Got a Case of the SITS?

Categories: Blog Jun 21, 2021

Shoulder injuries are no fun. You never really appreciate how much you need, and use, and love your shoulder until it isn’t happy. But then, that’s generally the way it is with everything. We often don’t know the joys of what we have until we no longer have it. 


Thank goodness for the joys of healthy shoulders! It is such a wonderful joint that allows us to truly enjoy life to the fullest. From picking up our coffee cup to driving our cars, to wiping our backsides - shoulders are wonderful, ball and socket joints that can move almost anywhere. At least that is their design. 


Sometimes though, they get boogered up and a person can develop a case of the SITS. The SITS is a rotator cuff injury or issue. Really, there are four rotator cuffs: The Supraspinatus, the Infraspinatus, the Teres Minor, and the Subscapularis (SITS). They are the dynamic stabilizers of our shoulders. More importantly, they are a team and every good team needs all its members functioning at full capacity to be strong and healthy. When one team member goes down, the whole team suffers. In the case of the SITS, the whole shoulder complex is compromised when one of the rotator cuff muscles is injured, impaired, or offline. As a consequence, the joys of freedom the shoulder allows us to have can become very narrow, robbing our quality of life. 


Traditionally, open chain exercises with light dumbbells, bands, or just the arm’s weight have been used to strengthen the rotators when they are injured. You’ve probably done these. They feel silly, they frustrate you, and they leave you wondering if they helped heal your shoulder or if the 6 months, the passing of time, you spent doing them is what healed your shoulder. 


The funny thing is, the traditional approach taken to strengthen, repair, or heal the rotator cuff looks nothing like the original way we build resilient rotator cuffs to start with. Do you remember making all these odd movements as a child? Do you remember isolating certain movements with light weights when you were building strong shoulders when you were young? 


Of course you don’t, because you didn’t do those things. But what you did do was simply brilliant - you placed weight on your hands and you used your body. You rocked on all fours and you crawled. Brilliant! 


As it turns out, if you get the SITS, the original way you strengthened your shoulder still may be the best way to restore your shoulder if it gets compromised. 


Bearing weight (closed chain) on all fours, rocking back and forth, and crawling. In fact, that may very well be “Steps 1, 2, and 3.” 


If you get the SITS, or you want to make sure you don’t get the SITS, here is a quick guide to building amazing shoulders that allow you to keep your freedom of movement so you can enjoy your quality of life: 


Step 1, Bear weight on all fours

  • If your shoulders allow, just get on your hands and knees and hang out and breathe. 
  • Spend about 1 to 2 minutes here.


Step 1.5, Bear weight on all three

  • if your angry shoulder allows, bear weight on it while you lift the non-injured shoulder from the ground.
  • Hang out and breathe here.
  • Spend about 30 seconds to 1 minute. It’s okay if you shake. 


Step 2, Rock on all fours

  • While on all fours, hold your head up and rock back and forth.
  • Only move where you can move with PAIN-FREE movement. Do not rock into pain. 
  • Don’t just rock forward and back, explore all vectors: side to side, in circles, etc.
  • Spend about 2 minutes gently rocking where you can. 


Step 2.5, Rock on all threes

  • Again, if your shoulder allows, bear weight on it by lifting your non-injured arm.
  • Gently rocking back and forth, side to side, and wherever you can without moving into pain. 
  • It’s okay if you tremor. 
  • Spend about 1 minute doing this. 


Step 3, Crawl backward.

  • If your shoulders allow, crawl backward while on your hands and knees.
  • Move gently. Practice soft removals and soft landings of your hands. 
  • Play with speed. Practice regular speed and super slow motion crawling.
  • Spend about 3 minutes gently crawling backward. 


You can do this every day and more than once a day if you like. 

For a video demonstrating how to do these, click here:

Rehabilitating from Rotator Cuff Injuries - Phase 1

This is SITS repair goodness, right here! It’s how you trained your SITS when you were young and it can be how you retrain and restore them now. Just remember, and this is important, HONOR what your shoulders are telling you. Only move where you can without pain. If that movement is only three inches of range of motion, great. Take advantage of moving inside that three-inch range of motion. If all you can do is just bear weight on the shoulders while on all fours, great. Just start there and breathe. Test the waters with the shoulders every few days and move where you can. It’s how you did it the first time. 


Your body is made to move. You are designed to heal. Your original movement template is key to being free to move in your own body. If you can find the wonder in your design and engage it, you’ll always be moving in the right direction to enjoy your life as you want to. 


Rock on!

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