Exercises for Rotator Cuff Strain
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Rotator cuff strengthening exercises as well as mobility and stretching exercises should form an integral part of a rotator cuff strain rehabilitation program.
Outlined below are a number of exercises specifically for rotator cuff rehabilitation. Depending on how bad the injury is will determine when they can begin and how fast the patient will progress.
Mobility exercises should begin as soon as pain allows. The aim is to restore full mobility to the shoulder joint. In some patients mobility could already be good depending on how bad their injury is.
Mobility should be done at least once a day and sometimes 2 or 3 times per days is recommended. Pendulum exercises are the starting point for most severe shoulder injuries and unless you have particularly bad strain then you would be expected to move onto pole or wand type exercises soon.
The aim of pendulum exercises is to increase mobility in the shoulder joint. If your injury was mild and the shoulder has not been immobile for very long then it is likely you will skip through these exercises relatively quickly and move onto more suitable flexibility and stretching exercises.
- Gently swing the in a circular motion whilst lying on your front or leaning forwards (as shown).
- Gradually increase the size of the circle to increase the range of motion. Try to relax the arm and use the momentum of the swing.
- It is important that range of motion exercises are done as early as possible and frequently to prevent the shoulder tightening up again.
- Use a long object such as a broom handle.
- Hold it in each hand, wider than shoulder width.
- Use the good arm to move the injured shoulder.
- Lift it as high as you can comfortably manage, stop if it is painful.
- Try to relax the injured arm so it is not working.
- Repeat several times a day, trying to gradually increase the range.
Stretching exercises move on from mobility and should be done as soon as pain allows. It is likely that if you have suffered a rotator cuff strain then the muscle involved may have gone into spasm or shortened and will need stretching. Try to find the stretching exercises which feel like they are working and perform them regularly throughout the day.
Front of shoulder against a wall
- Place one forearm against a fixed point (such as a doorway), with the elbow and shoulder at 90 degrees.
- Gently turn your body away to stretch the front of the shoulder and chest.
- Again, hold the position for 20 seconds and repeat 3 times.
- The athlete should feel a gentle stretch in the front of the shoulder but not pain.
Back of the shoulder stretch
- Place one arm across your chest and pull it in tight with the other.
- The athlete should feel a gentle stretch at the back of the shoulder.
- Again, hold the position for 20 seconds and repeat 3 times.
- The athlete should feel a gentle stretch in the back of the shoulder but not pain.
See more shoulder stretching exercises >>
Muscle energy technique
- The therapist will rotate the shoulder as far as it will go (without pain) one way (usually either medial or lateral rotation).
- They will then ask the patient to push against them (in this case in the direction of the white arrow) at about 20% of their maximum force
- This contraction is held for 10 seconds
- The patient then relaxes, as the therapist gently applies more force to increase the range of motion.
- This is held for another 20-30 seconds, before the process is repeated 3-5 times.
Isometric strengthening exercises
Static (or isometric) exercises are some of the first torn rotator cuff exercises to be done as they do not involve any movement. The patient pushes against a stationary object such as a wall, doorframe, or resistance provided by another person.
Because there is no movement, static exercises can be performed soon after injury, usually within 3-7 days, provided they are pain-free. If any exercises are painful, then do not continue with them. Rest for a longer period until they are comfortable.
- Push against the wall, start off gently, (e.g. about 50% max) and gradually increase the intensity.
- Keep the shoulder and upper arm still. Aim to hold the position for 10 seconds, relax for three seconds and contract again for 10 seconds.
- The duration of hold and number of repetitions can be increased until the athlete feels confident enough to move onto dynamic exercises.
- Stand facing the corner of the wall, with the palm and lower forearm against the wall (the other side from the photo opposite).
- Push against the wall, as if trying to rotate the forearm towards the body, keep the shoulder and upper arm still.
- Again, start off at 50% for 10 seconds, repeated twice.
- Gradually increase the intensity, duration and repetitions.
- Stand side-on to a wall, with the elbow bent and side of the forearm against the wall.
- Push outwards, against the wall, as it trying to lift the arm above the head.
- Start at 50%, hold for 10 seconds and repeat twice.
- Gradually increase as above.
These involve movement and can be done with resistance band or dumbelle weights. They can be performed in many different positions and can easily be progressed as your strength improves. These exercises can replace the static exercises (above) as soon as pain allows (usually 7 days plus).
Lateral rotation in standing
- Uses a resistance band to work the lateral rotator muscles in the shoulder.
- Attach a band to a fixed point and keeping the elbow close into the body rotate the shoulder so the arm moves outwards.
- Move through as large a range of motion as comfortable.
- This should be felt at the back of the shoulder after a few repetitions.
Lateral rotation in prone
- The athlete lies on their front with the arm out to the side.
- The dumbelle is lifted as the shoulder rotates upwards.
- Try to go through as large a range of motion as possible.
Lateral rotation in abduction
- The athlete stands holding the band with the elbow abducted in 90 degrees.
- The athlete elevates the arm, ensuring the elbow is also elevated.
- The shoulder is maintained at 90 degree abduction without horizontal adduction or abduction.
Standing 90/90 external rotation
- The resistance band is anchored in front and the other end is held in the hand, with the arm raised and elbow bent as shown.
- The athlete rotates the arm so that the fist points upwards.
- They then slowly return to the starting position and repeat.
Internal rotation in standing
- Start with the band attached to a fixed point to your side.
- Hold other end of the band in one hand, with the elbow bent and upper arm by your side.
- Keeping the elbow by your side, move your hand towards your stomach as far as is comfortable.
- Slowly return to the starting position.
Standing 90/90 internal rotation
- The athlete rotates the arm so that the forearm moves forwards, to a horizontal position.
- They then slowly return to the starting position.
- As strength develops the supporting hand can be removed.
Dozens of other shoulder rehabilitation exercises including functional shoulder exercises can be viewed in our shoulder rehabilitation exercise section.