We have just had the Australian Golf Open and to celebrate we’re going to be doing a series of in-depth articles on the muscle activities during the golf swing and how each of them can generate problems. In this first article we’re going to look at the rotator cuff in the shoulder and how it can be sabotaging that handicap.
What is the Rotator Cuff?
The rotator cuff is a series of muscles in the shoulder girdle. The shoulder girdle comprises the scapula (shoulder blade), the clavicle (collar bone) and the humerus (the bone in the upper arm). The rotator cuff is made up of the subscapularis, the teres major and minor, supraspinatus and infraspinatus. These five muscles arise from the scapula and attach into the humerus at different points.
The actual shoulder joint between the scapula and the humerus is the most unstable joint in the body, with the round head of the humerus resting against the vertical, relatively flat joint surface of the scapula. Left to its own devices the humerus would simply slide downwards off the scapula and dislocate.
It’s the job of the rotator cuff muscles to hold and stabilize the head of the humerus against the scapula. Through it’s attachments it’s also responsible for many of the rotation and sideways movements of the shoulder.
Let’s explore the different muscles in more depth.
Subscapularis attaches to the inside of the scapula (on the ribcage side) and runs out to the humerus. It acts to rotate the shoulder in.
Supraspinatus sits on top of the scapula and attaches in at the top of the humerus. As it contracts it lifts the arm out sideways (abduction of the shoulder).
The infraspinatus sits on the outside of the scapula and attaches into the top of the humerus. It acts to rotate the shoulder out.
Teres minor sits on the outside edge of the scapula next to the teres major. It rotates the shoulder out along with infraspinatus.
Many of these also assist with bringing the arm back down to the body (adduction) and with bringing the shoulder back (extension).
Rotator Cuff action during the golf swing.
The movements are for right-handed golfers. The reverse will be true for left-handed.
As you start your back swing the supraspinatus will cause the right shoulder to begin to abduct. The trapezius muscle is also very active lifting the shoulders up. Inflammation of the supraspinatus tendon or the shoulder structures like bursa will cause pain or limitation of movement, decreasing the backswing.
The infraspinatus and teres minor will rotate the right shoulder out. Weakness of these muscles or shortening of the subscapularis will reduce external rotation.
In the left shoulder the subscapularis is internally rotating the shoulder. Weakness here or tightness of the infraspinatus/teres minor will cause problems with this movement.
Forward swing and acceleration:
In the forward swing, the rotator cuff actions are reversed. Another shoulder muscle the serratus anterior, which attaches to the inside edge of the scapula and the ribcage is very active in the right arm.
Early and late follow through:
The same patterns continue in the rotator cuff into the follow through. The right shoulder is being moved into inward rotation by the subscapularis, and the left into external rotation by the infraspinatus/teres minor. Shortening or weakness in any of these muscles will distort the swing.
In addition, the rotator cuff is important for stopping the swing. If it fails in this task it can result in repeated micro-injuries or one large injury causing shoulder damage.
Ways to injure the Rotator Cuff.
A primary way to injure these muscles is through poor technique and/or pre-existing poor neuro-muscular tone. This causes repetitive injuries to the tendons, bursa, labrum and bodies of these muscles.
Pre-existing degenerative change in the shoulder will also increase the chances of injury, particularly in the supraspinatus area.
If you’re unlucky enough to be taking too much dirt when you take your swing, jarring the club, you can injure or tear the rotator cuff. Similarly striking tree roots or larger stones can have a similar effect.
Treatment of Rotator Cuff injuries.
Dr Adam Rocchi, the Perth Chiropractor at Spine Scan explains he uses the Trigenics neurological treatment system to evaluate and treat the rotator cuff injuries. The Trigenics system focuses on the relative length and strength of the neuromuscular system.
Using spinal cord and brain-based reflexes Dr Rocchi is quickly able to lengthen shortened muscles and facilitate weak muscles and restore strength. Many golfers don’t realise they are carrying a dysfunction that is predisposing them to injury and compromising their performance. They may be well aware of what is required with a good swing but simply can’t do it due to these underlying strength and length issues that many golfers have developed due to various stressors in life.
If you’re a golfer that’s carrying a shoulder injury or if you’d just like some help wiping strokes off your handicap call the practice now on (08) 61508785 Scarborough or (08) 61508783 Mount Pleasant to arrange an appointment.
A McHardy, H Pollard. Muscle activity during the golf swing Br J Sports Med 2005; 39:11 799-804 doi:10.1136/bjsm.2005.020271