The rotator cuff is a network of four muscles and their tendons that fuse to form a covering around the head of the humerus. The rotator cuff stabilizes the shoulder, allowing you to lift and rotate your arm. Pushups are highly dependent on these muscles, but performing too many or performing them improperly can result in a rotator cuff tear.
Rotator Cuff Anatomy
The rotator cuff is a group of four relatively small muscles: the supraspinatus, infraspinatus, teres minor and subscapularis. These muscles fuse around the humerus to keep the ball-and-socket joint intact. Tendons are connected individually to short muscles that originate from the scapula. When they contract, they cause the shoulder to rotate upward, inward or outward.
Rotator Cuff Tears
You may strain your rotator cuff muscles from overuse, particularly in sports such as swimming, baseball or tennis. Additionally, tears in the tendons can result from joint imbalances, where one set of muscles such as the deltoids are stronger than the rotator cuff muscles, putting stress on the rotator cuff. This can result in tendinitis, an inflammation of the muscle tendons, or, in some cases, the muscle tissue can be torn. The most common sign of a rotator cuff tear is aching in the top and front of the shoulder, or on the outer side of the upper arm. The pain usually increases when the arm is lifted to the overhead position. Depending on the severity of the injury, you may not be able to lift the arm forward or outward at all.
Pushups and the Rotator Cuff
While the shoulder rotation provided by the rotator cuff is essential to performing a proper pushup, the pushup itself does not necessarily make the rotator cuff stronger. Pushups work the abdominals, deltoids, triceps and pectoral muscles. If one of these muscle groups is too strong, muscle imbalance can result, causing the rotator cuff to strain and tear. Doing regular pushups after the rotator cuff is torn can cause the tear to get larger. Additionally, improper technique can put strain on the rotator cuff. When performing a pushup, keep your hands at shoulder-width. Placing them too far outside your shoulder can result in injury. However, certain pushup variations can provide options for rehabilitating a torn rotator cuff. Doing pushups against a wall, for example, can help reset the muscles while not putting a lot of strain on the cuff. Additionally, doing pushups with your hands on raised surfaces, such as your kitchen counter or an aerobic step, can achieve similar results.
Strengthening the Rotator Cuff
When strengthening the rotator cuff muscles, it is important not to train with a weight that's too heavy because those muscles are so small. Initially, a 3-pound or 5-pound dumbbell may suffice for most women and an 8-pound or 12-pound dumbbell may be appropriate for men. Perform the rotator cuff exercises slowly and with control, and stop training if the motion causes you pain. Strengthening exercises generally involve lying on your stomach or on your side while slowly rotating or lifting your arm. Ask your doctor or sports therapist for exercises that are appropriate for your physical needs.
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