0:05 How many of you have heard of the 0:08 rotator cuff before? A few people? 0:30 We got this and one graph 0:33 and we'll go to lunch, sound like a plan? 0:43 Your rotator cuff muscles, they're your 0:47 SITS muscles. How many of you have heard 0:52 that? This creates a little acronym for 0:56 you to memorize the rotator cuff muscles by and if you memorize them in 1:00 this order, it does help. It does help, I'm 1:03 going to show you how you can make this... becomes a graph that's really 1:07 easy to remember. First thing you have to 1:09 remember, unfortunately, is the names. 1:11 Supraspinatus, Infraspinatus, Teres minor 1:24 Make sure you know teres minor. 1:31 Subscapularis. Now I remember the first 1:37 time I learned these muscles. The names 1:42 kind of freaked me out. Supraspinatus, 1:45 sounds like a dinosaur. The 1:49 supraspinatus. No? Maybe I took that a 1:56 little too far, but nonetheless these 1:58 names do tell you where the muscles are 2:02 located. Remember I said anatomy is just 2:05 another language, so let's break this 2:07 word down. Supra sounds like what? 2:10 Superior. Spine, spine, what bone are 2:15 we on? Scapula. Does the scapula have a spine? It does. 2:25 The origin of this muscle is the supraspinous fossa. What's what's the 2:32 layman's term for fossa? Who wants to come 2:34 up with it? We got "bone bump" for tubercle and tuberosity, I like that. What's a 2:39 fossa? It's not a hole. A foramen is a whole. A fossa is a depression, an indent. This 2:52 depression right here is the 2:54 supraspinous fossa, which just happens to be superior to the spine of my scapula. 3:04 Makes sense now right? Your 3:07 supraspinatus runs in here, goes underneath your acromion process and it 3:12 attaches into the greater tubercle of 3:13 the humerus by running across the top of 3:16 the humerus. If it goes from the top of the scapula, on top of the humerus, number 3:22 one, what joint are we talking about? 3:26 Shoulder. So we're still using the same word bank. That hasn't changed. 3:30 We're still talking about the shoulder. 3:33 We're still using the same word bank. If 3:38 it goes from the top of the scapula to 3:42 the top of the humerus like that, what do you think it's going to contribute to, 3:46 join action wise? It does one of 3:47 these puppies. It contributes to... especially the initial part of abduction, 3:53 this is an abductor. 4:02 Infraspinatus is in the infraspinous fossa, what was the fossa again? 4:12 Indentation. Infra probably sounds like 4:16 inferior. Spine, spine. This actually 4:21 has some of the origins and insertions, 4:22 you can come up here on your 4:24 breaks and lunch and look at some of 4:25 this. The infraspinous fossa is all 4:28 this. The infraspinatus goes from 4:32 the back of the scapula to the back of 4:35 the humerus. What's it going to 4:37 contribute to? External rotation. 4:52 Teres minor, I don't know if you 4:54 can see this. This is probably easier way 4:56 to look. Can you see how the teres minor and the infraspinatus kind of 4:59 blend? The teres minor definitely 5:03 comes off the lateral border of the 5:05 scapula, it doesn't go all the 5:08 way over here like the infraspinatus 5:10 does but they kind of blend and go in 5:13 the same direction, which means they 5:14 probably contribute to what? The same joint action. They're both going to do 5:20 external rotation. I'll give you a little 5:25 cue for your tests, if you remember your rotator cuff as your SITS muscles, as 5:31 we're doing up here. IT externally 5:38 rotates. You with me? IT externally 5:45 rotates, which only leaves us one muscle. 5:49 Subscapularis. What does sub mean? Below. 5:56 What's weird about this 5:59 picture right here? You see the bottom 6:03 picture that points the subscapularis? 6:04 What's different about that picture than 6:07 the one above? It's an anterior view, 6:10 which means who's missing? Scapula is there. The ribs. I heard somebody say it. 6:21 The ribs have been removed from that 6:23 picture. You are looking at the 6:26 subscapularis from here. 6:29 Subscapularis is underneath the scapula, 6:33 so it goes from the front of the scapula 6:36 to the front of the humerus. What type of 6:39 rotation? Internal, right. Now you're on the 6:44 front, so it turns it this way. Does that 6:46 make sense? We have the two muscles in 6:49 the back that pulled us in this way, the one 6:51 on the top that pulled us this way and 6:53 then the one in the front that pulls us 6:55 this way. At least it's on the front of 6:58 the scapula. 7:06 A little aside, just to teach you 7:09 a little bit about muscular 7:10 function so you understand why you're 7:12 learning all this stuff. The interesting 7:14 thing about the rotator cuff 7:15 muscles is yes, those are the joint 7:17 actions and they'll actually do some 7:19 other joint actions as you get more into 7:20 advanced kinesiology and you start 7:22 talking about some other things it'll 7:23 do, but that's not the primary 7:27 function of the rotator cuff. To call the 7:31 glenoid fossa, which we were talking 7:32 about earlier, this part right here, 7:34 the "shoulder socket" is a little unfair. 7:39 Why is that? Does that look like a socket 7:45 to you? Does that look like something the 7:47 humeral head is just totally buried in? 7:51 This is what's supposed to be giving our 7:53 shoulder stability? It would be a better 7:57 analogy, rather than calling it a ball 7:58 and socket, to call it a "golf ball and 8:02 tee" joint. That's about how 8:08 much support the humeral head has. So who 8:11 keeps the humeral head on my glenoid 8:14 fossa? What ends up happening is 8:19 the rotator cuff comes along and goes 8:22 "Okay, we'll put one in front like this 8:23 we'll put a couple around the back, we'll 8:26 put one on top to make sure we hold you 8:28 in." From a training perspective, what 8:33 happens? Well, these muscle fibers for 8:37 rotator cuff and all of our stabilizing 8:40 muscles are mostly type one. What are type one 8:47 muscle fibers? Slow twitch, fatigue resistant, 8:51 they're our endurance fibers, so how do they want to be worked? 8:58 Probably a little bit slower, 9:00 probably a little bit slower tempo, but 9:03 most importantly for a higher rep range. 9:05 This isn't our 1-6 rep range, this is our 9:09 12 to 20 rep range and if we really want 9:12 to get sophisticated we'll do 12 to 20 reps at a slightly slower tempo and 9:16 since we know we're working on 9:17 stabilization, we'll work on progressing 9:19 exercises over time to more and more unstable 9:21 environments, so getting off of 9:24 machines, going to dumbbells, maybe 9:27 stuff on a stability ball. You have 9:29 seen some of the stuff? That's really 9:31 really important, but how many people do 9:34 you know, especially athletes, enjoy 9:35 endurance training? You don't see it very 9:39 often. What do all athletes want to do? Get big and do power 9:44 training. They want it fast and hard. 9:47 That's it. One to six reps, how 9:50 much can I lift, how fast can I lift it 9:53 and then I'm going to rest for three 9:54 minutes. That's great for your prime 9:57 movers, but who gets left behind? 10:01 Your stabilizing slow twitch fibers. 10:04 I will never forget, I used to play 10:05 ball against this guy in my complex and 10:08 he used to play Division II ball, guy 10:10 was probably about 6'6, probably 10:13 outweighed me by 20...25 pounds. He's up 10:18 there at around 250 pounds. Dude was a 10:20 beast. Big boy. Every time I went and played against him 10:26 "Oh I'm gonna hurt tomorrow." 10:29 And I'll never forget we played 10:32 for months and months and months and he 10:33 happened to actually work out at the gym 10:34 that I was a trainer at and I would 10:37 watch him work out a little bit, but I'm 10:39 not one of those people who's going to come 10:40 up to you and tell you everything that 10:41 you're doing wrong or everything that 10:42 you're doing right, you go and workout. 10:43 You want my advice you can come up and 10:44 ask me. But I did happen to notice with 10:46 this particular guy he spent a lot of 10:48 time on machines. He could lift a truck, 10:51 but he spent a lot of time on machines. 10:54 And then there was a period where I 10:56 didn't see him for a while. I didn't seem 10:57 down on the basketball court, I didn't 10:59 see him in the gym. The next time I saw 11:02 him, he's in a sling. I'm like "Dude." 11:10 I know what he could do to me, I'd hate 11:13 to see the guy who could do that to him. 11:15 That was my first thought, but 11:18 then I went over and asked him, 11:19 "What happened" and he said, 11:20 "I threw an outlet pass." I went, "What?" 11:24 You know what an outlet pass is? 11:25 He's a big enough guy, he can take a 11:27 basketball and do this and just chuck it. 11:30 He said he literally went like this 11:32 and dislocated his shoulder. So what had 11:38 happened? Right. 11:42 I'm starting to put all this together, he's 11:44 been working his prime movers, getting 11:45 huge, but his poor rotator cuff is 11:50 not getting any of the work it wants. It's 11:52 not getting fed the way it wants. I guarantee this is what happened when he 11:57 threw that ball. He saw that outlet pass, 11:59 knew he had to make it quick and powerful, probably B-line it, so he 12:06 could get it there on time. His prime 12:08 movers pulled on his humerus as 12:11 hard as they can and his rotator cuff 12:13 went, "Yeah, screw this." And he 12:19 dislocated his shoulder. That's how that 12:21 happens and meanwhile all he really had 12:22 to do with some stability work. It's not 12:25 like he needed to be any bigger to play 12:26 basketball. Six foot six, 260 to play 12:29 rec ball, you're big. 12:33 Do a little stability work he wouldn't have 12:34 ended up in a sling? Does that make sense on how the rotator cuff works? 12:37 Do you understand why you need to know your functional anatomy a 12:41 little bit too? Let's do this 12:43 one graph, reverse flye. Yeah, like a seatbelt. I like that, rotator 12:51 cuff is kind of like a seatbelt. Reverse flye. 12:57 Your reverse flye, all you are 13:01 going to do is fill it in just like you filled in that graph. You're going 13:04 to fill in, what plane of motion is a 13:07 reverse flye in? Transverse, good. We'l 13:08 do this one together since you haven't done one of these yet. 13:14 We're going to do quite a quite a few of these graphs. 13:15 What joints are involved in a 13:20 reverse flye? 13:26 My shoulder joint and if my shoulder is 13:29 involved, who else is going to be 13:30 involved? My scapula. Those 13:33 move together. Anytime you write shoulder on any graph that we do, 13:37 you need to right scapula too. I want you 13:40 to think about them as two separate joints though. You don't write those in 13:44 one box, but anytime you have shoulder, 13:46 you're going to have scapula. So shoulder, 13:50 what joint action is occurring at the 13:52 shoulder? Horizontal abduction. 14:06 Then we'll go down to our next box and 14:09 we have scapular retraction. 14:15 I have shoulder abduction, what muscle 14:19 is responsible for short of shoulder abduction? 14:21 It's a muscle that we've gone over to this point. 14:33 Posterior deltoid, good. What muscles are 14:39 responsible for scapular retraction? 14:46 Rhomboids and mid-traps, we've already done that one before. That's the nice 14:51 thing about learning these graphs, is anytime scapular retraction comes up, 14:54 who's involved? Who causes scapular 15:00 retraction? Rhomboids and mid-traps. If I 15:04 say scapular retraction for a seated row, 15:08 what muscles are responsible? Rhomboids and mid-traps. If I say a bent over 15:14 barbell row with scapular retraction, 15:16 scapular retraction is caused by...? Rhomboids and mid-traps. 15:19 Got it?
