Shoulder Series Part 1 Rotator Cuff - The High 5 by Osteopath Cameron Allshorn

The High 5, Something we all enjoy at any age, that crisp sound and the awe of those around you when that epic sound reverberates off the walls. How often have you considered what is going in in your shoulder during a High 5?

Before we can get to that end goal, we should take a look at the muscular components that make up the rotator cuff (RC), Supraspinatus, Infraspinatus, Teres Minor and Subscapularis, as implied by the name these muscles work together to rotate and move our shoulder. 

SUBSCAPULARIS

To set up for that high 5 you first need to stabilise the shoulder readying for what is to come. This is done in part by the Subscapularis, Sitting on the inner surface of the shoulder blade the muscle works to:

A.             stabilise the scapula in relation to the ribcage and humerus.

B.             Assist with internally rotating the shoulder when our arm is by our side.

C.             Assist with adduction of the upper arm

When tight, sore or overloaded, the subscapularis can limit shoulder abduction and external rotation and thus limit actions such as reaching, throwing and of course the ability to high 5.

SUPRASPINATUS

Next up is lifting and rotating the arm to get in position to generate the power for that high 5. This involves the Supraspinatus, a muscle that sits atop the scapula and weaves under the clavicle and acromioclavicular joint and works to:

A.             Aid in abduction of the upper arm

B.             Stabilse humeral head into shoulder joint

The supraspinatus is often at risk of impingement between the bony surfaces above and below. Impingement can be painful itself and also be precursor to further shoulder ailments if left unmanaged.  

Tears within the supraspinatus worth discussing here as they occur here in 80% of RC cases (1), often occurring as a result of a direct movement or action such as a fall on outstretched hand (FOOSH). Males (3:1 M/F ratio) aged 35-60 are considered most at risk of a supraspinatus tear (1). Injury to the supraspinatus is common, particularly within the sporting industry and can be avoided by early intervention and management.

INFRASPINATUS & TERES MINOR

Infraspinatus and Teres Minor form the final two components of the RC that we will discuss here. These sit closely together along the back of the scapula as shown in the images above and work to:

A.             Externally rotate the shoulder

B.             Assist in adduction

C.             Stabilise shoulder joint

These two muscles work are key components of overhead actions such as marking in AFL, spiking in volleyball or celebrating a wicket on the cricket pitch with a high 5 of course. A tight or restrictive infraspinatus or teres minor can limit function but can also reduced the ability of the shoulder to cope with activity increasing load on other structures around the shoulder.

A balanced shoulder is often a good and functional one however keep in mind there are many of other components beyond the rotator cuff that are important when considering the shoulder and isolating what is potentially causing pain or restriction. Lats, pectorals and deltoid are of key importance in terms of muscular control while the mobility of the cervical and thoracic spine is important when considering consistent nerve innervation and vascular supply to the aforementioned musculature.

So if you are finding that your high 5’s aren’t quite up to standard, perhaps taking some time to consider the biomechanics involved could give things a boost.

Stay mobile.

Cameron Allshorn

Osteopath.

Works Cited

Jancuska J, Matthews J, Miller T, Kluczynski M, Bisson L. A Systematic Summary of Systematic Reviews on the Topic of the Rotator Cuff. Orthopaedic Journal of Sports Medicine. 2018 September; 6(9).

Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 3rd ed.: McGraw Hill Companies; 2012.