When discussing shoulder pain and injury in sports and everyday life, you often hear the term “rotator cuff.” This group of muscles and connective tissues is a common source of shoulder problems for athletes and weekend warriors alike.
More common in sports and jobs that require repetitive hand movements (eg, baseball, tennis, carpentry) as well as with People over 40, rotator cuff pain can make exercise and daily activity—even sleep—uncomfortable, if not impossible. Associated shoulder discomfort usually takes the form of a dull ache.
If you are experiencing shoulder pain, your best course of action is to seek help from a healthcare professional. But for those looking to increase strength and mobility, rotator cuff exercises can help relieve or prevent some symptoms.
What is a Rotator Cuff?
The rotator cuff is a group of muscles and tendons that help secure the shoulder joint, says Erika Mundinger, DPT, a physical therapist in Minneapolis, Minnesota. These muscles include:
- Hyperspinal
- Infraspinatus
- Teres minor
- Subscapularis
Located in the shoulder blade, their broad, flat tendons wrap around the ball of your shoulder’s glenohumeral joint, the ball-and-socket joint that is among the most mobile in your body. This joint is part of a larger group of four joints often referred to as the “shoulder complex”:
- sternoclavicular joint: Also known as the “SC”, it is located between the sternum and the collarbone.
- Acromioclavicular joint: “AC” is the bony joint at the top of the shoulder.
- glenohumeral joint: The ball and socket joint most commonly associated with the shoulder.
- Thoracic joint: This is where the shoulder blade sits on the back of the ribcage.
Causes of rotator cuff injury
All four shoulder joints move together — you can’t affect one without affecting the others. If you injure one joint or the shoulder muscles surrounding it are weak, it will change how you use the other three joints. This can lead to poor movement patterns, muscle imbalances and — ultimately — pain and possible injury.
“Muscle imbalances are what we’re referring to when we talk about overuse injuries like tendinitis,” says Mundinger. And the muscles most commonly affected by shoulder overuse injuries are—you guessed it—the rotator cuff muscles.
When shoulder mechanics change—whether due to muscle weakness, injury, poor posture, or abnormal movement patterns—the rotator cuff muscles can become overused, resulting in irritation and inflammation (also known as tendinitis or shoulder impingement). In this condition, the position of the joint can change and the tendons can be compressed between the ball and the scapula.
“The longer this happens, the angrier and more painful they become, and the weaker they become as a result,” says Mundinger. From there, weak rotator cuff muscles can then compromise the stability of the glenohumeral joint.
Rotator cuff strengthening exercises
You can keep your shoulders healthy and pain-resistant by performing regular rotator cuff strengthening exercises.
Rotator cuff exercises can also improve posture and stability, but “keep in mind that strengthening the rotator cuff is [only] a part of the movement equation,” he says Cody BrownCSCS As he notes, you also need to increase shoulder mobility so your joints can move through their full range of motion.
To build much-needed strength and mobility in and around the shoulder joint, Mundinger recommends doing the following five moves. Once a day if possible.
1. Foam roller snow angels
- Lie on the floor with a foam roller placed lengthwise under your spine. Your knees should be bent, your feet flat on the floor and your hands resting on the floor beside you, palms up.
- Keeping the backs of your hands on the floor, extend both arms out to the sides and bring them as far as you can without arching your back or raising your shoulders. Then sweep both arms out to the sides and down toward your hips.
- Continue wiping your hands like you’re making a snow angel for a total of 10 reps.
2. Prone retraction of the scapula
- Lie face down on the floor with your arms at your sides, palms up. You may want to rest your forehead on a folded towel.
- Gently bring your shoulder blades straight back and squeeze them together. Hold for two to three seconds and slowly release your shoulder blades to return to the starting position.
- Repeat for three sets of 10 repetitions, making sure not to shrug at any point.
3. Wall angels
- Stand tall with your back against a wall and gently press your lower back into the wall to neutralize your spine.
- Raise both arms out to the sides and bend your elbows 90 degrees, keeping your back, elbows and the backs of your hands in contact with the wall
- Without raising your shoulders or arching your lower back, slowly slide your arms up. Don’t worry if you can’t move them very far at first.
- Once you’ve raised your arms as far as you can without causing pain, lower them back to the starting position.
- Repeat for a total of 10 reps.
4. Shoulder external rotation to 45 degrees of abduction
- Stand tall and raise your arms out to the sides 45 degrees from your body. Bend your elbows 90 degrees.
- Keeping your core engaged and your elbows locked in place, externally rotate your arms, bringing your forearms back as if you’re trying to touch a wall behind you. Then rotate your arms inward.
- Repeat for three sets of 10 repetitions, rotating your forearms only as far as is comfortable and avoiding raising your shoulders.
5. Plank with retraction/retraction of the scapula
- Get into a standard push-up position, with your feet together, your body straight from head to heels, your arms straight and your hands under your shoulders.
- Keeping your back flat, head neutral, and core engaged, straighten your shoulders, pressing through your hands to open your shoulder blades.
- Slowly return to the starting position. Then draw your shoulders back, letting your chest sink to meet your shoulder blades. This is a representative.
- Repeat for three sets of 10 repetitions without raising your shoulders during the exercise.
