disease Control and Prevention, “Simple Solutions: Ergonomics for Construction Workers” by James T. Alber and Cheryl E. Estill, accessed 02/24/2010)

5 Responses to “The Rotator Cuff Surfing Injury”

  1. Katrina Ison February 7, 2011 at 3:30 am Permalink

    This will be good one for my not so better half…..i will pass it on. Thanks John :)

    • John February 7, 2011 at 10:43 pm Permalink

      No worries Katrina…tell him to come in if he has an injury and I will discuss with him some stratagies with him FREE :)
      John Hart

  2. brent April 8, 2012 at 11:22 pm Permalink

    hi john, this sounds like an injury i got while surfing yesterday, all the symptoms seem the same as you have described, but i have noticed when looking in the mirror that my shoulder on that side looks like it is higher than the other shoulder when relaxed. Could it be some other shoulder injury?

    • John April 9, 2012 at 7:00 am Permalink

      Hi Brent,
      It could be…however you could have some slight scoliosis (curvature of the spine …up 85% of the general public has some form of this when they are born) your hips could be out of alignment or in fact an injury where your shoulder changes its position to protect an injury…Best idea Brent is have a Physio or exercise physiologist/scientist take a look either of them will subscribe some work to rectify or establish if you have anything to be concerned about…many people will have one shoulder slightly higher than the other and go through life without any issues. However if this has just suddenly appeared have it checked…
      John Hart

  3. andy January 20, 2014 at 8:40 am Permalink

    hi john. im a good surfer ,and suffered a supratinartus tear ,then frozen shoulder, tendon healed a lot through 6 months off work ,and is a 4 mm anterior tear now ,my problem now is im back at work but I still cant surf[paddle or push up on board ] its been 8 months ,what can I do ,I need to surf ,ive had to cancel surf trips to indo etc, I don’t know what to do now , any advice appreciated ,thank andy

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