When shoulder pain and injury in sports and everyday life is discussed, you often hear the term “rotator cuff.” This group of muscles and connective tissues is a common source of shoulder trouble for athletes and weekend warriors alike.
Most common in sports and jobs that require repetitive arm motion (e.g., baseball, tennis, carpentry) as well as with people over 40, rotator cuff pain can make exercise and daily activity — even sleeping — uncomfortable, if not impossible. Associated discomfort in the shoulder most often takes the form of a dull ache.
If you’re experiencing shoulder pain, your best course of action is to seek help from a health care professional. But for those looking to increase strength and mobility, rotator cuff exercises can help alleviate or prevent some symptoms.
What Is the Rotator Cuff?
The rotator cuff is a group of muscles and tendons that helps secure the shoulder joint, says Erika Mundinger, D.P.T., a physical therapist in Minneapolis, Minnesota. Those muscles include:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
Located on the shoulder blade, their wide, flat tendons wrap around the ball of your shoulder’s glenohumeral joint, the ball-and-socket joint that’s among the most mobile in your body. That 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’s located between the sternum and the clavicle.
- Acromioclavicular joint: The “AC” is the bony joint on the top of the shoulder.
- Glenohumeral joint: The ball-and-socket joint most commonly associated with the shoulder.
- Scapulothoracic joint: This is where the shoulder blade sits on the back of the ribcage.
Rotator Cuff Injury Causes
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, that 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 refer to when we talk about overuse injuries, like tendinitis,” Mundinger says. And the muscles most commonly affected by overuse injuries in the shoulder are — you guessed it — the rotator cuff muscles.
When shoulder mechanics change — whether by muscle weakness, injury, poor posture, or unnatural movement patterns — rotator cuff muscles can suffer overuse, resulting in irritation and inflammation (aka tendinitis or shoulder impingement). In this state, joint positioning can be altered and tendons can get compressed between the ball and shoulder blade.
“The more this happens, the more angry and painful they become, and the weaker they get as a result,” Mundinger says. From there, weak rotator cuff muscles can then compromise stability of the glenohumeral joint.
Rotator Cuff Strengthening Exercises
You can keep your shoulders healthy and pain resistant by performing regular exercises to strengthen the rotator cuff.
Rotator cuff exercises can also improve posture and stability, but “keep in mind that strengthening the rotator cuff is [only] one part of the movement equation,” says Cody Braun, C.S.C.S. As he notes, you must also 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 performing the following five moves. Once a day, if possible.
1. Snow angels on foam roller
- Lie on the floor with a foam roller positioned lengthwise under your spine. Your knees should be bent, your feet flat on the floor, and your arms resting on the floor beside you, palms facing up.
- Keeping the backs of your hands on the floor, extend both arms out to the sides and bring them as far overhead as you can without arching your back or shrugging your shoulders. Then, sweep both arms out to the side and down toward your hips.
- Continue sweeping your arms as if making a snow angel for a total of 10 reps.
2. Prone scapular retraction
- Lie face-down on the floor with your arms at your sides, palms facing up. You may want to support 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 reps, making sure not to shrug your shoulders 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 your sides, and bend your elbows 90 degrees, keeping your back, elbows, and the backs of your hands in contact with the wall
- Without shrugging your shoulders or arching your lower back, slowly slide your arms upward. 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 in 45-degree 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 them to a wall behind you. Then, rotate your arms inward.
- Repeat for three sets of 10 reps, rotating your forearms only as far as is comfortable and avoiding shrugging your shoulders.
5. Plank with scapular protraction/retraction
- Assume 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, your head neutral, and your core engaged, protract your shoulders, pushing through your hands to spread your shoulder blades apart.
- Slowly return to the starting position. Then, retract your shoulders, letting your chest dip to bring your shoulder blades together. That’s one rep.
- Repeat for three sets of 10 reps without shrugging your shoulders during the exercise.