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Rotator Cuff Issues?

Head Stand might help.


Before I start, inversions such as Sirsasana (headstand) are not for everyone. If you are not familiar with this posture, then please consult a health practitioner or qualified yoga therapist before attempting.  There are various conditions affecting the eyes, heart, neck and brain that contraindicate its practice.


When we read about the benefits of Sirasana, rarely do we see the potential positive effects on the rotator cuff muscles being mentioned. These muscles, which are vital to shoulder function, are commonly injured and a source of shoulder pain.

Image from Tara Mitra's Primary Series Chart

Holding headstand for 30s each day for 6 weeks improved pain and shoulder movement.

A study from 2005 (1) had individuals with tears of the rotator cuff perform either the classical or modified version of headstand using a chair. This was held for 30 seconds and practised each day for 6 weeks. At the end of the study, both pain and the ability to move the arm was significantly improved. Some subjects went from not being able to lift the arm above the shoulder to near full range.

Now that is a good result!  Rotator cuff tears can be very painful and very frustrating.  When treated by a physiotherapist or chiropractor, you would need to visit them many times to get this level of change, costing you time and money. 

Its believed this posture helps because of the unique way it activates specific muscles of the shoulder.  For example, the posture increased activity in the subscapularis muscle and decreased it in supraspinatus.

To understand the significance of this, I highly recommend seeing my article on the rotator cuff muscles.  

With many shoulder issues, there is poor balance or control of muscles that both move and stabilise the joint.

For example, if one muscle is too active, it can destabilise the joint and lead to injury.  This is clearly seen with many supraspinatus tendon injuries caused by the tendon being trapped between the head of the humerus and acromion process.   The uncontrolled action of supraspinatus pulls the humerus up into the acromion, irritating the tendon and bursae in this area.  These become inflamed, and if not addressed, lead to the tendon tearing. 

This situation can be helped by increasing activity of the other rotator cuff muscles, such as the subscapularis.  These muscles have actions that help prevent the head of the humerus from riding up and compressing the tendon.  This not only allows pain-free movement but also gives the damaged tissues a chance to heal.

In this video I explain one way the supraspinatus tendon can be torn

(taken from the Shoulder Course)
I first appreciated the importance of balance between the rotator cuff muscles during my second trip to Mysore, India, in 2002.  Many of my fellow ashtanga students were having shoulder pain from supraspinatus tendon impingement.  I was a massage therapist in those days, and in all of them, I found a typical pattern of tight, sensitive and underactive subscapularis, infraspinatus and teres minor muscles.   By stimulating these muscles, symptoms in many quickly disappeared.  Of course, I had no idea about using headstands back then; I just worked those muscles with my hands.

There are other reasons why injuries to the shoulder, including the rotator cuff, can occur. These include poor control of movment and shoulder blade stability (scapula winging)

Lastly, do keep in mind that this was a small study that really requires further investigation. For example, there were only 10 subjects involved, there was no control group, and there were no follow up MRI's taken to assess how well the tissues had healed.  In my opinion, though, in some people with rotator cuff tears, headstand practice is certainly worth exploring.

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The Shoulder

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Learn the shoulder and how to work with injuries, including rotator cuff & labral tears, instability & much, much more. 
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Do you need help with a rotator cuff tear or other issue?

I am available for online consultation.  

References

  1. Loren Fishman, Caroline Konnoth, Alena Polesin; Headstand for Rotator Cuff Tear: Shîrshâsana or Surgery. Int J Yoga Therap 1 January 2006; 16 (1): 39–47.