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by Deborah L. Mullen, CSCS

The rotator cuff muscles are crucial to the golf swing, yet many golfers are unaware of their function and therefore neglect their conditioning. Find out what the rotator cuff actually is, it’s role in golf, common injuries and how to prevent them.

What is the "rotator cuff" and why is it so important?
The shoulder is the most flexible, as well as the least stable, joint in the body (great range of motion comes at a price). Unlike the hip joint with its ball-and-socket design, the shoulder socket is a shallow saucer. While this allows for flexibility, the saucer doesn’t hold the ball of the joint as firmly as the hip socket. In addition, the shoulder joint’s ligaments are relatively weak. This means that stability must come from muscles and tendons that run across the joint. These 4 muscles are collectively called "the rotator cuff."

What role does the rotator cuff play in golf?
Along with stabilizing the head of the upper arm bone into its socket, the rotator cuff has other functions crucial to the golf swing. It was once thought that the deltoid muscles (thick muscles that cover the shoulder) were the primarily responsible for the power behind the golf swing. From research that measures muscle activity during the swing, we now know that the rotator cuff muscles are a major force, while the deltoids are relatively inactive. By stabilizing the shoulder girdle as well as turning the shoulder and arms, the rotator cuff provides power and control in the golf swing.

What are common rotator cuff injuries for golfers?
The drive is a high-effort power movement that puts a lot of stress on the rotator cuff. Add this to the fact that it’s generally weak and tight from negligence, and it’s no wonder that many golfers are sidelined with rotator cuff-related injuries. The most common is tendinitis, where one or more of the rotator cuff tendons become inflamed and painful. Another common affliction is bursitis. If the bursa (a fluid-filled sac that overlies the rotator cuff tendons) is irritated, it can become inflamed and cause pain. Since the tendons and bursa are close together, many times both problems coexist. Impingement can occur when the arm is repeatedly raised above the head in the golf swing, causing the rotator cuff tendons to rub, inflame and even tear.

According to Frank Jobe, MD, of the Centinela Hospital Medical Center, "It is of interest to note that all of the right-handed golfers seen by this office for shoulder problems have had left shoulder rotator cuff problems. Also, all of these golfers have a strong pull-through on the left. It is possible that as this group has attempted to equalize the roles played by the right and left arms, they may have overdone the role of the left. Thus, microtrauma and instability ensued…The significance of this is that a right-handed golfer must strengthen the rotator cuff muscles on the left as a preventive measure."

What can I do to prevent a rotator cuff injury?
Since unconditioned muscles are weak and inflexible causing them to be more susceptible to injury, performing simple exercises and stretches for the rotator cuff muscles will reduce the likelihood of injury by maintaining the strength and flexibility of these muscles. (A bonus is increased power in the swing!) Here are 3 stretches and 1 exercise for the rotator cuff:

For the stretches, go slowly and gently to the point of mild tension. Hold each stretch for 15 –30 seconds. No bouncing! Perform a stretch for the same length of time on each arm. Stretch after playing golf as well as before. To warm up the rotator cuff before play, perform 20 slow arm circles before stretching.

Back Cuff Stretch – Place right hand on left shoulder and left hand on right elbow. Gently pull back right arm. Repeat on left.

Underside Cuff Stretch – Place right hand behind your head and left hand on right elbow. Gently push arm toward your back. Repeat on left.

Front Cuff Stretch – Hold hands behind your back and slowly raise your arms. Stand tall—don’t lean forward.

There are 3 common exercises performed for the rotator cuff. Two, which many people know about, are for internal and external rotators. The following is not as well known and can be done without any equipment.

Rotator Cuff Exercise – Warm up with 20 slow arm circles. In each hand, hold a small dumbbell or soup can. With thumb pointing down, raise arms out to the side and slightly forward, like pouring water out of a can. Don’t raise hand past shoulder level. Repeat 10 times if no discomfort (if you experience discomfort, perform with the thumb up.)  Check with your doctor before doing this exercise if you already have shoulder problems or have another medical condition.

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