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Rotator cuff exercises

Shoulder exercises

The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its joint and help the shoulder joint to move in a coordinated and pain-free way. The tendons can be torn from overuse, injury, or wearing away over time.

Exercises can help strengthen the rotator cuff muscles and tendons to relieve your symptoms.

Your Shoulder Joint

The tendons of the rotator cuff pass underneath a bony area on their way to attaching to the top of the arm bone. These tendons join together to form a cuff that surrounds the shoulder joint. This helps keep the joint stable and allows the arm bone to move on the shoulder bone.

Injury to these tendons may result in:

  • Rotator cuff tendinitis, which is irritation and swelling of these tendons
  • A rotator cuff tear, which occurs when one of the tendons is torn due to overuse or injury

These injuries often lead to pain, weakness, and stiffness when you use your shoulder. A key part in your recovery is doing exercises to make the muscles and tendons in your joint stronger and more flexible.

Your health care provider may refer you to a physical therapist to treat your rotator cuff. A physical therapist is trained to help improve your ability to do the activities you want.

Evaluating Your Shoulder

Before treating you, a provider or therapist will evaluate your body mechanics. The therapist may:

  • Watch how your shoulder moves as you perform activities, including your shoulder joint and your shoulder blade
  • Observe your spine and posture as you stand or sit
  • Check the range of motion of your shoulder joint and spine
  • Test different muscles for weakness or stiffness
  • Check to see which movements seem to cause or worsen your pain

After testing and examining you, your provider or physical therapist will know which muscles are weak or too tight. You will then start a program to stretch your muscles and make them stronger.

Exercises for Your Shoulder

The goal is for you to function as well as possible with little or no pain. To do this, your physical therapist will:

  • Help you strengthen and stretch the muscles around your shoulder and shoulder blade to improve shoulder movement
  • Teach you proper ways to move your shoulder, for everyday tasks or sports activities
  • Teach you correct shoulder posture

Before doing exercises at home, ask your provider or physical therapist to make sure you are doing them properly. If you have pain during or after an exercise, you may need to change the way you are doing the exercise or lower the resistance.

Most exercises for your shoulder either stretch or strengthen the muscles and tendons around your shoulder joint.

Exercises to stretch your shoulder include:

Exercises to strengthen your shoulder:

References

Finnoff JT, Johnson W. Upper limb pain and dysfunction. In: Cifu DX, ed. Braddom's Physical Medicine and Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 35.

Mosich GM, Yamaguchi KT, Petrigliano FA. Rotator cuff and impingement lesions. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 47.

  • Rotator cuff problems

    Animation

  •  

    Rotator cuff problems - Animation

    Feeling pain in your shoulder when you lift your arm over your head may mean you have a have a problem with your rotator cuff. So, what causes rotator cuff problems? The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keeps it stable. Pain in your rotator cuff area usually means you have rotator cuff tendinitis, or inflammation of these tendons and inflammation of the bursa, smooth slippery sacs the tendons glide across; or a rotator cuff tear, when one the tendons is torn from overuse or injury. Rotator cuff tendinitis may be due to keeping your arm in the same position for long periods of time, such as doing computer work or hairstyling. Sleeping on the same arm each night can also cause this problem. You can also get tendinitis playing sports that require you to move your arm over your head repeatedly, such as in tennis, baseball especially pitching, swimming, and weight-lifting. Rotator cuff tears may happen if you fall on your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. Chronic tears occur slowly over time, particularly in people who have chronic tendinitis. At some point, the tendon wears down and starts to tear. If you have tendinitis, you'll have pain when you lift your arm over your head, such as when you brush your hair and reach for objects on shelves. The pain may be mild at first, but over time you may have pain at rest or at night, especially when you lie on your shoulder. The pain of a sudden rotator cuff tear can be intense. Your shoulder may be weak, and you may hear a snapping sound when you move your shoulder. Chronic symptoms include a gradual worsening of pain, weakness, stiffness or loss of motion. Most people with rotator cuff tears have worse pain at night and when they wake up. To treat your rotator cuff problem, your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. X-rays may show a bone spur, a bony projection. If your doctor thinks you have a tear, you may have an ultrasound or MRI. Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like ibuprofen may help reduce swelling and inflammation. Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff, which may help relieve the pressure on your tendons. Someone with a partial rotator cuff tear can try rest and exercise, if they don't normally put a lot of demand on their shoulder. But if there's a complete tear, or if the symptoms don't improve with therapy, you may need surgery to repair the tendon. But with rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.

  • Anterior shoulder stretch - illustration

    The anterior shoulder stretch is an exercise that stretches the anterior, or front, part of your shoulder.

    Anterior shoulder stretch

    illustration

  • Arm reach - illustration

    The arm reach is an exercise that strengthens the muscles that hold your should blade (scapula).

    Arm reach

    illustration

  • External rotation with band - illustration

    External rotation with a band is an exercise that strengthens or tones the muscles that help rotate your shoulder outward, or away from your body.

    External rotation with band

    illustration

  • Internal rotation with band - illustration

    Internal rotation with a band is an exercise that strengthens or tones the muscles that help rotate your shoulder inward, or towards your body.

    Internal rotation with band

    illustration

  • Isometric - illustration

    Isometric shoulder exercises strengthen and tone the muscles in your shoulder.

    Isometric

    illustration

  • Pendulum exercise - illustration

    The pendulum exercise stretches the joint capsule of your shoulder joint to keep it from getting stiff. Avoid this exercise if you have back pain.

    Pendulum exercise

    illustration

  • Shoulder blade retraction with tubing - illustration

    The shoulder blade retraction with tubing exercise stretches the muscles that hold your shoulder blade (scapula).

    Shoulder blade retraction with tubing

    illustration

  • Shoulder blade retraction - illustration

    The shoulder blade retraction with no tubing exercise stretches the muscles that hold your shoulder blade (scapula).

    Shoulder blade retraction

    illustration

  • Stretching back of your shoulder - illustration

    Stretching the back of your shoulder is an exercise that stretches the back part of your injured shoulder joint.

    Stretching back of your shoulder

    illustration

  • Up the back stretch - illustration

    The hand up your back stretch is an exercise that stretches the anterior, or front, part of your shoulder.

    Up the back stretch

    illustration

  • Wall push-up - illustration

    Wall push-ups are exercises that stretch the muscles and joint capsule of your shoulder joint.

    Wall push-up

    illustration

  • Wall stretch - illustration

    Wall stretches are exercises that help make your injured shoulder joint more flexible.

    Wall stretch

    illustration

  • Rotator cuff problems

    Animation

  •  

    Rotator cuff problems - Animation

    Feeling pain in your shoulder when you lift your arm over your head may mean you have a have a problem with your rotator cuff. So, what causes rotator cuff problems? The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keeps it stable. Pain in your rotator cuff area usually means you have rotator cuff tendinitis, or inflammation of these tendons and inflammation of the bursa, smooth slippery sacs the tendons glide across; or a rotator cuff tear, when one the tendons is torn from overuse or injury. Rotator cuff tendinitis may be due to keeping your arm in the same position for long periods of time, such as doing computer work or hairstyling. Sleeping on the same arm each night can also cause this problem. You can also get tendinitis playing sports that require you to move your arm over your head repeatedly, such as in tennis, baseball especially pitching, swimming, and weight-lifting. Rotator cuff tears may happen if you fall on your arm while it is stretched out, or after a sudden, jerking motion when trying to lift something heavy. Chronic tears occur slowly over time, particularly in people who have chronic tendinitis. At some point, the tendon wears down and starts to tear. If you have tendinitis, you'll have pain when you lift your arm over your head, such as when you brush your hair and reach for objects on shelves. The pain may be mild at first, but over time you may have pain at rest or at night, especially when you lie on your shoulder. The pain of a sudden rotator cuff tear can be intense. Your shoulder may be weak, and you may hear a snapping sound when you move your shoulder. Chronic symptoms include a gradual worsening of pain, weakness, stiffness or loss of motion. Most people with rotator cuff tears have worse pain at night and when they wake up. To treat your rotator cuff problem, your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. X-rays may show a bone spur, a bony projection. If your doctor thinks you have a tear, you may have an ultrasound or MRI. Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like ibuprofen may help reduce swelling and inflammation. Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff, which may help relieve the pressure on your tendons. Someone with a partial rotator cuff tear can try rest and exercise, if they don't normally put a lot of demand on their shoulder. But if there's a complete tear, or if the symptoms don't improve with therapy, you may need surgery to repair the tendon. But with rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.

  • Anterior shoulder stretch - illustration

    The anterior shoulder stretch is an exercise that stretches the anterior, or front, part of your shoulder.

    Anterior shoulder stretch

    illustration

  • Arm reach - illustration

    The arm reach is an exercise that strengthens the muscles that hold your should blade (scapula).

    Arm reach

    illustration

  • External rotation with band - illustration

    External rotation with a band is an exercise that strengthens or tones the muscles that help rotate your shoulder outward, or away from your body.

    External rotation with band

    illustration

  • Internal rotation with band - illustration

    Internal rotation with a band is an exercise that strengthens or tones the muscles that help rotate your shoulder inward, or towards your body.

    Internal rotation with band

    illustration

  • Isometric - illustration

    Isometric shoulder exercises strengthen and tone the muscles in your shoulder.

    Isometric

    illustration

  • Pendulum exercise - illustration

    The pendulum exercise stretches the joint capsule of your shoulder joint to keep it from getting stiff. Avoid this exercise if you have back pain.

    Pendulum exercise

    illustration

  • Shoulder blade retraction with tubing - illustration

    The shoulder blade retraction with tubing exercise stretches the muscles that hold your shoulder blade (scapula).

    Shoulder blade retraction with tubing

    illustration

  • Shoulder blade retraction - illustration

    The shoulder blade retraction with no tubing exercise stretches the muscles that hold your shoulder blade (scapula).

    Shoulder blade retraction

    illustration

  • Stretching back of your shoulder - illustration

    Stretching the back of your shoulder is an exercise that stretches the back part of your injured shoulder joint.

    Stretching back of your shoulder

    illustration

  • Up the back stretch - illustration

    The hand up your back stretch is an exercise that stretches the anterior, or front, part of your shoulder.

    Up the back stretch

    illustration

  • Wall push-up - illustration

    Wall push-ups are exercises that stretch the muscles and joint capsule of your shoulder joint.

    Wall push-up

    illustration

  • Wall stretch - illustration

    Wall stretches are exercises that help make your injured shoulder joint more flexible.

    Wall stretch

    illustration

Self Care

 
 

Review Date: 4/24/2023

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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