Is Yoga Tearing Up Your Rotator Cuff?

Trish Corley Author

Are rotator cuff injuries in yoga common? Can you prevent them?

You likely practice and teach yoga because you believe in the mental and physical benefits of the practice. But do you worry about injuries in yoga? It seems that rotator cuff injuries are among the common injuries that yoga teachers worry about. In this blog, we will explore what the rotator cuff is and the significance of its stability over major movements. We will address the common occurrence of rotator cuff tears and the surprising lack of pain associated with them. And, of course, we will look at what you, as a yoga teacher, can do to guide your students towards a healthy rotator cuff. 

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Understanding the Rotator Cuff in Yoga

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While many yoga teachers are talking about rotator cuff injuries, many don't really understand what the rotator cuff is. It's completely understandable if you don't. Most yoga teachers have a limited anatomy lesson in their teacher training. But you are here reading this article! Kudos to you for being a teacher who is committed to learning and gaining confidence to better serve your students!

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Anatomy of the Rotator Cuff

The rotator cuff is a group of four muscles that surround the shoulder joint. These muscles include the supraspinatus, infraspinatus, teres minor, and subscapularis. Each of these muscles attach from the scapula (shoulder blade) to the humerus (upper arm bone). Muscles attach from one bone to the other via tendons. In the case of the rotator cuff muscles, they all have tendons that extends from the muscle belly and travel through the shoulder joint to attach to the humerus (upper arm bone). Together, these tendons wrap around the head of the head of the humerus and form a "cuff". (The head of the humerus is the top portion of the upper arm bone and is shaped much like a ball.)

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The Rotator Cuff Muscles Provide Stability!

The rotator cuff muscles are small, particularly when you compare them to other major muscles of the shoulder. While they do assist with motions of the shoulder joint, their primary function is to maintain stability. They do not generate significant force or power. They act as a dynamic stabilizer, keeping the head of the humerus (upper arm bone) securely within the shallow socket of the shoulder blade (scapula) during movements. This stability is crucial during yoga practice, especially with weight bearing postures such as upward facing dog, crow, and handstand! Stability not only leads to ease of various yoga postures, it can also decrease the risk of injury. 

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You likely know someone with a rotator cuff injury, but what exactly is a rotator cuff injury?

Now that you know that the rotator cuff is actually four muscles, you can now understand that a rotator cuff injury is an injury to one or more of these four muscles. Most often, injuries to the rotator cuff muscles occur in the tendons. (Tendons are the part of the muscle that attach the muscle to the bone). The injury is often referred to as a rotator cuff tear. Such injuries range from very small tears to much larger tears. Think of this like holes in a t-shirt. Have you ever noticed one of those tiny little holes that somehow appears? You don't even know how it got there and it has no impact on the function of the shirt. In fact, you might even still wear the shirt. Then there are tears that are larger and make you reconsider wearing the shirt. Finally, your shirt may have such a large tear in it that you know you can't wear it anymore! Rotator cuff tears vary in their size and impact on shoulder function as well. Minor tears may go unnoticed or result in mild discomfort and limited shoulder mobility, while larger or complete tears can cause significant pain, weakness, and difficulty performing everyday activities.

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Does yoga cause rotator cuff tears?

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Rotator cuff tears can occur due to various factors, including acute trauma, such as a fall or a sudden forceful movement. They may also develop slowly over time. Some people call this "wear and tear". Although possible, it is uncommon for people to fall and sustain a traumatic rotator cuff tear while practicing yoga. However, concern does get raised with development of injury overtime with regular yoga practice. But before we decide if yoga is the cause of these "wear and tear" injuries, lets look at how common rotator cuff injuries are. 

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Rotator Cuff Tears Are Common and Often Not Painful!

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Rotator cuff tears are more common than one might expect. Research has shown that these tears can be found in a significant percentage of the population, even in individuals who are asymptomatic or experience minimal pain. A study conducted by Yamamoto et al. (2010) examined the prevalence of rotator cuff tears in asymptomatic individuals and found that nearly 50% of participants aged 60 or older had partial or full-thickness rotator cuff tears. This intriguing finding emphasizes the fact that the presence of a rotator cuff tear does not necessarily equate to debilitating pain or functional impairment. It does highlight the adaptability and compensatory mechanisms of the shoulder joint, as many people continue to perform daily activities, including yoga, despite these tears.

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What's to Blame for Rotator Cuff Injuries?

Certain factors and activities can increase the risk of rotator cuff injuries. According to a study published in the American Journal of Sports Medicine by Minagawa et al. (2013), some common causes of rotator cuff injuries include repetitive overhead motions, trauma or accidents, lifting heavy objects, and age-related degeneration. Other contributing factors may include poor posture, muscle imbalances, and inadequate warm-up or conditioning before engaging in physical activities. While research aims to find the common causes of rotator cuff tears, we may not be able to every say specifically what caused a person's rotator cuff injury. There is likely more than one cause!

So maybe yoga is to blame for rotator cuff injuries? But maybe not? 

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Based on statistics, many of your yoga students already had rotator cuff injuries before they started practicing yoga and they don't even know it. What you can do as a yoga teacher is continue to educate yourself and your students. If poor posture and muscle imbalances are a cause, that's good news! As yoga teachers, this is what we are good at! We can actually use our understanding of yoga asana to improve posture and muscle balance. This is why the Yoga Anatomy School exists - to help yoga teachers like you better understand anatomy and be able to teach your students optimal postural alignment.

The shoulder joint has a large range of mobility, but there is a limited amount of space inside the joint for the tendons of the rotator cuff muscles. With optimal alignment, the space is maximized. With sub-optimal alignment there is less space inside the joint. This leads to a rubbing or impingement of the rotator cuff tendons. So "wear and tear" actually comes from overuse with poor alignment, not just frequent use. 

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When Alignment Matters

As yoga teachers, we need to encourage good alignment of the shoulder. Of course, we also need to understand that stability of the shoulder is not solely reliant on the rotator cuff muscles.  Stability stems from engagement and optimal alignment of the entire body. By understanding the interplay between the rotator cuff and the entire body, you can help students cultivate a harmonious and holistic practice that fosters strength, stability, and well-being. 

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The Foundations Course inside the Yoga Anatomy School will teach you the principles of Optimal Postural Alignment. Rather than learning the alignment of hundreds of postures, you learn one set of principles that can be applied to any posture. After this 30 hour course, you will be able to teach any yoga posture with confidence in your anatomy and alignment knowledge!

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Module 9 of The Foundations Course covers the anatomy of the shoulder including the rotator cuff. And more importantly, we cover simple ways to obtain (and teach) optimal alignment of the shoulder!

All 14 modules of the Foundations Course are available inside the Yoga Anatomy School Membership!

Categories: : Injuries & Yoga, Shoulders, Yoga Anatomy