A rotator cuff is a versatile group of muscles in the shoulder joint. Repetitive overhead movements, throwing movements, or reaching tasks at work can irritate the rotator cuff tendons. To prevent the risk of injury to these muscles, weekly strengthening and neuromuscular exercises are advisable. This can be done by doing the correct exercises at the correct time. That is why it's always best to consult a Physiotherapist before attempting any exercises. The physiotherapist provides a tailored treatment plan for a quick recovery. In this blog, we have mentioned a few exercises for individuals suffering from rotator cuff injury.

Rotator Cuff Muscles

The rotator cuff is made of four different muscles supraspinatus, infraspinatus, subscapularis, and teres minor. These muscles originate from the shoulder blade on the back and wrap around to the top of the shoulder. The shoulder joint is a very shallow, strong, and stable joint.  The physiotherapist takes the assessment first and then prescribes an appropriate exercise, depending on the severity of the rotator cuff injury.

Below are examples of rotator cuff exercises that will not only help you keep your hard-earned gains, but also promote your recovery as well. These exercises could be attempted at various stages through the rehab program, as guided by your Physiotherapist.

Shoulder Flexion and Extension with a stick:
For Flexion:
  • Stand and hold the stick in front.
  • Keep the elbows fully extended.
  • Raise both hands to the point where slight pain is felt.
  • Lower the stick down, repeat this exercise and lower it down slowly again.
  • Repeat the exercise for 10-15 repetitions in a single session.
For extension:
  • Stand and hold the stick behind your back.
  • Take the stick back up to the pain-free range and then bring it back to the starting position.
  • Repeat this exercise 15 to 20 times, initially slight pain may be felt but do it 10 to 15 times in a session.

Isometric External Rotation:
  • Resist pushing the arm inwards/outwards.
  • Hold each direction for 30-40 seconds.
  • Slight pain is felt initially.
  • Repeat this exercise3 times, once to twice, daily, depending on the pain.

Internal and External strengthening Exercises:

For Internal rotation:
  • Use a resistance band, and stand on the end of it with the foot on the opposite side of the injured shoulder.
  • Start the movement near the hip on the opposite side, keep the elbow straight, and pull the band across the body.
  • This movement looks as if drawing a sword.
  • Repeat this exercise 8-12 times 3-4 times per week as pain allows.
  • Slight pain should be felt during this exercise.

For External rotation:
  • Hook a large theraband to a sturdy structure.
  • Stand in front of it and hold the band with the affected arm.
  • Tuck the same arm beside the body and bend the elbow to 90 degrees.
  • While working on the right shoulder, turn the entire body clockwise. Turn counter-clockwise if it's the left shoulder.
  • Stop turning when the bent elbow forms a 90-degree angle with the resistance band.
  • Pull the band away, while keeping the arm tucked beside the body and the elbow bent to 90 degrees
  • Once the resistance band is taut, slowly return the arm to the starting position.
  • Repeat 10 times.

Pendulum Exercise:
  • Hold onto a table or a chair with a good arm and bend forward using the hips.
  • Relax and let the injured arm hang freely.
  • Use the lower body to build momentum, shifting forward and back or side to side.
  • Let the upper arm bone gently swing with the body.
  • Do this exercise for 10 repetitions. 

Crossover arm stretch:
  • Gently pull the injured arm across the chest as far as possible.
  • A slight stretch is felt at the back of the affected arm and shoulder blades.
  • Hold the stretch for 30 seconds, and repeat the same 3 times.
Anterior capsule rotator cuff stretching using a towel:
  • Use a towel or a bedsheet to stretch the muscles on the front side of the shoulder.
  • Put the hand on the painful side of the back and hold the bottom end of the towel.
  • With the normal hand, grab the upper end of the towel and stretch the muscles on the front side of the shoulder.

 Shoulder Taps:
  • Begin in a push-up position with the elbows straight.
  • Make sure that the hands are in line with the shoulder and keep the back straight.
  • Lift one hand and tap the shoulder on the opposite side.
  • Repeat with the other side.
  • Doing both sides counts as 1 repetition.
  • Repeat 10 times. 
  • Get on all fours with the hands a little wider than the shoulders.
  • Keep the head and spine in line, with the elbows straight.
  • Lower the whole body until the chest is close to the floor.
  • Pause for a few seconds, and push yourself up, back to the initial position.
  • Repeat 10 times.

Doorway Stretch:
  • Stand in the middle of a door.
  • Place the hands at the side of the door, forming the letter T (to stretch the upper part) or the letter V (for the middle-lower part).
  • In that position, bend the elbows 90 degrees.
  • Then, lean forward and push yourself into the door.
  • A slight stretch should be felt on the ch*est and shoulders.
  • Hold this position for 30 seconds and repeat the same exercise 3 times. 

Band Pulls Apart:
  • Stand with the head and neck in good alignment.
  • Hold a resistance band shoulder-width apart, with the palms facing upward.
  • Lift the hands to shoulder height and pull the band apart while squeezing the shoulder blade.
  • Return to the starting position and repeat this exercise 10 times.

Avoid any exercise that causes you pain. Get yourself first assessed by the physiotherapist. Secondly, take rest until the pain eases, or else modify the exercise by doing it in such a way that you can avoid doing that activity.