As someone who has had to start from scratch when it comes to building up shoulder strength and stability after shoulder surgery, I know first hand how frustrating a weak, painful and unstable shoulder can be. Luckily for you, I've been through the good, the bad and the ugly exercises; both myself and with the patients in my clinic, and I've come up with my favourite 7 exercises to help you strengthen your rotator cuff muscles to fight shoulder pain forever. The majority of them also involve a resistance band, which means you handily take it with you and do them where you are! Rotator cuff pain can be painful so it can be beneficial to either treat it early, or aim to prevent it all together. The rotator cuff tendons in the shoulder joint can easily become over worked if they aren't conditioned well, so performing controlled shoulder movements that require them to be activated can be great for improving the health of your shoulder girdle and reducing the risk of shoulder injuries like rotator cuff tendinitis or rotator cuff impingement.
Firstly, it's important to have your shoulder assessed by a physical therapist or health care provider if you are currently experiencing shoulder pain or a rotator cuff injury before starting any kind of exercise program. A rotator cuff tear can usually be managed with exercise, but it's important to have yours looked at first just to be sure it's safe to start with strengthening exercises. However if you're not in pain, you just want to but up the strength of your shoulder muscles... then it's time to crack on!
Before we start, I'll just give you a quick overview of the rotator cuff muscles themselves. I'm sure you've heard of them if you've already done some Google'ing and found your way here.. but do you know what the term actually means?
What is the rotator cuff?
The rotator cuff is a group of muscles within shoulder, quietly playing a crucial role in its stability and mobility. Comprising a group of four muscles and their tendons—supraspinatus, infraspinatus, teres minor, and subscapularis—the rotator cuff forms a cuff-like structure around the shoulder joint. This dynamic team works harmoniously to facilitate various arm movements and maintain the integrity of the shoulder complex. Whether you're reaching for the top shelf or throwing a perfect pitch, the rotator cuff is there, providing the necessary support and control. Despite its relatively low profile, the rotator cuff's significance becomes glaringly apparent when injury strikes, causing discomfort and hindering the smooth functioning of the shoulder. Proper care and attention to this often-overlooked group of muscles are essential for preserving shoulder health and ensuring a full range of pain-free motion. A rotator cuff problem usually leads to ongoing issues with pain, posture and a lack of stability within the joint. It's like the seat belt of your shoulder.
Should you stretch or strengthen your shoulder?
A common question, not just around the shoulder but generally speaking. My personal approach to this is that strengthening a structure should always be the first option, if safe to do so. Stretching exercises are good to increase the range of movement available at a muscle in the short term which allows us more movement to strengthen in a wider range, but over time it will return to the length it was before you stretched. Whereas if you build up strength in a muscle, over time it becomes much more able to adapt and cope with the demands it's being put under. So using the bicep as an example; if you are doing some daily activities like carrying heavy objects, your bicep might become tight at the end of the day. Stretching and performing range of motion exercises will give you some short term relief but if you did the same amount of lifting and carrying the following week, you are likely going to be just as "stiff" again. Whereas if you built up the strength of your bicep to be able to cope with the weight of what you are carrying, you'll find it muscle easier and will be less likely to suffer from DOMS (delayed onset muscle soreness).
I would nearly always prefer to strengthen... Although increasing mobility is sometimes beneficial too.
The 7 best rotator cuff exercises
So, what is best to strengthen the rotator cuff? Here are my 7 favourite rotator cuff exercises, and the ones of found most helpful during my 12 month recovery from shoulder surgery.
External Rotation with Resistance Band:
- Attach a resistance band to a fixed point at elbow height as a starting position.
- Stand with the band in the hand of your injured arm, keeping your elbow at a 90-degree angle.
- Rotate your forearm outward against the resistance, engaging the external rotator muscles.
- Perform 2-3 sets of 10-15 repetitions on each arm.
Internal Rotation with Resistance Band:
- Similar to external rotation, attach the band at waist level.
- Stand with the band in the hand of your uninjured arm, elbow bent at 90 degrees.
- Rotate your forearm inward against the resistance, targeting the internal rotators.
- Complete 2-3 sets of 10-15 reps for each arm.
Prone Shoulder External Rotation:
- Lie on your stomach on a flat surface with a light dumbbell in your hand at shoulder height.
- Keep your elbow at a 90-degree angle and lift the weight by externally rotating your shoulder.
- Lower the dumbbell with control. Aim for 2-3 sets of 12-15 repetitions with a fairly light weight.
Side-Lying External Rotation:
- Lie on your side with a light dumbbell in your hand, elbow bent at 90 degrees.
- Lift the weight upward by externally rotating your shoulder.
- Lower it slowly. Perform 2-3 sets of 12-15 reps on each side.
Y-T-W-L Shoulder Exercises:
- Lie face down on an incline bench, holding light dumbbells in each hand.
- Form the letters Y, T, W, and L with your arms, engaging different parts of the rotator cuff.
- Aim for 2 sets of 10 repetitions for each letter.
- Sit or stand with a resistance band anchored in front of you as a start position.
- Hold the band with both hands, arms extended, and pull your shoulder blades together.
- Focus on squeezing the shoulder blades. Do 2-3 sets of 15-20 reps.
Rotator Cuff Isometrics:
- Stand or sit with your elbow at a 90-degree angle, forearm against a fixed surface like a door frame.
- Press your forearm into the surface, engaging the rotator cuff isometrically.
- Hold for 10-15 seconds, and repeat for 2-3 sets on each arm.
Remember, start with lighter resistance and gradually progress as your strength improves. Always prioritise proper form and consult with a healthcare professional or fitness expert if you have any concerns or existing rotator cuff injuries. If you do experience pain when performing any of the exercises above, reduce the resistance or reps until you feel comfortable. You do not need much load for the small muscles to begin to work. It's much better to start with light exercises but use higher reps until progressing to heavier weights or stronger resistance bands.
Top tip: if you have one weaker shoulder, complete the exercises to either failure or until you begin to fatigue, then match the reps with your unaffected arm. This way, your weaker or injured rotator cuff will begin to catch up in terms of strength and endurance gains, while your stronger side will maintain where it is current at. This avoids muscular imbalances becoming more obvious. Once you have reduced any imbalance, you can start progressing them gradually.
Using these exercises can be not only great for recovering from rotator cuff surgery but can be fantastic for the prevention of a shoulder injury. Conditions like shoulder tendonitis can be frustrating and painful so avoiding them through exercise can be a good idea. Because they are small and little is known about them in the majority of people, the significance of the rotator cuff muscles becomes clear when injury or weakness compromises daily activities that rely on a fully functioning shoulder. Strengthening the rotator cuff is not merely a fitness luxury but a necessity, as it enhances stability, prevents injuries, and fosters a full range of pain-free motion. Whether you're an athlete aiming for peak performance or an individual navigating the demands of everyday life, investing time in targeted rotator cuff exercises is a proactive step toward maintaining a resilient and agile shoulder complex. The old saying "an ounce of prevention is worth a pound of cure" holds true here—cultivating rotator cuff strength is a small investment that pays off in spades when it comes to preserving the vitality and longevity of your shoulders.
I probably neglected my rotator cuff for way too long, which might be to blame for my need for shoulder surgery! But one thing is for sure now... I will certainly carry on strengthening them regular to avoid any issues in the future!