You can only view 3 videos without an account. Become a Member to access all videos on the website.
Rotator Cuff and First Exercise Graph: Video #9 of Introduction to Functional Anatomy
This video from the Introduction to Functional Anatomy series explains the anatomy of the rotator cuff and demonstrates a first exercise graph designed to target the rotator cuff muscles. The rotator cuff is composed of four muscles: the supraspinatus, infraspinatus, subscapularis, and teres minor, located in the should joint which support the arm's movement. The video shows how to perform a first exercise graph which uses body weight exercises to strengthen and stretch the
Transcript
00:00:0500:00:08
How many of you have heard of the
00:00:0500:00:08
...blank
00:00:0800:00:13
rotator cuff before? A few people?
00:00:3000:00:33
We got this and one graph
00:00:3300:00:43
and we'll go to lunch, sound like a plan?
00:00:4300:00:47
Your rotator cuff muscles, they're your
00:00:4700:00:52
SITS muscles. How many of you have heard
00:00:5200:00:56
that? This creates a little acronym for
00:00:5600:01:00
you to memorize the rotator cuff muscles by and if you memorize them in
00:01:0000:01:03
this order, it does help. It does help, I'm
00:01:0300:01:07
going to show you how you can make this... becomes a graph that's really
00:01:0700:01:09
easy to remember. First thing you have to
00:01:0900:01:11
remember, unfortunately, is the names.
00:01:1100:01:24
Supraspinatus, Infraspinatus, Teres minor
00:01:2400:01:31
Make sure you know teres minor.
00:01:3100:01:37
Subscapularis. Now I remember the first
00:01:3700:01:42
time I learned these muscles. The names
00:01:4200:01:45
kind of freaked me out. Supraspinatus,
00:01:4500:01:49
sounds like a dinosaur. The
00:01:4900:01:56
supraspinatus. No? Maybe I took that a
00:01:5600:01:58
little too far, but nonetheless these
00:01:5800:02:02
names do tell you where the muscles are
00:02:0200:02:05
located. Remember I said anatomy is just
00:02:0500:02:07
another language, so let's break this
00:02:0700:02:10
word down. Supra sounds like what?
00:02:1000:02:15
Superior. Spine, spine, what bone are
00:02:1500:02:22
we on? Scapula. Does the scapula have a spine? It does.
00:02:2500:02:32
The origin of this muscle is the supraspinous fossa. What's what's the
00:02:3200:02:34
layman's term for fossa? Who wants to come
00:02:3400:02:39
up with it? We got "bone bump" for tubercle and tuberosity, I like that. What's a
00:02:3900:02:52
fossa? It's not a hole. A foramen is a whole. A fossa is a depression, an indent. This
00:02:5200:02:54
depression right here is the
00:02:5400:03:04
supraspinous fossa, which just happens to be superior to the spine of my scapula.
00:03:0400:03:07
Makes sense now right? Your
00:03:0700:03:12
supraspinatus runs in here, goes underneath your acromion process and it
00:03:1200:03:13
attaches into the greater tubercle of
00:03:1300:03:16
the humerus by running across the top of
00:03:1600:03:22
the humerus. If it goes from the top of the scapula, on top of the humerus, number
00:03:2200:03:26
one, what joint are we talking about?
00:03:2600:03:30
Shoulder. So we're still using the same word bank. That hasn't changed.
00:03:3000:03:33
We're still talking about the shoulder.
00:03:3300:03:38
We're still using the same word bank. If
00:03:3800:03:42
it goes from the top of the scapula to
00:03:4200:03:46
the top of the humerus like that, what do you think it's going to contribute to,
00:03:4600:03:47
join action wise? It does one of
00:03:4700:03:53
these puppies. It contributes to... especially the initial part of abduction,
00:03:5300:03:57
this is an abductor.
00:04:0200:04:12
Infraspinatus is in the infraspinous fossa, what was the fossa again?
00:04:1200:04:16
Indentation. Infra probably sounds like
00:04:1600:04:21
inferior. Spine, spine. This actually
00:04:2100:04:22
has some of the origins and insertions,
00:04:2200:04:24
you can come up here on your
00:04:2400:04:25
breaks and lunch and look at some of
00:04:2500:04:28
this. The infraspinous fossa is all
00:04:2800:04:32
this. The infraspinatus goes from
00:04:3200:04:35
the back of the scapula to the back of
00:04:3500:04:37
the humerus. What's it going to
00:04:3700:04:44
contribute to? External rotation.
00:04:5200:04:54
Teres minor, I don't know if you
00:04:5400:04:56
can see this. This is probably easier way
00:04:5600:04:59
to look. Can you see how the teres minor and the infraspinatus kind of
00:04:5900:05:03
blend? The teres minor definitely
00:05:0300:05:05
comes off the lateral border of the
00:05:0500:05:08
scapula, it doesn't go all the
00:05:0800:05:10
way over here like the infraspinatus
00:05:1000:05:13
does but they kind of blend and go in
00:05:1300:05:14
the same direction, which means they
00:05:1400:05:20
probably contribute to what? The same joint action. They're both going to do
00:05:2000:05:25
external rotation. I'll give you a little
00:05:2500:05:31
cue for your tests, if you remember your rotator cuff as your SITS muscles, as
00:05:3100:05:38
we're doing up here. IT externally
00:05:3800:05:45
rotates. You with me? IT externally
00:05:4500:05:49
rotates, which only leaves us one muscle.
00:05:4900:05:56
Subscapularis. What does sub mean? Below.
00:05:5600:05:59
What's weird about this
00:05:5900:06:03
picture right here? You see the bottom
00:06:0300:06:04
picture that points the subscapularis?
00:06:0400:06:07
What's different about that picture than
00:06:0700:06:10
the one above? It's an anterior view,
00:06:1000:06:21
which means who's missing? Scapula is there. The ribs. I heard somebody say it.
00:06:2100:06:23
The ribs have been removed from that
00:06:2300:06:26
picture. You are looking at the
00:06:2600:06:29
subscapularis from here.
00:06:2900:06:33
Subscapularis is underneath the scapula,
00:06:3300:06:36
so it goes from the front of the scapula
00:06:3600:06:39
to the front of the humerus. What type of
00:06:3900:06:44
rotation? Internal, right. Now you're on the
00:06:4400:06:46
front, so it turns it this way. Does that
00:06:4600:06:49
make sense? We have the two muscles in
00:06:4900:06:51
the back that pulled us in this way, the one
00:06:5100:06:53
on the top that pulled us this way and
00:06:5300:06:55
then the one in the front that pulls us
00:06:5500:06:58
this way. At least it's on the front of
00:06:5800:07:00
the scapula.
00:07:0600:07:09
A little aside, just to teach you
00:07:0900:07:10
a little bit about muscular
00:07:1000:07:12
function so you understand why you're
00:07:1200:07:14
learning all this stuff. The interesting
00:07:1400:07:15
thing about the rotator cuff
00:07:1500:07:17
muscles is yes, those are the joint
00:07:1700:07:19
actions and they'll actually do some
00:07:1900:07:20
other joint actions as you get more into
00:07:2000:07:22
advanced kinesiology and you start
00:07:2200:07:23
talking about some other things it'll
00:07:2300:07:27
do, but that's not the primary
00:07:2700:07:31
function of the rotator cuff. To call the
00:07:3100:07:32
glenoid fossa, which we were talking
00:07:3200:07:34
about earlier, this part right here,
00:07:3400:07:39
the "shoulder socket" is a little unfair.
00:07:3900:07:45
Why is that? Does that look like a socket
00:07:4500:07:47
to you? Does that look like something the
00:07:4700:07:51
humeral head is just totally buried in?
00:07:5100:07:53
This is what's supposed to be giving our
00:07:5300:07:57
shoulder stability? It would be a better
00:07:5700:07:58
analogy, rather than calling it a ball
00:07:5800:08:02
and socket, to call it a "golf ball and
00:08:0200:08:08
tee" joint. That's about how
00:08:0800:08:11
much support the humeral head has. So who
00:08:1100:08:14
keeps the humeral head on my glenoid
00:08:1400:08:19
fossa? What ends up happening is
00:08:1900:08:22
the rotator cuff comes along and goes
00:08:2200:08:23
"Okay, we'll put one in front like this
00:08:2300:08:26
we'll put a couple around the back, we'll
00:08:2600:08:28
put one on top to make sure we hold you
00:08:2800:08:33
in." From a training perspective, what
00:08:3300:08:37
happens? Well, these muscle fibers for
00:08:3700:08:40
rotator cuff and all of our stabilizing
00:08:4000:08:47
muscles are mostly type one. What are type one
00:08:4700:08:51
muscle fibers? Slow twitch, fatigue resistant,
00:08:5100:08:57
they're our endurance fibers, so how do they want to be worked?
00:08:5800:09:00
Probably a little bit slower,
00:09:0000:09:03
probably a little bit slower tempo, but
00:09:0300:09:05
most importantly for a higher rep range.
00:09:0500:09:09
This isn't our 1-6 rep range, this is our
00:09:0900:09:12
12 to 20 rep range and if we really want
00:09:1200:09:16
to get sophisticated we'll do 12 to 20 reps at a slightly slower tempo and
00:09:1600:09:17
since we know we're working on
00:09:1700:09:19
stabilization, we'll work on progressing
00:09:1900:09:21
exercises over time to more and more unstable
00:09:2100:09:24
environments, so getting off of
00:09:2400:09:27
machines, going to dumbbells, maybe
00:09:2700:09:29
stuff on a stability ball. You have
00:09:2900:09:31
seen some of the stuff? That's really
00:09:3100:09:34
really important, but how many people do
00:09:3400:09:35
you know, especially athletes, enjoy
00:09:3500:09:39
endurance training? You don't see it very
00:09:3900:09:44
often. What do all athletes want to do? Get big and do power
00:09:4400:09:47
training. They want it fast and hard.
00:09:4700:09:50
That's it. One to six reps, how
00:09:5000:09:53
much can I lift, how fast can I lift it
00:09:5300:09:54
and then I'm going to rest for three
00:09:5400:09:57
minutes. That's great for your prime
00:09:5700:10:01
movers, but who gets left behind?
00:10:0100:10:04
Your stabilizing slow twitch fibers.
00:10:0400:10:05
I will never forget, I used to play
00:10:0500:10:08
ball against this guy in my complex and
00:10:0800:10:10
he used to play Division II ball, guy
00:10:1000:10:13
was probably about 6'6, probably
00:10:1300:10:18
outweighed me by 20...25 pounds. He's up
00:10:1800:10:20
there at around 250 pounds. Dude was a
00:10:2000:10:26
beast. Big boy. Every time I went and played against him
00:10:2600:10:29
"Oh I'm gonna hurt tomorrow."
00:10:2900:10:32
And I'll never forget we played
00:10:3200:10:33
for months and months and months and he
00:10:3300:10:34
happened to actually work out at the gym
00:10:3400:10:37
that I was a trainer at and I would
00:10:3700:10:39
watch him work out a little bit, but I'm
00:10:3900:10:40
not one of those people who's going to come
00:10:4000:10:41
up to you and tell you everything that
00:10:4100:10:42
you're doing wrong or everything that
00:10:4200:10:43
you're doing right, you go and workout.
00:10:4300:10:44
You want my advice you can come up and
00:10:4400:10:46
ask me. But I did happen to notice with
00:10:4600:10:48
this particular guy he spent a lot of
00:10:4800:10:51
time on machines. He could lift a truck,
00:10:5100:10:54
but he spent a lot of time on machines.
00:10:5400:10:56
And then there was a period where I
00:10:5600:10:57
didn't see him for a while. I didn't seem
00:10:5700:10:59
down on the basketball court, I didn't
00:10:5900:11:02
see him in the gym. The next time I saw
00:11:0200:11:09
him, he's in a sling. I'm like "Dude."
00:11:1000:11:13
I know what he could do to me, I'd hate
00:11:1300:11:15
to see the guy who could do that to him.
00:11:1500:11:18
That was my first thought, but
00:11:1800:11:19
then I went over and asked him,
00:11:1900:11:20
"What happened" and he said,
00:11:2000:11:24
"I threw an outlet pass." I went, "What?"
00:11:2400:11:25
You know what an outlet pass is?
00:11:2500:11:27
He's a big enough guy, he can take a
00:11:2700:11:30
basketball and do this and just chuck it.
00:11:3000:11:32
He said he literally went like this
00:11:3200:11:38
and dislocated his shoulder. So what had
00:11:3800:11:42
happened? Right.
00:11:4200:11:44
I'm starting to put all this together, he's
00:11:4400:11:45
been working his prime movers, getting
00:11:4500:11:50
huge, but his poor rotator cuff is
00:11:5000:11:52
not getting any of the work it wants. It's
00:11:5200:11:57
not getting fed the way it wants. I guarantee this is what happened when he
00:11:5700:11:59
threw that ball. He saw that outlet pass,
00:11:5900:12:06
knew he had to make it quick and powerful, probably B-line it, so he
00:12:0600:12:08
could get it there on time. His prime
00:12:0800:12:11
movers pulled on his humerus as
00:12:1100:12:13
hard as they can and his rotator cuff
00:12:1300:12:19
went, "Yeah, screw this." And he
00:12:1900:12:21
dislocated his shoulder. That's how that
00:12:2100:12:22
happens and meanwhile all he really had
00:12:2200:12:25
to do with some stability work. It's not
00:12:2500:12:26
like he needed to be any bigger to play
00:12:2600:12:29
basketball. Six foot six, 260 to play
00:12:2900:12:33
rec ball, you're big.
00:12:3300:12:34
Do a little stability work he wouldn't have
00:12:3400:12:37
ended up in a sling? Does that make sense on how the rotator cuff works?
00:12:3700:12:41
Do you understand why you need to know your functional anatomy a
00:12:4100:12:43
little bit too? Let's do this
00:12:4300:12:51
one graph, reverse flye. Yeah, like a seatbelt. I like that, rotator
00:12:5100:12:57
cuff is kind of like a seatbelt. Reverse flye.
00:12:5700:13:01
Your reverse flye, all you are
00:13:0100:13:04
going to do is fill it in just like you filled in that graph. You're going
00:13:0400:13:07
to fill in, what plane of motion is a
00:13:0700:13:08
reverse flye in? Transverse, good. We'l
00:13:0800:13:14
do this one together since you haven't done one of these yet.
00:13:1400:13:15
We're going to do quite a quite a few of these graphs.
00:13:1500:13:20
What joints are involved in a
00:13:2000:13:23
reverse flye?
00:13:2600:13:29
My shoulder joint and if my shoulder is
00:13:2900:13:30
involved, who else is going to be
00:13:3000:13:33
involved? My scapula. Those
00:13:3300:13:37
move together. Anytime you write shoulder on any graph that we do,
00:13:3700:13:40
you need to right scapula too. I want you
00:13:4000:13:44
to think about them as two separate joints though. You don't write those in
00:13:4400:13:46
one box, but anytime you have shoulder,
00:13:4600:13:50
you're going to have scapula. So shoulder,
00:13:5000:13:52
what joint action is occurring at the
00:13:5200:14:00
shoulder? Horizontal abduction.
00:14:0600:14:09
Then we'll go down to our next box and
00:14:0900:14:15
we have scapular retraction.
00:14:1500:14:19
I have shoulder abduction, what muscle
00:14:1900:14:21
is responsible for short of shoulder abduction?
00:14:2100:14:33
It's a muscle that we've gone over to this point.
00:14:3300:14:39
Posterior deltoid, good. What muscles are
00:14:3900:14:42
responsible for scapular retraction?
00:14:4600:14:51
Rhomboids and mid-traps, we've already done that one before. That's the nice
00:14:5100:14:54
thing about learning these graphs, is anytime scapular retraction comes up,
00:14:5400:15:00
who's involved? Who causes scapular
00:15:0000:15:04
retraction? Rhomboids and mid-traps. If I
00:15:0400:15:08
say scapular retraction for a seated row,
00:15:0800:15:14
what muscles are responsible? Rhomboids and mid-traps. If I say a bent over
00:15:1400:15:16
barbell row with scapular retraction,
00:15:1600:15:19
scapular retraction is caused by...? Rhomboids and mid-traps.
Related Videos
Nervous System and Receptors 2: Video #24 of Introduction to Functional Anatomy
Pectoralis Major, Latissimus Dorsi and Teres Major: Video #10 of Introduction to Functional Anatomy
Functional Roles of Muscles: Video #25 of Introduction to Functional Anatomy
Muscles of the Lower Leg: Video #17 of Introduction to Functional Anatomy
Deltoid Muscles: Video #8 of Introduction to Functional Anatomy