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Rotator Cuff Strengthening Exercises
C. W. Schurman, MS, CSCS 1/19/04
Do you feel as though your shoulders "give out" during your upper body workouts? Do you wonder if perhaps including some rotator cuff strengthening exercises might help? Below we discuss how to perform three rotator cuff exercises and two shoulder stretches that may help you see improvement in performance in the rest of your upper body workouts.
WHAT IS THE ROTATOR CUFF?
The rotator cuff is a group of four relatively small muscles (the Supraspinatus, Infraspinatus, Teres Minor and Subscapularis, or “SITS” for an easy way to remember them all) that help keep the ball-and-socket joint intact. Rotator cuff muscles get strained from 1) sudden impact (a fall or high-velocity movement such as throwing when a person is not used to that particular activity), 2) overuse, particularly in sports such as swimming, baseball or tennis, 3) training with too much weight in the primary movements such as bench pressing or overhead pressing without proper recovery time, and 4) doing too much of certain types of movements without balancing them out with opposing movements (i.e. not enough pulling and too much pushing.)
Because the rotator cuff muscles are so small, when strengthening them, it is important not to train with too heavy a weight. Initially a 3 or 5-pound dumbbell may suffice for most women, and an 8 to 12 pound dumbbell for men. When performing rotator cuff exercises, keep the movement slow and controlled, and be sure to train in the pain-free range of motion. Keep your wrists neutral rather than flicking the wrist to add range. You can also use therabands or exercise tubing, although remember that in doing so, the end range of motion will be overloaded far more than the start, and in this case handheld weights (be it soupcans, 2-liter bottles or dumbbells) or cables are preferable to bands.
When in doubt before beginning any of these exercises, see a sports medicine doctor, or get a referral to a specialist like a physical therapist who can help assess whether what you need truly IS rotator cuff strengthening, or if there is another entirely different muscle group to target instead.
EXTERNAL ROTATOR EXERCISES
- External Rotator on Knee: To perform this exercise sit on a bench with foot propped on seat so that when you rest your elbow on the knee, the upper arm remains parallel to the floor. Start with your hand in the air, perpendicular to the floor, and slowly rotate your upper arm in an arc toward the midline of your body (keeping a right angle to the elbow) until your forearm is just above parallel to the floor. Exhale and arc the arm back up to vertical, repeat for 12-15 repetitions and then perform on the other arm, 1-3 sets each. If you anticipate that one arm is weaker than the other, complete the exercise with your weak arm first and only do the same number of reps on the strong arm as you can complete with good form on the first.
- Propped External Rotator: For this exercise, sit on a bench with a barbell behind you so that your upper arm is parallel to the floor. Rest your elbow on the barbell and just as for the Knee exercise above, slowly lower the dumbbell until the upper arm is parallel to the floor and focus on contracting the small muscles in the back of the shoulder to lift the weight back to vertical. Be careful not to use so heavy a load that the weight pulls your hand too far down! Exhale on the lift and complete 12-15 repetitions, 1-3 sets each on both arms.
- Side-Lying External Rotator: The final strengthening exercise to try for the external rotators is to lie on your side (on the floor or on a wide bench) with a towel or sweatshirt propped underneath your elbow to help keep it away from your hip and allow you to keep your arm at a right angle. Keep the elbow in that 90 degree position and exhale as you slowly raise the hand up toward the ceiling, stopping just shy of vertical to keep constant tension on the rotators rather than shifting the effort to the larger deltoid muscles. Slowly lower the weight back down toward your abdomen and repeat. If you feel yourself shifting your body back or taking a rest briefly at the top of the movement, lower the weight until you have a weight you can complete for 12-15 repetitions under constant tension, 1-3 sets on each arm.
As part of a balanced routine that includes fairly even numbers of sets of pulling and pushing exercises for the large muscles in the chest, shoulders and back, be sure to include some stretching following your strength and rehabilitation work. The following two stretches might be perfect ones to add to your routine. Hold each for 30 seconds, and again, be cautious of pushing too hard into the stretch – the goal here should be to release tension in worked muscles, NOT cause any pain!
- Door Jamb Chest Stretch: We recommend this stretch for climbers, computer programmers, bench press fanatics, or any other people who typically have forward-shoulder posture or sedentary sitting jobs. You need no equipment other than a door jamb, tree, or corner of a building. Extend your arm out from the torso at a right angle, and bend your elbow 90 degrees. Place your forearm against a wall (or do both at the same time, in a door jamb) and lean forward. You can even stagger your stance with one foot forward, if it feels more comfortable. Hold the stretch on each side for about 20-30 seconds. For optimal benefit, place this static stretch at the end of your workout before taking it to its limits.
- Hug a Tree Stretch: This stretch feels heavenly after rotator cuff work and stretches the lats, obliques, arms, lower back and shoulders. It is a good one for most climbers, desk workers, and any other people who carry a lot of stress in the upper neck and back. Find a sturdy vertical surface (pictured, a squat rack, but a tree or coat rack might also do nicely) and grasp both hands around it, with feet about a foot away. Allow yourself to bend at the hips, butt back, until arms are straight, and allow your head to relax between the elbows. If you are also tight in the hamstrings you might feel a good stretch in the back of the legs.
If any of the strength or stretching exercises cause further aggravation to your shoulders, 1) lower the weight, 2) limit the range of motion to whatever you can complete pain free, 3) try the movement without any weight to see if the movement itself is causing the problem, 4) have someone familiar with the exercise check your form, and 5) see your doctor if, after 2-3 weeks, it does not improve somewhat with ice, rest, anti-inflammatories, stretching and strengthening.