Shoulder pain is a very common reason individuals present to physiotherapy. Whether it is from an injury or of gradual onset, shoulder pain can have a big impact on day-to-day life. Activities such as reaching up, out, or behind your back, lifting, and even sleeping can become difficult and painful. Difficulty with these activities can affect work, sport/performance, hobbies, and daily life. Maintaining or improving your shoulder health is therefore important and can be as easy as just a few exercises! A good place to start is with the rotator cuff.
The rotator cuff is a key anatomical muscle group of the shoulder and is important for good shoulder function. The rotator cuff can be injured acutely, or it can happen slowly over time. Research involving ultrasound and MRI imaging has shown the rate of tears in the cuff increase markedly as we age (please note, tears in the rotator cuff do not always translate to pain or loss of shoulder function). Most rotator cuff injuries can improve without surgery.
The rotator cuff is made up of four muscles that arise from the scapula (shoulder blade), and blend into the shoulder joint capsule to form a stable yet mobile joint that allows you to generate efficient movement of your shoulder/arm. These four muscles are the supraspinatus, infraspinatus, subscapularis, and teres minor. The tendons of these muscles close to the shoulder joint are where injury to the rotator cuff commonly occurs.
We have compiled 5 exercises to help improve/maintain your rotator cuff health. They should be performed within comfort and tolerance.
1. Standing Row
EMG studies have shown this exercise results in high muscular activity of all 4 muscles of the rotator cuff (interestingly, standing and performing the row elicited more EMG activity than performing the row in sitting).
You can use a resistance band, cables, or bungee. Or if you are a keen cyclist, this is a good way to recycle your inner tubes (a trick I learnt from my ingenious clients). Loop it around a stable surface, hold on to each end with your arms out straight. Pull the band back so your elbows bend to 90 degrees, squeeze your shoulder blades back together as you pull. Slowly release back to the start position.
2. Push up Plus
In a plank position with straight arms, drive away from the ground by pushing your rib cage up towards the ceiling, gluing your shoulder blades onto your back – to regress this exercise, perform the plank on a bench/table or wall, to progress it, try to hold the push up plus position while you lift one hand away from the floor/surface. Try to maintain your trunk position (don’t lean to one side). Slowly lower your hand back down and repeat with the other hand.
3. Long Lever Pull Down (shoulder extension)
Tie a knot or loop in the band and shut it in the top of a door, or tie it to something sturdy overhead. With your back to the door, hold one end of the band overhead. Keep your arm straight and slowly pull down until your arm is straight down at your side. Slowly release back up overhead.
4. External Rotation in Side Lying
Lying on your side, hold a small weight (or no weight) in your top hand and bend your elbow to 90 degrees. Keep your elbow in at your side as you rotate your arm up/out, as far as is comfortable. Slowly lower back towards your tummy.
5. Prone Horizontal Extension/Abduction/Flexion (A’s, T’s and Y’s)
Lying on your tummy with your hands down by your sides, lift your arms up off the bed/floor, rotating your hands outwards. Hold for 5 seconds, relax back down.
Repeat this but with your arms straight out to the sides, and again with your arms overhead.