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By Charles Goodwin, M.D.
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| | Dr. Charles B. Goodwin is a sports medicine orthopedic surgeon who has worked with the US Tennis Association, the New York Knicks, and the NY Mets, among others. He can also play a mean game of squash. Contact Dr. Goodwin at the Hospital for Special Surgery in NY, NY, at 212-317-4600. |
Last month, we discussed the pain that many squash players experience in the rotator cuff of the shoulder. Four muscles within the shoulder—the subscapularis, supraspinatus, infraspinatus, and teres minor—along with their tendons make up the rotator cuff. But the repetitive motions of squash tend to break down this delicate tissue. Below are several exercises to help condition and strengthen the muscles to prevent future injury.
CONDITIONING THE ROTATOR CUFF
Preventive steps aimed at maintaining the flexibility and strength of these muscles will help keep the shoulder stable and injury-free. The first three exercises will make your rotator cuff muscles more flexible.
Back cuff stretch: Bring one arm across the front of your neck and rest it on the opposite shoulder. Place your free hand on the extended elbow and gently pull it so the arm crosses over the chest. Hold for 15 seconds; repeat five times, then switch sides.
 Back Cuff Stretch
Underside cuff stretch: raise one arm and bend it behind your head to touch your opposite shoulder. With your free hand, gently push the elbow towards your back. Hold for 15 seconds; repeat five times, then switch sides.
 Underside Cuff Stretch
Front cuff stretch: Put your arms behind your back, join your hands, and slowly raise your arms upward. Stand straight with your focus remaining level. Hold for a 15-second count, return to the start, and repeat five times.
 Front Cuff Stretch
STRENGTHENING EXERCISES
The basic strengthening exercises will help maintain shoulder motion and enable the joint to withstand the power movements common not only to squash but to so many sports. Use light weights (something you can control—2.5 pounds is a good starter weight—and allows you to finish the repetitions with good form). If you experience any shoulder pain, use lighter weights. Continuation of pain may indicate a rotator cuff injury. Contact your physician.
Internal rotation: Lie on your side on a bench. Keep the upper portion of the arm on the bench alongside your body and supported by the bench. Hold a light dumbbell in your hand with the palm facing upward, forearm pressed against your abdomen, and elbow bent at approximately 90 degrees. Without moving your body and while keeping your arm close to your body, lower the dumbbell away from your body until it extends over the side of the bench. (How far your forearm will go below horizontal depends on your shoulder flexibility.) Slowly raise the dumbbell to the starting position following the same arc. Repeat 10 times and then perform with the opposite arm.
External rotation: Lie on a bench with one hand supporting your head. Hold a light dumbbell next to your abdomen, palm facing inward, elbow flexed at 100 degrees and approximately two inches up from your side. Keeping the elbow stationary, rotate the dumbbell as far as you comfortably are able. Slowly return to the start and repeat 10 times each side.
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Feb 2010
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