If shoulder pain is getting in the way of your arm workouts at the gym or just making day-to-day activities more difficult, you're not alone: Between seven and 25 percent of people will experience a rotator cuff tear each year, making it the most common cause of shoulder pain, according to a 2016 study in the journal Trauma.
While this type of injury doesn't always cause pain, in some instances, it can significantly affect your daily life. Fortunately, there are several steps you can take to remedy this issue, including rotator cuff injury exercises and stretches to increase your range of motion and decrease pain.
What Is a Rotator Cuff Injury?
Your rotator cuff is comprised of four muscles that surround or "cuff" the ball portion (called the humeral head) of the ball-and-socket shoulder joint. These muscles, which include the infraspinatus, supraspinatus, teres minor and subscapularis, provide the stability necessary to keep your upper arm in its socket as it moves around during the day.
In the case of a rotator cuff injury, fraying or tearing can occur along a portion of one or more of these muscles. While a traumatic event like a fall can cause this issue, according to the Mayo Clinic, rotator cuff tears most commonly occur as a result of wear and tear in the shoulder joint over time. Older individuals and those who frequently perform repetitive overhead tasks are at a higher risk.
What to Do After a Rotator Cuff Injury
Rotator cuff injuries can lead to a variety of symptoms, including shoulder pain, weakness or difficulty lifting the arm and restricted range of motion, according to the American Society for Surgery of the Hand. Feelings of catching, locking or instability in the joint can also occur.
Immediately after your shoulder injury, it's important to rest your arm and stop any activity that's painful or aggravating. This may help prevent further damage to the cuff muscles. In addition, you can apply ice to your shoulder to relieve soreness and inflammation.
If your symptoms aren't improving, it's a good idea to consult with your doctor who may temporarily suggest taking over-the-counter or prescription medication to help relieve your pain. A cortisone injection to the shoulder joint may also be recommended, though this can lead to further breakdown of your tendons and should be used sparingly, according to the Mayo Clinic.
Why Is It Important to Strengthen Your Rotator Cuff?
In addition to the early measures above, strengthening the shoulder muscles can also be beneficial in preventing a rotator cuff injury as well as helping with the recovery process, according to a 2016 study in the Annals of Rehabilitative Medicine.
Gentle rotator cuff exercises, designed to improve your shoulder's mobility and increase strength in the injured muscle and the ones around it, can help improve your arm's range of motion and decrease pain. With time, a proper strengthening regimen can help you return to your normal activities and start feeling like yourself again.
Rotator Cuff Exercises and Stretches
Once your acute pain begins to subside, you may be ready to start a light shoulder workout. If you're unsure, err on the side of caution and double check with your doctor or physical therapist before starting any rotator cuff exercises.
Try three sets of 10 to 15 repetitions of each of the following exercises twice per day to help resolve your rotator cuff injury symptoms. Remember to go slowly and to avoid forcing into painful motions. As you progress, you can incorporate these into your workout warm-up.
The pendulum exercise, also referred to as the Codman's technique, is an easy initial way to get your arm moving after a rotator cuff injury.
- Bend forward at the waist and support yourself against a counter with your healthy arm. Let your injured arm hang toward the ground.
- Slowly shift your weight from side to side and allow your body's momentum to move your arm back and forth (like a pendulum). Remember, it's the side to side trunk movement — not the muscles in your shoulder — that cause the motion.
- As it gets easier, you can also move your body and shoulder forward and backward as well as in clockwise and counter-clockwise circles.
Active Assisted Elevation
Active assisted elevation uses your non-injured arm to help the muscles in the injured rotator cuff get moving again.
- Lie on your back and clasp your hands together at your waist.
- Slowly lift both arms up toward the ceiling and over your head.
- When you're unable to go any higher without causing pain, pause for a second or two before lowering back to your abdomen.
At first, you may need to do most of the work with the uninvolved arm. As the technique gets easier, however, try to do more and more of the lifting with the injured side.
Side-Lying External Rotation
A 2016 study in BMC Musculoskeletal Disorders found that strengthening regimens that included this side-lying external rotation exercise were helpful in enhancing shoulder function and overall quality of life of people who sustained a rotator cuff tear.
- Lie on your side with your bottom arm supporting you and your top elbow bent at a 90-degree angle, with your upper arm along your side and your palm resting against your stomach.
- Move your shoulder blade down and back like you're trying to tuck it into your back pocket.
- Lift your palm up and away from your abdomen without allowing your elbow to leave the side of your body. Go as far as you can without pain.
- After holding this position for a second or two, slowly return to the initial position.
- Stand facing a wall with the hand of your injured arm against it and a towel under your palm to decrease the friction.
- Raise your arm and push the towel up the wall with a moderate amount of force.
- Go as high as you can without causing pain or shrugging your shoulder and hold the position for five seconds.
- Slide your palm back down the wall without losing your pressure against the towel.
If your rotator cuff injury was caused by a trauma or if symptoms don't improve, it's important to see your doctor. While the exercises detailed above can be helpful, waiting too long to speak to a physician can limit your surgical options should this become necessary. Your health care professional can work with you to develop the best course of treatment for your shoulder.
- Trauma: Rotator Cuff Tears: Review of Epidemiology, Clinical Assessment and Operative Treatment
- American Academy of Orthopedic Surgeons: Rotator Cuff Tears
- Mayo Clinic: Rotator Cuff Injury: Symptoms and Causes
- American Society for Surgery of the Hand: Rotator Cuff Injuries
- Mayo Clinic: Rotator Cuff Injury: Diagnosis and Treatment
- Annals of Rehabilitation Medicine: Clinical Outcomes of Conservative Treatment and Arthroscopic Repair of Rotator Cuff Tears: A Retrospective Observational Study
- International Journal of Sports Physical Therapy: Exercise Rehabilitation in the Non-Operative Management of Rotator Cuff Tears: A Review of the Literature
- BMC Musculoskeletal Disorders: Enhanced Function and Quality of Life Following 5 Months of Exercise Therapy for Patients with Irreparable Rotator Cuff Tears – An Intervention Study
- University of Kentucky: A Literature Review of Studies Evaluating Rotator Cuff Activation during Early Rehabilitation Exercises for Post-Op Rotator Cuff Repair
- Operative Techniques in Orthopaedics: Natural History of Rotator Cuff Disease and Implications on Management