Rotator Cuff Syndrome

DEFINITION: Tear or total break in one or more shoulder muscles, the supraspinatus, infraspinatus, subscapularis or teres minor. More than 90% of the time it is the supraspinatus. BENEFICIAL POSES: Iyengar Headstand (with shoulders elevated) and variations lifting shoulders while inverted with thighs supported on a chair, or triangular forearm support done in tilted standing position with forearms against the wall toward which one is tilted. TECHNIQUE: After staying in one of the positions with shoulders drawn away from the ears and supraspinatus unengaged for 45 seconds, one must quickly stand up and then bravely and fearlessly abduct the arms rapidly to overhead at least twice, and flex the shoulders, bringing the arms in front and overhead at least twice in rapid succession. This requires courage because these are exactly the movements that were painful just a minute before. See video below. EXPLANATION: Holding the shoulders aloft while inverted activates the subscapularis, which can work to elevate the arm (when standing up) by pulling the head of the humerus down while the deltoid holds the first part of the bone steady. This raises the shaft the way a cantilever bridge, or “teeter-tauter” works. The deltoid acts as a fulcrum, holding the first part of the humerus steady while the subscapularis pulls the head of the bone down. This raises the shaft of the humerus up. Once learned, possibly by a mechanism similar to operant conditioning, the person keeps using this painless, effective way of lifting the arm, which supplants the painful, ineffective use of the torn supraspinatus. People have been followed for more than 15 years and remain with full active painless range of motion although the supraspinatus muscle may not heal. REFERENCE: Fishman LM..   “Headstand in the treatment of rotator cuff syndrome – Sirsasana or surgery. Journal of the International Association of Yoga Therapists. (16): October 2006. 137-45.