Rotator cuff/shoulder pain:

Shoulder pain many times is related to the pain and dysfunction in the rotator cuff muscles and tendons.  I commonly see people who are trying to rehabilitate their shoulder using exercises that focus on the rotator cuff muscles, usually involving shoulder movements that train external rotation of the shoulder.  While this is useful as the muscles that perform external rotation of the shoulder are commonly weakened compared to the internal rotators which is usually only part of the cause of the shoulder dysfunction.

If we look at the connections that the shoulder has with the lower body the hip needs to be properly balanced to support the shoulder above.  Looking lower the knee and ankle need to properly support the hip alignment and position.  Therefore, an ankle sprain, injury to the knee or hip weakness and malalignment can lead to weakness of the shoulder girdle.  Weakness of these muscles leads to trauma of the tendons including impingement as the humeral head of the humerus is not stable in the shoulder socket.

To properly rehabilitate the shoulder an evaluation will need to include the hips and lower body.  The goal is to stabilize the weight bearing joints under the shoulder, improve the alignment from the ankle, to the knee, and hip.  Core stability and shoulder blade stabilization need to be accomplished before rotator cuff strengthening.  The stability of the lower body, hips, spinal column and scapula will lead to successful strengthening of the shoulder girdle and rotator cuff muscles.  People need to be patient as this will take 3-6 months or longer depending on the level of shoulder dysfunction, however this approach will lead to lasting results.

John Russell RMT