What I am going to chat about today is rotator cuff exercises and why/when/how to use a towel when performing rotator cuff exercises.
When I was working in a large rehabilitation centre, I work with a wide variety of physical therapists. They all had different ideas on exercises for the rotator cuff. The majority of them would not support the elbow when performing rotator cuff exercises but the odd one would.
Rotator Cuff External Rotation Exercise Set Up
How I set up a client for the rotator cuff external rotation exercise would be to have the client stand with feet hip width apart and toes pointing forward. The core would be activated in order to prevent any trunk rotation. Upper arm would be at the side and elbow bent to 90 degrees. The pulley or tubing would be adjusted so it was parallel to the floor. The focus of the exercise would be external rotation in the shoulder from 0 degrees to maximum.
Why Rotator Cuff Exercises with a Rolled Up Towel?
For some clients, I would be asked to roll up a towel and place the towel under their elbow. With the towel between the upper arm and body it would bring the arm out about 20 degrees away from their body.
I had asked many physical therapists on why should you support the elbow with a towel? None of them had a good answer on why.
When I was completed my master’s degree on rotator cuff exercises, I came across a research article that talked about why to support the elbow. Let me share with you what it said.
The reason why the arm is supported is in order to decrease the stretch that is put on supraspinatus. The supraspinatus muscle is the most frequently injured muscle of the rotator cuff. If your client has their arm at their side and the rotator cuff’s injured, what ends up happening is your client gets a stretch through the supraspinatus.
If you put a towel underneath the arm, this will decrease or eliminate the stretch that is on the supraspinatus.
Why / How / When To Use a Towel During Rotator Cuff Exercises
#1) To sum it up, I will get my clients to use the towel if they are in the early stages of recovery when it comes to a rotator cuff injury especially if the supraspinatus involved.
#2) If the client reports discomfort in the shoulder and specifically in the deltoid area when getting into the starting position of the external rotation exercise, then I would put a towel under the elbow.
I hope this post has helped you on why, when and how to use a towel for your clients recovering from rotator cuff injuries. Make sure you try this out with your next client and let me know how it goes.
Rick Kaselj, MS