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Functional anatomy of the rotator cuff. Joint actions, location, pictures, and exercises for the supraspinatus, infraspinatus, teres minor, and subscapularis a.k.a. rotator cuff muscles. 

Lesson 9: Rotator Cuff

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

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I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

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Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

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This course describes the rotator cuff muscles, including the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles are likely most well known for their function as deep stabilizers of the shoulder joint (glenohumeral joint) and are commonly referred to when performing rotator cuff exercises during physical therapy for a rotator cuff injury. (Note, there is no such thing as a “rotator cup”, this is a mispronunciation of "rotator cuff".)

This course describes each of the rotator cuff muscles and their location, function, actions, and practical applications. For example, the infraspinatus muscle and teres minor muscle are the primary external rotators (lateral rotators) of the shoulder joint, and may be strengthened with corrective exercises like resisted external rotation (lateral rotation), which may be beneficial for individuals exhibiting rounded shoulder posture. The subscapularis muscle is a strong internal rotator (medial rotator) of the shoulder joint, and may be targeted with subscapularis activation, and this may be beneficial for individuals exhibiting shoulder instability. Last, the supraspinatus muscle is an abductor of the shoulder joint, and is often the muscle involved in rotator cuff tendonitis and rotator cuff tears, and over-activity in this muscle may be addressed with release techniques. Another important function of the rotator cuff is shoulder stability. This is accomplished via synergistic recruitment of all rotator cuff muscles during all shoulder movement to maintain alignment between the humeral head (upper arm bone) and the glenoid fossa of the scapula (shoulder blade). This occurs during all activities of daily living (e.g. putting a cup in a cupboard), commonly recommended exercises (e.g. bench press), and sports motions (e.g. baseball pitch).

Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the rotator cuff muscles for detailed analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing more complex topics including neural innervations of the rotator cuff (e.g. suprascapular nerve), the complex insertions of the rotator cuff tendons (e.g. lesser tubercle of the humerus and transverse ligament), its synergistic function with upper arm muscles (e.g. biceps brachii, pectoralis major), injury (e.g. shoulder muscle tendon dysfunction, shoulder injuries, shoulder pain, shoulder impingement syndrome, rotator cuff injuries, rotator cuff strain, rotator cuff tear - you don't always need rotator cuff repair or shoulder surgery), and rotator cuff exercises for rotator cuff weakness and sports performance (e.g. throwing, shooting, punching, lifting).

Certified Personal Trainer (CPT) Certification

Pre-approved for Continuing Education Credits for:

For more advanced anatomy check out our integrated functional anatomy courses:

For rotator cuff specific exercises and techniques check out:

Shoulder External Rotator Exercises (Activation)

The rotator cuff muscles of the shoulder, including the supraspinatus, infraspinatus, and teres minor

Course Description: Rotator Cuff Muscles

Rotator Cuff Muscles Study Guide

Course Study Guide: Rotator Cuff Muscles

This video describes the rotator cuff muscles including the supraspinatus, infraspinatus, teres minor, and subscapularis. We identify the relative location of the four rotator cuff muscles, and discuss the joint actions that may be performed by each muscle. Further, This course describes how these muscles contribute to motion and stability of the humerus at the shoulder joint (glenohumeral joint) with many examples of daily activities, exercises, sports motions, and movement analysis. This is foundational knowledge for all movement professionals, including personal trainers, physical therapists, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.

Course Video Lesson: Rotator Cuff

Etymology: Rotator Cuff Muscles

Rotator Cuff Muscles: Attachments

Introduction

A visual of the supraspinatus muscle performing abduction of the humerus

Supraspinatus: Attachments

The supraspinatus running from the supraspinous process of the scapula to the humerus

Supraspinatus Activity

Supraspinatus Answer Key

Supraspinatus

An image of the infraspinatus muscle attaching from the scapula to the humerus

Infraspinatus: Attachments

The infraspinatus muscle on the posterior side of the shoulder complex

Infraspinatus Activity

Infraspinatus Answer Key

Infraspinatus

Teres minor attaching from the scapula to the humerus

Teres Minor: Attachments

The infraspinatus and teres minor on the posterior side of the scapula

Teres Minor Activity

Teres Minor Answer Key

Teres Minor

Relative location of the subscapularis muscle on the anterior side of the scapula

Subscapularis: Attachments

The subscapularis muscles from a birds-eye view

Subscapularis Activity

Subscapularis Answer Key

Subscapularis

Although the above activities have highlighted the joint actions each rotator cuff muscle will contribute to (specifically internal rotation, external rotation, and abduction), it is the combined role of these muscles that are likely of greatest importance.

When you examine the anatomy of the glenoid fossa and the humeral head, you will see that calling this joint a "Ball and 

" is a stretch (look to the illustration on the left in the image below). A better analogy would be a golf ball on a golf tee. The glenoid fossa is certainly not a deep cup that is capable of holding the humeral head in place. The rotator cuff surrounds the humeral head from the top, front, and back and holds the humeral head on the glenoid fossa during movement. This is sometimes referred to as "dynamic stabilization of the shoulder."

Although it is a bit premature within this lesson to discuss arthrokinematics - I feel this is an opportunity to allude to further education. From a rehab, fitness, and performance standpoint the joint actions above are only helpful in creating exercise to target a specific muscle, the ability to assess which muscle should be targeted has more to do with their role as dynamic stabilizers and the ability of each muscle to contribute to glide, spin, roll, and compression in an effort to keep the humeral head centered on the glenoid fossa. In essence, these muscles keep the golf ball from rolling off the tee, and understanding which way the golf ball rolls off will dictate which muscle will slide it back into the center.

Combining function and physiology. The rotator cuff has a higher density of Type I (fatigue resistance/endurance) fibers; the fiber type that adapts best to longer periods of time under tension. This alludes to the importance of strength endurance training, e.g. 12 -20 slow repetitions. 

If you combine this knowledge with the discussion above about the rotator cuff's function as a dynamic stabilizer of the shoulder, you may guess that doing higher rep stability work to ensure optimal strength and function of the rotator cuff is paramount for optimal shoulder health and performance. In short, occasionally we have to put the heavyweight down and work on endurance and stability if we want to stay at the top of our game.

The rotator cuff acks as a stabilizing mechanims to maintain congruency of the humeral head and the glenoid cavity

Note how the humeral head only meets the glenoid fossa - in no way is the glenoid fossa a deep depression that is capable of stabilizing the humeral head without the help of the rotator cuff. - http://www.colinmcnulty.com/online-courses/online-courses/blog/wp-content/uploads/2011/08/what-is-the-rotator-cuff.png

Why Are These Muscles So Important

Activity: Reverse Fly Exercise

Reverse Fly Answer Key

Practical Application Activity

Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004

John V. Basmajian, Carlo J. De Luca. Muscles Alive: Their Function Revealed by ElectroMyography. 1985

Lesson 9: Rotator Cuff

Related Courses:

Course Description: Rotator Cuff Muscles

Course Study Guide: Rotator Cuff Muscles

Course Video Lesson: Rotator Cuff

Introduction
2 Sub Sections

Supraspinatus
3 Sub Sections

Infraspinatus
3 Sub Sections

Teres Minor
3 Sub Sections

Subscapularis
3 Sub Sections

Why Are These Muscles So Important

Practical Application Activity
2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Lesson 9: Rotator Cuff

Related Courses:

Course Description: Rotator Cuff Muscles

Course Study Guide: Rotator Cuff Muscles

Course Video Lesson: Rotator Cuff

Introduction2 Sub Sections

Supraspinatus3 Sub Sections

Infraspinatus3 Sub Sections

Teres Minor3 Sub Sections

Subscapularis3 Sub Sections

Why Are These Muscles So Important

Practical Application Activity2 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Introduction
2 Sub Sections

Supraspinatus
3 Sub Sections

Infraspinatus
3 Sub Sections

Teres Minor
3 Sub Sections

Subscapularis
3 Sub Sections

Practical Application Activity
2 Sub Sections