WO1994006518A1

WO1994006518A1 - Rotator cuff development system

Info

Publication number: WO1994006518A1
Application number: PCT/US1993/008689
Authority: WO
Inventors: Dale R. Greenwald
Original assignee: Orthodyne International Ltd.
Priority date: 1992-09-16
Filing date: 1993-09-15
Publication date: 1994-03-31
Also published as: AU4922293A

Abstract

A frame (30, 102) which includes a portion (50) which is adjacent to the elbows of the user (12) and carries a pivotal device (42) which provides resistance to both clockwise and counterclockwise rotation can be mounted on the upper body of a user (12) for rotator cuff development. An elbow cup (50) is mounted at each resistance pivotal device (42), and a pivot arm connected to the pivotal resistance device extends outward from each resistance device, with an adjustable handgrip located on each pivot arm. In a modified version, the upper arms of the user are positioned by a device (100) at an angle from 0° to 130°, and the user rotates one or both pivot arms (44) inwardly or outwardly against the resistance of the adjustable pivotal resistance device (42).

Description

Title: ROTATOR CUFF DEVELOPMENT SYSTEM

BACKGROUND OF THE INVENTION Technical Field This invention relates to an exercise device, and more particularly, but not by way of limitation, to a portable, user manipulated force resisting device for exercising or rehabilitating the rotator cuff muscles, and to the methods of using such a device.

Background Art The rotator cuff musculature is made up of the teres minor, infraspinatus, supraspinatus and the subscapularis muscles. In rehabilitation, sports activity, daily activity, repetitive work patterns, and injuries due to trauma, one can experience shoulder injuries specific to, or inner related to the rotator cuff musculature. Also, through the repetitive throwing of an object, such as a ball, swinging of a racquet, striking of a volleyball, swimming, or any sport or other activity in which the arm is extended from the shoulder joint and rotated or moved, the rotator cuff muscles are susceptible to injury. The reason that this type of injury occurs is that the internal rotator cuff muscles experience the development of a greater level of strength as a result of repetitive overhead movement, especially when accompanied by a powerful follow through, as compared to the lesser strength developed by the external rotator cuff muscles in the same activity, thereby creating an uneven antagonistic muscle balance. As a result, there is a greater chance for injury to the rotator cuff muscles, and more specifically to the weaker external rotator cuff muscles. This is because the weaker external rotator cuff muscles can not maintain balance nor keep pace with the stronger internal rotator cuff muscles or the powerful pectoralis muscles during overhead and powerful follow through movement, and especially not during repetitive overhead movement, of the arm. Even in the absence of uneven antagonistic internal and external rotator cuff muscle balance, the rotator cuff muscle group is susceptible to injury when subjected to strain without having been properly warmed or limbered up. Another problem related to the rotator cuff musculature may come into existence following an injury to the shoulder, or after shoulder surgery, in which the individual may no longer have an adequate range of movement for either the external or the internal rotation of the shoulder and arm, for example, due to adhesions, or simply due to lack of muscle strength. Heretofore there have been a variety of different types of exercise apparatus and devices used for rehabilitation due to sport and accident related injuries. In U.S. Patent 3315,959 to Carnielli, U.S. Patent 4,592^45 to Sagedahl et al., U.S. Patent 4,773398 to Tatom and U.S. Patent 5,039,091 to Johnson variorø types of exercise and physical therapy apparatus are described. In U.S. Patent 5,C . 332 to Van Der Hoeven a portable abdominal exerciser is disclosed for isolating and developing the abdominal muscles groups. The unit uses a pulley and cable

SUBSTIT system with a restraining cylinder for exercising the stomach muscles. This device, while portable, does not address nor teach the importance of the isolation and exercising of the external and internal rotator cuff muscles. None of these prior art patents either specifically describe, teach, or suggest an exercise method which is useful for the development of rotator cuff musculature by isolating the rotator cuff muscles during internal and external rotation against external resistance while fixing the upper heads of the ulna and radius bones of the lower arm of a user at the point where they join to form the elbow, while also fixing the associated scapula against movement, and then moving the lower arm internally and externally against resistance at a 90° angle to the upper arm, to thereby cause the intermediate humerus bone, and especially the upper head of the humerus bone within the glenoid cavity, to be substantially isolated for movement during internal and external rotation of the lower arm against resistance, all while minimizing compensatory movement patterns and the use of larger muscle groups, with the result that both the internal and external rotator cuff muscles are strengthened somewhat equally to provide balance and antagonistic muscle harmony between the internal and external rotator cuff muscle groups for the purposes of providing rotator cuff exercise, and to help prevent rotator cuff injuries, and for assisting in the provision of proper rehabilitation of rotator cuff injuries. Furthermore, none of these prior art patents either specifically describe, teach, or suggest a device for accomplishing these methods, in which a portable frame which includes a portion which is adjacent to the elbows of the user carries a pivotal device which provides resistance to both clockwise and counterclockwise rotation, can be adjustably mounted on the upper body of a user, and which includes an element at each resistance pivotal device for securing the elbows of a user against movement during the use of the device, and a pivot arm with an adjustable handgrip or hand rest receiving means extending outward the length of the lower arm of a user, located on each pivot arm, so that with the upper arms substantially vertical, and the lower arms positioned at 90° from the upper arm, that by then rotating the pivot arms inwardly against resistance the internal rotator cuff muscles are exercised, and by then rotating the pivot arms outwardly against resistance the outer rotator cuff muscles are exercised, as described herein.

DISCLOSURE OF THE INVENTION It is therefore an object of the present invention to teach an exercise device which is useful for the development of rotator cuff musculature in an efficient, easy and effective way by isolating the rotator cuff muscles during internal and external rotation against external resistance. It is another object of the present invention to teach a method of exercising the rotator cuff muscles, which method fixes the upper heads of the ulna and radius bones of the lower arm of a user at the point where they join to form the elbow, while also fixing the associated scapula against movement, and then moving the lower arm internally and externally against resistance at a 90° angle to the upper arm, thereby causing the intermediate humerus bone, and especially the upper head of the humerus bone within the glenoid cavity to be substantially isolated for movement. It is yet another object of the present invention to teach a method of exercising the rotator cuff muscles in which, during internal and external rotation of the lower arm against resistance, all of the force of the internal and external rotator cuff muscles is efficiently isolated as internal and external turning force, while minimizing compensatory movement patterns and the use of larger muscle groups, with the result that both the internal and external rotator cuff muscles are strengthened somewhat equally, thereby providing balance and antagonistic muscle harmony between the internal and external rotator cuff muscle groups for the purposes of providing proper rotator cuff exercise, and to help prevent rotator cuff injuries, and for assisting in the provision of proper rehabilitation of shoulder rotator cuff injuries. It is still yet another object of the present invention to teach such a method of internal and external rotator cuff muscle development against resistance which may be carried out with the upper arm adjacent to the body and substantially vertical, or in one or more predetermined paths, or angles of the upper arm from the body, so that the use or rehabilitation of the rotator cuff muscles for different activities can be enhanced. It is a further object of the present invention to teach a device for accomplishing these methods, in which a frame which includes a portion which is adjacent to the elbows of the user and carries a pivotal device which provides resistance to both clockwise and counterclockwise rotation can be adjustably mounted on the upper body of a user. It is yet a further object of the present invention to teach such a device which has an element, such as a tapered rotatable elbow cup mounted at each adjustable resistance pivotal device, for securing the elbows of a user during the use of the device and a pivot arm having a first end connected to each resistance device and extending outward the length of the lower arm of a user, with an adjustable handgrip or hand rest receiving means located on each pivot arm. Another object of the present invention is to teach the operation of such a device which can be placed on the body of the user, and adjusted, after which the user positions his or her elbows firmly in the tapered elbow securing cups, grasps the handgrips or hand rest receiving means with his or her upper arms substantially vertical, and the lower arms positioned at 90° from the upper arm, and then rotating one or both pivot arms inwardly against the resistance of the pivotal resistance device, thereby exercising the internal rotator cuff muscles, and then, when this movement is completed, rotating one or both pivot arms outwardly against the resistance assembly, thereby exercising the external rotator cuff muscles. Yet another object of the present invention to teach a modified version which provides for the upper arms of the user being positioned by the device at an angle from 0 to 130°, or more, so that the user may rotate one or both pivot arms inwardly or outwardly against the resistance of the angularly adjustable pivotal resistance device.

SUBSTITUTE SHEET It is a further object of the present invention to provide such a rotator cuff exercise device which is easily portable and which is size adjustable for a wide variety of users, and which is usable in nearly any environment. It is further object of the present invention to teach such an exercise device which also provides a scale which measures the true range of movement of the internal and external rotation of the shoulder and of the isolated rotator cuff muscles of a user during internal and external rotation. The preferred embodiment of the present invention includes a curved, substantially rigid frame with adjustable straps for use in mounting it adjacent to the front of the midsection of a user at about the level of the elbows. The rigid frame includes a right end and a left end, each of which extends laterally beyond the body of the user and adjacent to the elbows of the user. Connected to the rigid frame are adjustable waist straps, or adjustable shoulder straps, or combinations of waist straps and shoulder straps which are designed to be positioned and hold the frame comfortably adjacent to the front of the midsection of a user. Mounted on both the right end and the left end of the frame is a separate pivotal device which provides an adjustable resistance to both clockwise and counterclockwise rotation. In preferred embodiments the adjustable resistance pivotal devices are clutch assemblies of the type which are well known in the art, and which resist both clockwise and counterclockwise rotation. A freely rotatable elbow cup is mounted on the top of each adjustable resistance pivotal device. In preferred embodiments the elbow cup is tapered and padded. A pivot arm having a first end connected to the clutch assembly extends horizontally outward from each clutch assembly. Each pivot arm is positioned to be adjacent to, and have a second end which extends to at least about the length of the lower arm and hand portions of a user. Where the adjustable resistance pivotal device is a clutch assembly, it includes a resistance adjustment hand nut for increasing or decreasing the pivot resistance of each clutch, and thereby of each associated pivot arm. A handgrip or hand rest receiving means is located adjacent to the second end of each pivot arm. In preferred embodiments, the handgrip or hand rest receiving means is adjustable along the length of the pivot arm in order to accommodate the different lengths of the lower arms of different users. As used herein, the term "handgrip" or "gripping means" refers to both handgrips, hand rests, or other hand or arm receiving means. In the operation of the portable exercise device of the present invention, the device is placed on the body of the user, with the straps adjusted so that the rigid frame is mounted adjacent to the front of the midsection of a user at about the level of the elbows, with the right end and left end of the frame extending laterally beyond the body of the user and adjacent to the elbows of the user. Either before or after being so placed, the resistance of the pivotal assemblies is adjusted. The user then positions his or her elbows firmly in the freely rotatable padded and tapered elbow cups mounted on the top of each clutch, and the lateral position of the handgrips are adjusted along the length of the pivot arm in order to receive the hands of the user. After these adjustments are completed, each handgrip is grasped by one of the hands of the user, and with his or her upper arms substantially vertical, and the elbows in the elbow cups, the lower arms of the user are positioned at approximately 90° from the upper arm. Then, while holding a handgrip or hand rest in each hand or arm, the user rotates one or both pivot arms inwardly against the resistance of the clutch assembly, or other pivotal resistance device, thereby exercising the internal rotator cuff muscles. When this movement is completed, the user may then rotate one or both pivot arms outwardly against the resistance of the dutch assembly or other pivotal resistance device, thereby exercising the external rotator cuff muscles. The two pivot arms may be rotated simultaneously inwardly and then simultaneously outwardly, or simultaneously outwardly and then simultaneously inwardly, or one outwardly and the other inwardly, or one at a time, as the user desires or is directed by a coach or therapist. In a modified version of the present invention, a back frame including a vertical member, an upper padded cross member adjustably attached to the top of the vertical member at shoulder height, and a lower padded cross member attached to the bottom of the vertical member at waist height. Straps are provided which are designed to be positioned and to hold the frame comfortably adjacent to the back of a user. The upper cross member includes a right end and a left end. Mounted on both the right end and the left end of the upper cross member is a separate pivotal device, each of which is substantially adjacent to the shoulders of the user. An upper arm unit is connected to each pivotal device. The upper arms are nominally capable of 360° of rotation, but, as detailed below, will normally vary from a downward position, which will be considered to be the 0° position, for example, upward to form a line with the upper cross member and parallel to the ground when worn by a standing or seated user who has their upper body in a vertical position, which will be considered to be the 90° position, or even to a position above the shoulders of 130°, or more. On the bottom end of each upper arms there is a mounting plate on which is mounted a separate pivotal device which provides an adjustable resistance to both clockwise and counterclockwise rotation, such as a clutch assembly. The mounting plates can be adjusted along the length of the upper arms to accommodate the varying upper arm lengths of the users. The mounting plates can also be rotated. A freely rotatable tapered elbow cup is mounted on each adjustable resistance pivotal device. A pivot arm having a first end connected to the pivotal resistance device extends outwardly to at least about the length of the lower arm and hand portions of a user. A handgrip which is adjustable along the length of the pivot arm is located adjacent to the second end of each pivot arm. As described below in greater detail, in the operation of this modified portable exercise device of the present invention, after the device is placed on the back of the user, it is adjusted so that the upper cross member is mounted adjacent to and at about the level of the shoulders. The mounting plate at the bottom of each upper arm is then adjusted for both the length of the upper arms of the user, and oriented to accommodate the direction of orientation and the angle

B of the arm to the body in which the user will be moving his or her arms. The user then positions his or her elbows firmly in the freely rotatable padded and tapered elbow cups, and the lateral position of the handgrips are adjusted along the length of the pivot arm in order to be receive by the hands of the user. Either before or after being so placed, the resistance of the resistance assemblies is adjusted. After these adjustments are completed, each handgrip is grasped by one of the hands of the user, and with his or her upper arms at the desired angle, from 0 to about 130°, or more, and the elbows in the tapered elbow cups, the lower arms of the user are positioned at approximately 90° from the upper arm. Then, while holding a handgrip in each hand, the user rotates one or both pivot arms inwardly or outwardly against the resistance of the clutch assembly, or other pivotal resistance device, thereby exercising the internal or external rotator cuff muscles. As detailed below, the upper arm members may be substantially vertical position of approximately 0°, raised to a position of approximately 45° from the side of the body, raised to a position close to 90° and level of with the shoulder of the user, and to any other angle between 0 and about 130°, or higher. When in the 0° position, this modified embodiment of the present invention will function in substantially the same manner as the first embodiment. In each position, the tapered elbow cups serve to maintain the upper arms of the user at a 90° angle to the lower arms of the user in order to isolate the movement of the head of the humerus, thus isolating the internal and external rotator cuff muscles, in accordance with the teaching and the method of the present invention. These and other objects of the present invention will become apparent to those skilled in the art from the following detailed description, showing the contemplated novel construction, combination, and elements as herein described, and more particularly defined by the appended claims, it being understood that changes in the precise embodiments to the herein disclosed invention are meant to be included as coming within the scope of the claims, except insofar as they may be precluded by the prior art.

BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings illustrate complete preferred embodiments of the present invention according to the best modes presently devised for the practical application of the principles thereof, and in which: FIG. 1 is a perspective view of one embodiment of the subject portable exercise device with the frame received adjacent to the front of the midsection of the body of the user, with the upper arms held substantially vertical, and adjacent to the body of the user, and with the lower arms extending outwardly at about 90° from the upper arms. PIG.2 illustrates an enlarged, exploded perspective view of an elbow cup and of a clutch assembly with a resistance adjusting hand nut, and showing a portion of a pivot arm extending outwardly therefrom. FIG. 3 is a bottom view of the clutch assembly of FIG. 2.

SUBSTITUTE SHEET FIG.4 is a further enlarged, exploded side view, partially in phantom, of the structure of the dutch assembly. FIG.5 is a top view of the exercise device of FIG. 1, without the elbow cups and shoulder straps. FIG. 6 is a back view of a modified embodiment of the exercise device of the present invention which will allow a user to hold his or her upper arms at various angles away from the upper body. FIG. 7 is a perspective view, partially in phantom, of the modified embodiment of FIG. 6, showing a user carrying the portable device, and with the device adjusted to an angle, such that the left upper arm is raised to about 90°, or to shoulder height, and with the right upper arm raised to about 45°. FIG. 8 is a perspective view of the portable exerdse device embodiment of FIGS. 1 -5 with the frame resting on and connected to and supported by a stand, and showing the use of hand rests in place of hand grips.

BEST MODE FOR CARRYING OUT THE INVENTION AND INDUSTRIAL APPLICABILITY Referring to FIG. 1, one embodiment of the subject portable rotator cuff musde development device of the present invention is shown having general reference numeral 10. Portable device 10 is received on an upper portion 12 of a body of a user 14, having a midsection 16, shoulders 18, upper arms 20, lower arms 22, hands 24 and tapered elbows 26. The device 10 indudes a frame 30 which is curved or contoured for receipt adjacent to the front of midsection 16 of body 12. In this embodiment, frame 30 has a pair of adjustable padded shoulder straps 32 for receipt around shoulders 18 of user 14 to secure device 10 to body 12. Frame 30 also indudes a first end 34 and a second end 36 which extend laterally beyond the body 12 of user 14 and adjacent to elbows 26. There are elongated openings 38 in both first end 34 and a second end 36 for receiving a portion of threaded hand screws 40 therethrough. Hand screws 40, shown in FIGS. 3 and 5, serve to secure a dutch assembly 42 on first and second ends 34 and 36. Pivot arms 44 extends outwardly from each dutch assembly 42, and pivot in an arcuate pivot opening 45 in a curved side of housing 46. As detailed below, opening 45 may have an arc of 180°, or more, for allowing a full range of motion of the lower arm 22 of a user 14. Mounted on the bottom of the assembly housing 46 is a hand nut 48 which is used to tighten and loosen the movement of dutdi assembly 42, and to thereby tighten and loosen the apparent resistance of pivot arm 44 in both the dodcwise and counterdockwise directions. Freely pivotally mounted on top of each assembly housing 46 is a tapered elbow cup 50, as shown in FIGS. 1 and 2. Each tapered elbow cup 50, indudes a semi-cylindrical elongated tray 52 for receiving a portion of the elbow 26 and a portion of the lower arm 22 therein. Tapered elbow cup 50 also indudes a semi-circular upright stop 54 mounted at the rear of tray 52 for receiving a lower portion of the upper arm 20 thereagainst. In preferred embodiments, elbow cups

TE HEET 50 are tapered and padded to comfortably receive and hold the elbow 26. Tapered elbow cup 50 is adapted to receive and hold an elbow 26 therein and the lower arm 22 is held at an angle of 90° to the upper arm 20. As detailed below, this is extremely important during the exercising of the rotator cuff musdes because it eliminates excess compensatory movement of the arm and shoulder. Handgrips 56 are adjustably mounted along the length of pivot arms 44. In FIG. 1, the elbows 26 can be seen resting in tapered elbow cups 50 with the hands 24 of user 14 grasping handgrips 56 which are adjusted on pivot arms 44 for the length of the lower arms 22. FIG. 2 shows an enlarged perspective view of tapered elbow cup 50, dutch assembly 42 and hand nut 48. In this view, tapered elbow cup 50 is shown with a cup shaft 62 extending downwardly from tray 52 and positioned for receipt in an opening 64 on the top of a threaded shaft 66, which extends through assembly housing 46. Additional details of this structure are shown in FIG. 4. Slidably mounted on top of housing 46 are a pair of range of motion markers 68. Markers 68 are secured to threaded shaft 66, and extend over the top and down the side of housing 46. A scale 70 is located on the side of housing 46. Markers 68 indicate the degree of movement of pivot arm 44 when arm 44 engages a portion of marker 68 and moves one of the markers 68 outwardly as shown by arrow 60 or inwardly as indicated by arrow 58. For example, in FIG. 2, pivot arm 44 which has been previously pivoted outwardly, is shown to have moved threaded shaft 66, and thereby marker 68 which is secured to threaded shaft 66, past 60° on scale 70. Using markers 68 and scale 70, the range of motion of the rotator cuff musdes and rotation of the shoulders of a user can be monitored and progress noted during exercise training and rehabilitation. While scale 70 is shown from 0° to 90°, scale 70 can easily be increased to 120°, or greater, depending on the degree of movement of pivot arm 44 on dutdi assembly 42. In FIG. 3 a bottom view of the dutdi assembly 42 of FIG. 2 is shown with hand nut 48 secured to a threaded end portion 72 of threaded housing shaft 66. Also shown in the drawing are two hand screws 40 positioned for receipt in a pair of threaded bores 74, shown in phantom, on a flat side 76 of assembly housing 46. A portion of pivot arm 44 is shown extending outwardly from assembly housing 46. In FIG.4 a further enlarged exploded front view of the individual parts making up dutdi assembly 42 are shown. In this view threaded housing shaft 66 is positioned for receipt through an aperture 78 in a top portion 79 of the assembly housing 46. A bottom portion 80 of housing 46 is hollowed out for receipt of a pivot ring 82, a plastic sleeve 84, a rubber washer 86, a compression ring 88 and thrust bearing 90. When hand nut 48 is tightened on shaft 66, the thrust bearing 90 engages compression ring 88 which is forced against washer 86 and sleeve 84 and tightens pivot ring 82 inside assembly housing 46. Pivot arm 44 is threadedly connected into a portion of pivot ring 82 and therefor the resistance to movement of pivot arm 44 is influenced by the tightening and loosening of hand nut 48. It can be appreciated that when the user 14 of exerdse device 10 begins training, he or she may wish to loosen hand nut 48 for ease in the

SUBSTITUTE SHEET movement of pivot arms 44 during the initial exercise of the internal and external rotator cuff musdes. As the strength of the user increases, hand nut 48 can be tightened on assembly housing 46, making it more difficult to rotate pivot arms 44. As pivot ring 82 is rotated by connected pivot arm 44, threaded housing shaft 66 also rotates, causing connected markers 68 to rotate and indicate the range of motion, as described above. In FIG. 5 a top view of exercise device 10 is shown with elbow cups 50 and straps 32 removed from the top of dutch assemblies 42. In this view, dutch assemblies 42 can be seen attached to ends 34 and 36 of frame 30. Also in this view, frame 30 can be seen having a concave mid-portion 92 contoured for comfortable receipt around a portion of the midsection 16 of the body 12. The frame 30 can be made in various sizes for children, and women and men of different sizes. Also, dutdi assemblies 42 can be adjusted along the length of frame 30 using elongated openings 38 and hand screws 40, so that they may be positioned for different body sizes and exercise starting positions so that the elbows 26 can always be secured while resting comfortably inside tapered elbow cups 50. The method of operation of this embodiment is shown by reference to FIG. 1, in which a vertical axis "X" is shown, as are axes "Y" and "Z", which together form a horizontal plane. In FIG. 1, the user 14 is sitting or standing with the upper body 12 vertically upright along the "X" axis, and operating pivot arms 44 in the horizontal plane formed by the "Y" and "Z" axes. The user 14 by pivoting the pivot arms 44 inwardly and toward each other, as shown by arrows 58, exercises the internal rotator cuff musdes. The user 14 by pivoting pivot arms 44 outwardly and away from each other, as shown by arrows 60, exercises the external rotator cuff musdes. More specifically, when straps 32 have been adjusted to fit user 14, and elbows 26 are placed and locked in tapered elbow cups 50 and upright hand grips 56 appropriately adjusted along pivot arms 44 for the length of the lower arms 22 of user 14, and resistance has been set by adjusting hand nut 48 and dutdi assembly 42, then internal and external exercise rotation may begin. User 14 will start to exercise with pivot arm 44 extending from housing 46 at the 0° mark on scale 70 and with markers 68 also at the 0° mark on scale 70. User 14 moves the pivot arm 44 internally by moving hand grip 56 inward. When executing this movement, user 14 is working the internal rotator cuff musculature, primarily the subscapularis musde. Because elbow 26 is secured in tapered elbow cup 50, and lower arm 22 is held at a 90° angle to upper arm 20, when user 14 pivots arm 44 in an inward or internal rotation motion, the internal rotation and depression of the head of the humerus is isolated and kept within the glenoid cavity, through the action of the subscapularis. When user 14 pivots arm 44 in an outward or external rotation motion the external rotator cuff musculature, primarily the infraspinatus, teres minor and the supraspinatus musdes, are engaged, and the external rotation of the head of the humerus occurs, while being kept within the glenoid cavity. User 14 is encouraged to rotate pivot arms 44 externally to the greatest extent of his or her physiological limit, or that set by the coach or therapist.

SUBSTITUTE SHEET When performing external rotation, the head of the humerus is isolated and kept within the glenoid cavity and rotated externally through the action of the infraspinatus, teres minor and the supraspinatus. After completion of the selected number of internal and external rotation repetitions, the range of motion can be observed by the position of the markers 68 on the scale 70. Isolation of movement of the head of the humerus is accomplished by holding the upper arms 20 and lower arms 22 at a fixed substantially 90° angle to one another, with elbows 26 secured in a tapered and adjustably padded elbow cup 50 that eliminates any compensatory or unneeded lower arm or scapula movements. Thus, true isolation of external and internal rotation can be measured using markers 68 and scale 70 and the isolated internal and external rotator cuff musdes can be worked without the involvement of stronger and larger musde groups. When using device 10 the user 14 can strengthen the weaker external rotator cuff musdes to somewhat equal the strength of the internal rotator cuff musdes, due to dutdi assembly 42 providing somewhat equal resistance for both movements. The user can also increase and monitor the range of motion gains, as well as, the ability to warm-up the rotator cuff musculature before performing activities that involve use of the shoulder. ' In FIG. 6 a back view of a modified embodiment of the exer se device of the present invention is shown which allows a user to hold his or her upper arms at various angles away from the upper body. In this modified embodiment of device 10, a contoured back frame 100 having a vertical member 102, an upper cross member 104 adjustably attached to the top of vertical member 102, and a lower cross member 105 attached to the bottom of vertical member 102. Vertical member 102 indudes an elongated opening 106 for receiving a threaded hand screw 108 attached to upper cross member 104 for use in adjusting the height of cross member 104 on vertical member 102. Vertical member 102 can be made with appropriate sizes and contours for different size children, women and men. Upper cross member 104 is padded for comfort against the back of the shoulders 18, while lower cross member 105 is also padded and contoured for receipt against the lower back of the body 12. Upper cross member 104 has shoulder straps 110 which are designed for receipt over the shoulders 18 of a user 14, and attached to a front waist strap 112. Waist strap 112 is attached to the ends of lower cross member 105. Straps 110 and 112 releasably secure the contoured back frame 100 to the body 12. On both the first end 114 and the second end 116 of upper cross member 104 is pivotally mounted an upper arm 118. Upper arms 118 are secured to cross member 104 by hand nuts 120 secured to bolts extending from ends 114 and 116. Ends 114 and 116 have a scale 122 for indicating the position of arms 118 from a 0° position upward to a 90° position, or greater, for example to 130°. In the 90° position upper arm 118 extend in a line from upper cross member 104, and are parallel to the ground when worn by a standing user. A marker 124 on a top end 126 of arms 118 is used to index with scale 122 in showing the position of each assembly arm 118 on frame 100.

SUBSTITUTE SHEET Adjacent to the bottom end 128 of upper arms 118 is mounted an mounting plate 130. Mounting plates 130 are secured to upper arms 118 using hand screws 132. Openings 134 in mounting plates 130 allow mounting plates to be adjusted along length of upper arms 118. Plates 130 also indude an aperture 136 and a curved opening 138 for receiving hand screws 40 used in securing a dutdi assembly 42 thereto. The curved opening 138 allows the dutch assembly 42 to be rotated to any desired position on each mounting plate 130. In FIG. 7, a perspective view, partially in phantom, of the modified embodiment of FIG. 6, showing the contoured back frame 100 of portable device 10 secured to the upper portion of the body 12 of a user 14, with elbows 26 secured in tapered elbow cups 50. In this view, dutch assemblies 42 are shown secured to each mounting plate 130. Also, in this view, assembly arm 118 and mounting plate 120 have been adjusted so that the left upper arm 20 of the user, and upper arm 118 of device 10 have both been raise about 90°, almost to the level of shoulder 18 and upper cross member 104. Referring again to FIG. 6, upper arm 118 used with the left upper arm 20 would now indicate that arm 118 has been raised on scale 122 to a position dose to 90°. Also, in FIG. 7 upper arm 118 and mounting plate 120 for the right upper arm 20 has been raised to a position of approximately 45° from the side of the body 12. The tapered elbow cups 50 in this view continue to secure elbows 26 and to maintain the upper arms 20 at a 90° angle from the lower arms 22, thereby isolating the movement of the humerus and the exercise of the internal and external rotator cuff musdes. As detailed above, exerdse device 10 in FIG. 1 held the lower arms 22 in a horizontal plane for movement back and forth as indicated by arrows 58 and 60. In FIG. 7 it can be seen that using the contoured back frame 100 with adjustable upper arms 118 and mounting plates 130, dutdi assembly 42 and tapered elbow cups 50 can be positioned next to the side of the body 12 or raised to various positions up to shoulder height and above. Note in FIG. 7, arrow 142 indicates the movement of the left arm of the user 14 in exercising the rotator cuff musdes found on the left shoulder 18, while arrow 144 indicates the movement of the right arm of the user 14 in exercising the rotator cuff musdes found in the right shoulder 18. The modified version of the present invention which is shown in FIGS. 6 and 7 allows a user 14 to position upper arms 20 at varying angles from 0 to about 90°, or more, well above shoulder height, and relative to the mid-section 16 of the user 14. The advantage of this diversity in angles of positioning upper arms 20, is that they allow user 14 to specifically strengthen and isolate the rotator cuff musculature in a variety of specific functioning activity positions. The position shown in FIG.7 could represent a position that is specific for a tennis player, racquet ball player or an individual throwing a ball above shoulder height. In rehabilitation, specific angles can be found and utilized for strengthening the rotator cuff musculature in a weakened or restricted angle or region, or at an angle that is not greatly invasive or painful to the user 14. In the modified version which is shown in perspective view in FIG.8 the portable exercise device embodiment of FIGS. 1 -5 is shown with the frame 30 resting on and connected to and

SUBSTITUTE SHEET supported by a free standing portable stand, having a general reference numeral 152. Frame 30 of exercise device 10 is mounted on a vertical stand 152 having an upper inverted "L" shaped upper tube member 154 slidably adjustably received in a lower tube member 156 using a plurality of indexing holes 158 and pin 160. This arrangement allows the height of stand 152 to be adjusted. The stand 152 is mounted on a ground engaging "H" shaped base 162. In this embodiment the exercise device 10 is mounted on the horizontal arm of upper tube member 154 at tab 164 which carries a keyed opening, not shown, through which a metal button 166 can be easily engaged and disengaged. Metal button 166 is secured to the center of frame 30. Other art known means for securing exercise device 10 to a support frame, such as 152, may be provided. By using support frame 152 to support exerdse device 10, a user has the convenience of using the equipment without the need to bear the weight of the device. It also provides an embodiment in which the exercise device may be used as a permanent piece of equipment without the great expense which is normally entailed in the purchase of permanent equipment. Portable stand, 152 may also be used with exercise device 100, in a similar manner. Also shown in FIG.8 is the use of hand rests 172 in place of hand grips 56, with the hand 24 received inside an opening 174 in hand rest 172. The advantage of the use of hand rest 172, is that the hand or arm of the user is adjustable along the length of the pivot arm 44. The hand 24 may be used to grip one side of the hand rest 172 during an exercise period or the hand 24 can merely rest inside of the hand rest 172. Hand rest 172 presents the possibility of use by a person having an injured or missing hand or fingers, or having a prosthetic hand. In addition, the use of hand-rest 172 allows the user to place their relaxed hand, forearm or prosthesis in hand rest opening 174. No hand or forearm musde or wrist joint involvement or action is required. This eliminates any unnecessary or compensatory involvement of other musde groups or joints in the arm or elbow, other than the shoulder joint and the rotator cuff musdes, thereby allowing further isolation of the rotator cuff musdes, and also allowing for the more accurate measurement of internal and external shoulder rotation. Hand rest 172 may be padded for comfort. It is therefore seen that the present invention teaches an exercise device which is useful for the development of rotator cuff musculature in an effident, easy and effective way by isolating the rotator cuff musdes during internal and external rotation against external resistance. This is accomplished using a method of exercise which fixes the upper heads of the ulna and radius bones of the lower arm of a user at the point where they join to form the elbow, while also fixing the assodated scapula against movement, and then moving the lower arm internally and externally against resistance at a 90° angle to the upper arm. This causes the intermediate humerus bone, and especially the upper head of the humerus bone within the glenoid cavity to be substantially isolated for movement. As a result, during internal and external rotation of the lower arm against resistance, all of the force of the internal and external rotator cuff musdes is effiάently isolated as internal and external turning force, while minimi-ring compensatory movement patterns and the use of larger musde groups, with the result that both the internal and external rotator cuff musdes

TITUTE SHEET are strengthened somewhat equally. This provides balance and antagonistic musde harmony between the internal and external rotator cuff musde groups for the purposes of providing proper rotator cuff exercise to help prevent rotator cuff injuries, and for assisting in the provision of proper rehabilitation of shoulder rotator cuff injuries. This method of internal and external rotator cuff musde development against resistance may be carried out with the upper arm adjacent to the body and substantially vertical, or in one or more predetermined paths, or angles of the upper arm from the body, so that the use or rehabilitation of the rotator cuff musdes for different activities can be enhanced. It is further seen that the present invention teaches a device for accomplishing these methods, in which a frame which indudes a portion which is adjacent to the elbows of the user and carries a pivotal device which provides resistance to both dockwise and counterdockwise rotation can be adjustably mounted on the upper body of a user. The device has been taught to have a tapered rotatable elbow cup mounted at each adjustable resistance pivotal device, and a pivot arm having a first end connected to each resistance device extends outward the length of the lower arm of a user, with an adjustable handgrip located on each pivot arm. The operation of the device has been taught, in which it is placed on the body of the user, and adjusted, after which the user positions his or her elbows firmly in the tapered elbow cups, grasps the handgrips with his or her upper arms substantially vertical, and the lower arms positioned at 90° from the upper arm. It has been taught that the user may then rotate one or both pivot arms inwardly against the resistance of the pivotal resistance device, thereby exercising the internal rotator cuff musdes, and that when this movement is completed, the user may then rotate one or both pivot arms outwardly against the resistance assembly, thereby exercising the external rotator cuff musdes. A modified version of the device has been taught which provides for the upper arms of the user being positioned by the device at an angle from 0 to 130°, or more, and the user rotating one or both pivot arms inwardly or outwardly against the resistance of the adjustable pivotal resistance device. It is further seen that the exercise device of the present provides such a rotator cuff exercise device which is easily portable and which is size adjustable for a wide variety of users, and which is usable in nearly any environment. It is further seen that the exercise device of the present invention also provides a scale which measures the true range of movement of the internal and external rotation of the shoulder and of the isolated rotator cuff musdes of a user during internal and external rotation. While the invention has been particularly shown, described and illustrated in detail with reference to the preferred embodiments and modifications thereof, it should be understood by those skilled in the art that equivalent changes in form and detail may be made therein without departing from the true spirit and scope of the invention as claimed, except as preduded by the prior art.

Claims

What is claimed is: 1. An exerdse device which is useful for the development of rotator cuff musculature by isolating the head of the humerus in the glenoid cavity during internal and external rotation against external resistance, induding in combination: a frame which indudes at least one portion which is to be located adjacent to the elbows of a user; at least one pivotal resistance means which is mounted on said frame at one said portion which is to be located adjacent to the elbows of a user, which pivotal resistance means provide resistance to dockwise and to counterdockwise rotation; means associated with each said pivotal resistance means for receiving and securing the elbow of a user; means associated with said elbow receiving and securing means for guiding the lower arm of a user at about a 90° angle to the upper arm of a user; pivot arm means having a first end and a second end, said first end connected to said pivotal resistance means and rotatably movable against the resistance of said pivotal resistance means, said second end of said pivot arm means extending from said pivotal resistance means; and gripping means associated with said second end of said pivot arm means; whereby, when a user positions an elbow in said means for receiving and securing the elbow, and holds said gripping means with the lower arm positioned at about 90° from the upper arm of the user, and then rotates said pivot arm, the head of the humerus is substantially isolated in the glenoid cavity during both internal and external rotation, and the inner rotator cuff musdes and the outer rotator cuff musdes of the user are exercised and strengthened.

2. The exercise device of claim 1 in which said frame is portable.

3. The exercise device of claim 2 in which there is associated with said frame, means for positioning and adjusting said frame adjacent to the midsection of a user at about the level of the elbows of the user.

4. The exercise device of claim 3 in which said means for positioning and adjusting said frame positions said frame adjacent to the front of the midsection of a user.

5. The exercise device of claim 4 in which said frame indudes a right end and a left end, each of which said ends will extend laterally beyond the body of a user and adjacent to the elbows of a user, each said right end and left end carries said pivotal resistance means; whereby, when a user positions both elbows in both said means for receiving and securing the elbow, and holds both said gripping means with both lower arms positioned at about 90° from the upper arms of the user, and then rotates both said pivot arms, the heads of the humerus in both arms are

SUBSTITUTE SHEET substantially isolated in the glenoid cavity during internal and external rotation, and the inner rotator cuff musdes and the outer rotator cuff musdes of both shoulders of the user are exercised and strengthened.

6. The exercise device of claim 5 in which said means for securing the elbow of a user against movement and said means for guiding the lower arm of a user at a 90° angle to the upper arm of a user are a single combined means.

7. The exercise device of claim 5 in which said pivot arm means are at least the length of the lower arm of a user, and said gripping means are located substantially adjacent to said second end of said pivot arm means.

8. The exercise device of claim 7 in which said hand grips are adjustable along the length of said pivot arm means in order to accommodate users having different lengths of lower arms.

9. The exercise device of claim 1 in which a floor stand is provided and in which said exercise device is removably mounted for use on said floor stand.

10. The exercise device of claim 1 in which said pivotal resistance means indudes scale means which measure the range of movement of the internal and external rotation of the shoulder and of the isolated rotator cuff musdes of a user during internal and external rotation of the exercise device.

11. The exercise device of claim 1 in which the resistance to rotation of said resistance means is adjustable.

12. The exercise device of claim 1 in which said frame is designed to be mounted adjacent to the back and across the shoulders of a user, and indudes means for positioning and holding the upper arms of a user at an angle of from about 0 to about 130° from the body of the user, and which further indudes a vertical member having a top and a bottom, with an upper cross member attached to the top of the vertical member at what will be the shoulder height of a user by the use of adjusting means associated with said frame, wherein said upper cross member indudes a right end and a left end, separate pivotal means mounted on both said right end and said left end of said upper cross member at locations which will be substantially adjacent to the shoulders of a user when the frame is positioned adjacent to the back of a user, a pair of upper arm unit means having an upper end and a lower end, said upper end of said upper arm unit means being rotatably connected to said pivotal means, said upper arm unit being rotatable

SUBSTITUTE SHEET towards and away from said frame, and mounting means substantially adjacent to said second end of each said upper arm unit means, with said pivotal resistance means being carried by each mounting means.

13. An exercise device which is useful for the development of rotator cuff musculature by isolating the head of the humerus and the rotator cuff musdes during internal and external rotation against external resistance, induding in combination: a back frame, said back frame induding a vertical member having a top and a bottom, with an upper cross member attached to the top of said vertical member, said upper cross member having a right end and a left end; adjusting means associated with said frame for positioning said right end and said left end of said upper cross member at what will be the shoulder height of a user; separate pivotal means mounted on both said right end and said left end of said upper cross member at locations which will be substantially adjacent to the shoulders of a user when said frame is positioned adjacent to the back of a user; a pair of upper arm unit means having an upper end and a lower end, said upper ends of said upper arm unit means being rotatably connected to said pivotal means, said upper arm unit means being rotatable towards and away from said frame; means for securing and holding said upper arm unit means at an angle of from about 0° to about 130° from said frame; mounting means substantially adjacent to said second end of each said upper arm unit means; pivotal resistance means which is mounted on said mounting means, which pivotal resistance means provides resistance to dockwise and counterdockwise rotation; means associated with each said pivotal resistance means for receiving and securing the elbow of a user; means associated with said elbow receiving and securing means for guiding the lower arm of a user at about a 90° angle to the upper arm of a user; pivot arm means having a first end and a second end, said first end connected to said pivotal resistance means and rotatably movable against the resistance of said pivotal resistance means, said second end of said pivot arm means extending from said pivotal resistance means; and gripping means associated with said second end of said pivot arm means; whereby, when a user positions an elbow in said means for receiving and securing the elbow, and holds said gripping means with the lower arm of the user positioned at about 90° from the upper arm of the user, and then rotates said pivot arm, the head of the humerus is substantially isolated in the glenoid cavity during internal and external rotation, and the inner rotator cuff musdes and the outer rotator cuff musdes of the user being exercised and strengthened.

SUBSTITUTE SH-rfrr

14. The exercise device of claim 13 in which said a floor stand is provided and in which said exercise device is removably mounted for use on said floor stand.

15. The method of operating the portable exercise device of claim 13 in which: said frame is placed on the back of a user; said adjusting means are adjusted so that said upper cross member is mounted adjacent to and at about the level of the shoulders with said right end and said left end of said upper cross member extending laterally beyond the body of the user and adjacent to the shoulders the user; adjusting said mounting means at said bottom of each upper arm means for both the length of the upper arms of the user, and to accommodate the direction of orientation and the angle of said upper arm means to said frame; positioning the elbows of the user in said means for holding the elbows; positioning the lower arms of the user in said means for guiding the lower arm of a user at about a 90° angle to the upper arm; adjusting the lateral position of said handgrips along the length of said pivot arms to receive the hands of the user; grasping said handgrips with the hands of the user; and then with the upper arms of the device and of the user at a desired angle, from about 0° to about 130°, rotating one or both pivot arms inwardly or outwardly against the resistance of the pivotal resistance device, thereby exercising the internal and external rotator cuff musdes, while isolating the heads of the humerus.

16. The method of operating the portable exercise device of claim 5 in which: said frame and said means for positioning and adjusting said frame are placed on the body of a user; said means for positioning and adjusting said frame are adjusted so that said frame is mounted adjacent to the front of the midsection of a user at about the level of the elbows of the user, with said right end and said left end of said frame extending laterally beyond the body of the user and adjacent to the elbows of the user; positioning the elbows of the user in said means for holding the elbows; positioning the lower arms of the user in said means for guiding the lower arm of a user at about a 90° angle to the upper arm; adjusting the lateral position of the handgrips along the length of the pivot arms to receive the hands of the user; grasping the handgrips with the hands of the user; and then rotating one or both pivot arms inwardly or outwardly against the resistance of the pivotal resistance device, thereby exercising the internal and external rotator cuff musdes, while isolating the heads of the humerus.

SUBSTITUTE SHEET

17. A method of exercising the rotator cuff musdes, which indudes the steps of: fixing the upper heads of the ulna and radius bones of the lower arm of a user at the point where they join to form the elbow, fixing the scapula associated with the fixed elbow against movement; and then moving the lower arm internally and externally against resistance at about a 90° angle to the upper arm, thereby causing the associated humerus bone, and the upper head of the humerus bone within the glenoid cavity to be substantially isolated for movement, so that substantially all of the force of the internal and external rotator cuff musdes is isolated as internal and external turning force, and compensatory movement patterns and the use of larger musde groups is minimized, with the result that both the internal and external rotator cuff musdes are strengthened, thereby providing balance and antagonistic musde harmony between the internal and external rotator cuff musde groups.

SUBSTITUTE SHEET