How many of you have heard of the
rotator cuff before? A few people?
We got this and one graph
and we'll go to lunch, sound like a plan?
Your rotator cuff muscles, they're your
SITS muscles. How many of you have heard
that? This creates a little acronym for
you to memorize the rotator cuff muscles by and if you memorize them in
this order, it does help. It does help, I'm
going to show you how you can make this... becomes a graph that's really
easy to remember. First thing you have to
remember, unfortunately, is the names.
Supraspinatus, Infraspinatus, Teres minor
Make sure you know teres minor.
Subscapularis. Now I remember the first
time I learned these muscles. The names
kind of freaked me out. Supraspinatus,
sounds like a dinosaur. The
supraspinatus. No? Maybe I took that a
little too far, but nonetheless these
names do tell you where the muscles are
located. Remember I said anatomy is just
another language, so let's break this
word down. Supra sounds like what?
Superior. Spine, spine, what bone are
we on? Scapula. Does the scapula have a spine? It does.
The origin of this muscle is the supraspinous fossa. What's what's the
layman's term for fossa? Who wants to come
up with it? We got "bone bump" for tubercle and tuberosity, I like that. What's a
fossa? It's not a hole. A foramen is a whole. A fossa is a depression, an indent. This
depression right here is the
supraspinous fossa, which just happens to be superior to the spine of my scapula.
Makes sense now right? Your
supraspinatus runs in here, goes underneath your acromion process and it
attaches into the greater tubercle of
the humerus by running across the top of
the humerus. If it goes from the top of the scapula, on top of the humerus, number
one, what joint are we talking about?
Shoulder. So we're still using the same word bank. That hasn't changed.
We're still talking about the shoulder.
We're still using the same word bank. If
it goes from the top of the scapula to
the top of the humerus like that, what do you think it's going to contribute to,
join action wise? It does one of
these puppies. It contributes to... especially the initial part of abduction,
this is an abductor.
Infraspinatus is in the infraspinous fossa, what was the fossa again?
Indentation. Infra probably sounds like
inferior. Spine, spine. This actually
has some of the origins and insertions,
you can come up here on your
breaks and lunch and look at some of
this. The infraspinous fossa is all
this. The infraspinatus goes from
the back of the scapula to the back of
the humerus. What's it going to
contribute to? External rotation.
Teres minor, I don't know if you
can see this. This is probably easier way
to look. Can you see how the teres minor and the infraspinatus kind of
blend? The teres minor definitely
comes off the lateral border of the
scapula, it doesn't go all the
way over here like the infraspinatus
does but they kind of blend and go in
the same direction, which means they
probably contribute to what? The same joint action. They're both going to do
external rotation. I'll give you a little
cue for your tests, if you remember your rotator cuff as your SITS muscles, as
we're doing up here. IT externally
rotates. You with me? IT externally
rotates, which only leaves us one muscle.
Subscapularis. What does sub mean? Below.
What's weird about this
picture right here? You see the bottom
picture that points the subscapularis?
What's different about that picture than
the one above? It's an anterior view,
which means who's missing? Scapula is there. The ribs. I heard somebody say it.
The ribs have been removed from that
picture. You are looking at the
subscapularis from here.
Subscapularis is underneath the scapula,
so it goes from the front of the scapula
to the front of the humerus. What type of
rotation? Internal, right. Now you're on the
front, so it turns it this way. Does that
make sense? We have the two muscles in
the back that pulled us in this way, the one
on the top that pulled us this way and
then the one in the front that pulls us
this way. At least it's on the front of
A little aside, just to teach you
a little bit about muscular
function so you understand why you're
learning all this stuff. The interesting
thing about the rotator cuff
muscles is yes, those are the joint
actions and they'll actually do some
other joint actions as you get more into
advanced kinesiology and you start
talking about some other things it'll
do, but that's not the primary
function of the rotator cuff. To call the
glenoid fossa, which we were talking
about earlier, this part right here,
the "shoulder socket" is a little unfair.
Why is that? Does that look like a socket
to you? Does that look like something the
humeral head is just totally buried in?
This is what's supposed to be giving our
shoulder stability? It would be a better
analogy, rather than calling it a ball
and socket, to call it a "golf ball and
tee" joint. That's about how
much support the humeral head has. So who
keeps the humeral head on my glenoid
fossa? What ends up happening is
the rotator cuff comes along and goes
"Okay, we'll put one in front like this
we'll put a couple around the back, we'll
put one on top to make sure we hold you
in." From a training perspective, what
happens? Well, these muscle fibers for
rotator cuff and all of our stabilizing
muscles are mostly type one. What are type one
muscle fibers? Slow twitch, fatigue resistant,
they're our endurance fibers, so how do they want to be worked?
Probably a little bit slower,
probably a little bit slower tempo, but
most importantly for a higher rep range.
This isn't our 1-6 rep range, this is our
12 to 20 rep range and if we really want
to get sophisticated we'll do 12 to 20 reps at a slightly slower tempo and
since we know we're working on
stabilization, we'll work on progressing
exercises over time to more and more unstable
environments, so getting off of
machines, going to dumbbells, maybe
stuff on a stability ball. You have
seen some of the stuff? That's really
really important, but how many people do
you know, especially athletes, enjoy
endurance training? You don't see it very
often. What do all athletes want to do? Get big and do power
training. They want it fast and hard.
That's it. One to six reps, how
much can I lift, how fast can I lift it
and then I'm going to rest for three
minutes. That's great for your prime
movers, but who gets left behind?
Your stabilizing slow twitch fibers.
I will never forget, I used to play
ball against this guy in my complex and
he used to play Division II ball, guy
was probably about 6'6, probably
outweighed me by 20...25 pounds. He's up
there at around 250 pounds. Dude was a
beast. Big boy. Every time I went and played against him
"Oh I'm gonna hurt tomorrow."
And I'll never forget we played
for months and months and months and he
happened to actually work out at the gym
that I was a trainer at and I would
watch him work out a little bit, but I'm
not one of those people who's going to come
up to you and tell you everything that
you're doing wrong or everything that
you're doing right, you go and workout.
You want my advice you can come up and
ask me. But I did happen to notice with
this particular guy he spent a lot of
time on machines. He could lift a truck,
but he spent a lot of time on machines.
And then there was a period where I
didn't see him for a while. I didn't seem
down on the basketball court, I didn't
see him in the gym. The next time I saw
him, he's in a sling. I'm like "Dude."
I know what he could do to me, I'd hate
to see the guy who could do that to him.
That was my first thought, but
then I went over and asked him,
"What happened" and he said,
"I threw an outlet pass." I went, "What?"
You know what an outlet pass is?
He's a big enough guy, he can take a
basketball and do this and just chuck it.
He said he literally went like this
and dislocated his shoulder. So what had
I'm starting to put all this together, he's
been working his prime movers, getting
huge, but his poor rotator cuff is
not getting any of the work it wants. It's
not getting fed the way it wants. I guarantee this is what happened when he
threw that ball. He saw that outlet pass,
knew he had to make it quick and powerful, probably B-line it, so he
could get it there on time. His prime
movers pulled on his humerus as
hard as they can and his rotator cuff
went, "Yeah, screw this." And he
dislocated his shoulder. That's how that
happens and meanwhile all he really had
to do with some stability work. It's not
like he needed to be any bigger to play
basketball. Six foot six, 260 to play
rec ball, you're big.
Do a little stability work he wouldn't have
ended up in a sling? Does that make sense on how the rotator cuff works?
Do you understand why you need to know your functional anatomy a
little bit too? Let's do this
one graph, reverse flye. Yeah, like a seatbelt. I like that, rotator
cuff is kind of like a seatbelt. Reverse flye.
Your reverse flye, all you are
going to do is fill it in just like you filled in that graph. You're going
to fill in, what plane of motion is a
reverse flye in? Transverse, good. We'l
do this one together since you haven't done one of these yet.
We're going to do quite a quite a few of these graphs.
What joints are involved in a
My shoulder joint and if my shoulder is
involved, who else is going to be
involved? My scapula. Those
move together. Anytime you write shoulder on any graph that we do,
you need to right scapula too. I want you
to think about them as two separate joints though. You don't write those in
one box, but anytime you have shoulder,
you're going to have scapula. So shoulder,
what joint action is occurring at the
shoulder? Horizontal abduction.
Then we'll go down to our next box and
we have scapular retraction.
I have shoulder abduction, what muscle
is responsible for short of shoulder abduction?
It's a muscle that we've gone over to this point.
Posterior deltoid, good. What muscles are
responsible for scapular retraction?
Rhomboids and mid-traps, we've already done that one before. That's the nice
thing about learning these graphs, is anytime scapular retraction comes up,
who's involved? Who causes scapular
retraction? Rhomboids and mid-traps. If I
say scapular retraction for a seated row,
what muscles are responsible? Rhomboids and mid-traps. If I say a bent over
barbell row with scapular retraction,
scapular retraction is caused by...? Rhomboids and mid-traps.