Introduction 00:00:01 You’re listening to From pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain, and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.
Susi 00:00:23 Welcome and welcome back. I’m so glad that you’re here, because today we’re digging into the rotator cuff. Now, I’ve spoken about the rotator cuff on previous episodes. We’re going to take a slightly different angle today. Now, in this podcast, I often explore the science, the art, and lived experience of healing and movement. I’ve been working with people for over 30 years, helping them to reduce and eradicate physical pain; and training health care professionals and yoga teachers, how I do what I do so they can get the similar results as I do. It’s all about helping people to tune into their bodies deeply, consciously and intelligently. So today, with the rotator cuff, I want to work with some of the ideas that are often misunderstood about it.
Susi 00:01:07 Sometimes the rotator cuff can be oversimplified, but also overcomplicated. It can also be overtrained and also undertrained. So it’s a bit of a conundrum of an area of our body, perhaps. And I hope to bring some simplicity to this process in terms of how I work with it, and how I’ve seen results really skyrocket when people tune in and then think about coordinating patterns. You’ve likely heard that if you’ve got shoulder pain that’s related to the rotator cuff, that you should strengthen your rotator cuff. But what if: what if strengthening isn’t what’s needed? What if it’s actually the last thing that you should do? Let’s just consider that. This episode is really about peeling back the layers, not just of your shoulder, but of the assumptions we’ve been taught about pain, weakness, and what it means to fix the body. So let’s begin by looking at some of the traditional views versus a whole body lens. We’ll start by considering what most people are taught about the rotator cuff, that it’s a group of four muscles: the supraspinatus, infraspinatus, minor, and subscapularis that keep your shoulders stable and help it move.
Susi 00:02:18 Which is true. And when you’re in pain or dealing with a rotator cuff injury, the common advice is to strengthen those muscles, especially with bands and resistance. The challenge is that this advice assumes isolated weakness is the problem. And in the real world, especially with the clients and professionals that I work with, what I see oftentimes that is related to rotator cuff injuries that are staying persistent, is that I see a lot more compensations. I see people overusing the traps, gripping with their bellies, collapsing through their rib cages, holding their breath because their system is doing everything it can to create a sense of control, even if that control comes through tension. So then the question becomes, are the rotator cuff muscles truly weak? Or are they inhibited by compensation for load transfer and nervous system driven bracing? Now, before I carry on, I also want to suggest that both of these things could be true. The rotator cuff muscles could really be weak and they could be inhibited by compensation, poor load transfer and nervous system driven bracing.
Susi 00:03:21 So let’s keep holding that, those two ideas together. So let’s take a deeper look into the rotator cuff muscles and nerd out just a wee bit. So each of these muscles has a unique role where the supraspinatus helps lift the arm away from the body. The infraspinatus and teres minor assist with external rotation, and the subscapularis manages internal rotation and stabilizes the front of the shoulder. Now imagine these four as teammates: if one is working overtime because another one isn’t showing up, or because the shoulder blade isn’t moving well, like the shoulder blade is stuck or it’s kind of ratcheting/moving on the ribcage, things can go sideways and pain can show up. But again, the root cause may not be the shoulder at all. Which brings me to one of my favourite puzzles to solve, because that’s kind of what this whole process is. If you follow my work for a while, you know that I love showing how pain in one area can be influenced by what’s happening elsewhere. And so this is one story with a client who came in with a lingering rotator cuff pain, post injury, and she had done all the typical strength protocols, but couldn’t get past a certain point without a flare up.
Susi 00:04:34 When we slowed things down and explored how her body actually moved, not just her shoulder but her whole system, we noticed that her pelvis was unstable, her core was gripping, trying to create control, and she was unsteady on her feet. Once we addressed those items and brought in better support from that central area of the pelvis, thinking of like the pelvis as the platform, then allowing for that leg bone to swing well in the socket and those feet to find a space on the ground. Then voila! Her shoulder had more freedom. Her movement became smoother, her breath became easier, and her pain started to dissolve. It’s a great example of the magic of integration. So if we go a layer deeper now and into the nervous system because muscles don’t just fire because we want them to, they activate when there’s sufficient safety in the system to allow for coordination and load transfer. So much of helping someone reduce and eradicate pain is about improving this coordination and load transfer, and what can be in the way is over-bracing. Gripping. Holding.
Susi 00:05:51 But it’s not that we need to get the over-bracing and gripping or holding away. It’s acknowledging that it’s a protective response and this protective response can often be a pattern shaped by experience, by perception, and how a system our system, a person’s physical, physiological, psychological system, has learned to stabilize itself. It’s not that the body is deciding anything in a conscious way, but from a pattern perspective, it might be attempting to create stability through tension, especially when deeper and more efficient stabilizing strategies aren’t accessible in the moment. The rotator cuff is especially sensitive to this if the breath is held, if the ribs are flared, if the scapula or the shoulder blade is really clamped down, then no matter how many external rotations that you do with the theraband, the function of the rotator cuff is not going to become optimal. It’s not that the cuff is weak, but it’s working in a system that’s trying to protect itself, often at the expense of really, really, really smooth coordination and control.
Susi 00:07:09 So that’s why in my work, when I’m thinking about helping somebody, it’s starting with creating the conditions for a sense of inner trust, of inner safety: in breath, in load, in stillness. And from there coordination can improve. And from coordination, strength naturally emerges without having to force it. It’s not that we have to override the system, but rather we get to work with it, which ultimately is what leads to long lasting progress. For all the yoga teachers and the physios and the OTs, the movement professionals that are listening, this really is a call to sharpen your observation. Instead of asking: how can I strengthen this rotator cuff? Consider adding: how does the rib cage move during this action or not move during this action? What happens at the pelvis or the feet when they lift their arm? Is their breath smooth or held? Are they relying on their upper traps or their pecs, or are they gripping in their belly in order to make the movement happen? And what else are you noticing generally with their movement patterns? These questions will really help lead you to more of a truth of what’s happening, far more than any isolated muscle test will.
Susi 00:08:49 And for those of you who are working with your own shoulder pain, here’s what I’d love for you to explore. Begin by starting really simply. Even if it’s just lifting your arm slowly and noticing how it feels can reveal a lot. Remember, we’re not trying to coerce our body into a movement, but rather to notice the movement that is actually there, and then what sensations are present. And then try softening your breath. Are you holding your breath as you move? Notice the phases of your breath as you move. Are you focused only on moving on one phase of breath? Like, must you exhale as you lift? And just see if you can allow for the breath to free up a little bit. So it’s not married to the movement. And notice what shifts. How does it feel when you get into your movement and you notice the three points on the bottom of your feet? So let’s say you’re doing theraband movement. Maintain the movement only as much as you can connect with your feet, and not like using your brain to go down and feel your feet but can you feel your feet against the floor or against the shoes that you’re standing in?
Susi 00:09:59 And as you do that, as you notice those simple cues, how does your shoulder respond? Recognize that more is not necessarily better, because we can do more and more and more, and do it with compensatory patterns that lead to less coordination and control, more gripping and bracing, and not give the rotator cuff a really solid chance to improve. And a reality I see over and over and over again is that strength can emerge when we do less and feel more. And it’s not about like, doing less like sitting on the couch, but doing less like you’re moving your body only as much as it needs to. And then you’re keeping that down into a reduced compensatory strategy, so the muscles that are meant to be doing the movement actually do the movement and you’ll find better engagement, because the muscles that are meant to be doing the work are doing the work. This is really at the core of the work that I do with people inside of my programs that work with the rotator cuff.
Susi 00:11:10 Not power from pushing, but rather power from coherence and connection. From clarity. From letting go of compensations that are in the way. If this episode is sort of niggling at you of like, oh yeah, there’s something good here. If you’re a professional who wants to support your clients more effectively, or you’re someone who wants to understand your own body better, then I invite you to join me for my upcoming Power of the Rotator Cuff workshop. If you’re listening to this episode today, we’re running it on May 5th, 2025. And if you’re listening to this after May 5th, then it’s now available on demand. And in this session, we’re going to be digging into the science behind the rotator cuff and its integrated function. We’re going to look at real world compensations and what they tell us. We’re going to practice movements to uncover clarity and restore function. We’re going to discuss load, breath and nervous system readiness and guide you into the kind of simplicity that actually works. So you’re going to leave with understanding why your clients, or you, might be stuck, and how to move forward with clarity.
Susi 00:12:18 You can learn more over at functionalsynergy.com/cuff. Thanks for tuning in. This work is all about seeing things differently not to be contrarian, but to be effective. To be simple. To relieve pain. To restore ease, and to help people return to the lives they really, really want to live. So we’ll catch you next week. Until then, stay curious. Keep listening to your body and to possibility. See you next time.
