Rotator Cuff Strengthening is so important to build strong shoulders. The shoulder is an extremely important joint and provides us with almost 360 degree movement in multiple directions. Without the available movement of the shoulder, we would have difficulty with basic everyday activities such as driving, washing our hair or hanging up the washing.
Basically anything we do with our hands and arms require the movement of the shoulder. Since the shoulder has such a large range of motion, the ball and socket of the joint has a small contact area. Without the muscles and ligaments around it, the shoulder is quite an unstable joint. So in order for it to stay in position while moving, it relies heavily on the rotator cuff muscles.
What are your Rotator Cuff muscles?
The rotator cuff muscle complex is made up of 4 muscles. They work together to provide stability to the shoulder and keep the joint in the best position. All 4 muscles are attached to the scapula (shoulder blade) and extend towards the humerus (upper arm) but each attach to a specific point on the humerus.
The supraspinatus is located at top of the scapula. This muscle allows the shoulder to abduct or raises the arm and moves it away from the body.
The subscapularis is at the front side of the scapula, or when looking from behind it is tucked underneath the scapula. It allows the shoulder to internally rotate or turn the upper arm towards the body.
Infraspinatus and teres minor
The infraspinatus and teres minor muscles are on the back of the scapula. They enable the upper arm to externally rotate or turn outwards away from the body.
Although each rotator cuff muscle moves the shoulder in a specific direction, they work together to ensure that it is centred in the joint throughout all ranges of movement.
Related article: Top 3 Stretches to Treat and Prevent Swimmer’s Shoulder
Why are Rotator Cuff Strengthening exercises important?
It is important to keep the ball of the humerus centred in the socket and the rotator cuff plays a significant roll in doing so. If it is not, abnormal stress is placed on the surrounding tissue and cartilage which will make the shoulder susceptible to injury.
Some common rotator cuff injuries include:
- Rotator cuff tears
- Shoulder impingement
- Labral tears
Another important reason to strengthen rotator cuffs is to minimise the risk of age-related changes. As you get older, degenerative changes occur which include a gradual loss of muscle mass and reduced elasticity of the rotator cuff tendons. Both these changes can be minimised or prevented with strengthening exercises. Research by SMARTT in 2012 found that 4% of patients aged 40 years or under presented with partial or complete rotator cuff tears. This prevalence further increased as people got older, with 54% showing rotator cuff issues over the age of 6o.
Some other risk factors associated with rotator cuff injuries include:
- High BMI
- Recurrent lifting and overhead motions
- Athletes who play overhead motion sports (i.e. swimming, baseball, tennis, etc.)
- Poor posture (slouched, shoulders rolled forward and poked neck)
- Poor cervical and thoracic spine mobility
Exercises for Rotator Cuff Strengthening
1. External rotation with band
This exercise is excellent for strengthening the external rotators and for general scapula stability. Use a relatively light resistant band and tie to a door knob. Stand with your side to the door, place a towel underneath your arm and lock your elbow in by your side with it bent at 90 degrees.
Grasp the band and imagine that you’re holding a full wineglass. Now stand nice and tall, while rotating your arm away from your body and then back to the starting position slowly. Remember not to spill the wine! It is important that you maintain a good posture while doing this exercises, which means keeping your shoulder blades back and down throughout the entire movement.
Complete 3 sets on each arm, each set reaching fatigue.
2. Internal rotation with band
This exercise is similar to the external rotation exercise above, however this strengthens the subscapularis muscle.
Stand with your side to the door, elbow at 90 degrees and the band tied to a door knob. Again, visualise a full wineglass as you now rotate your arm towards your body. Remember to keep those shoulder blades back and down throughout the entire movement.
Complete 3 sets on each arm, each set reaching fatigue.
3. Elbow Raises
The third one may look easy, but requires some concentration to be performed correctly. I find using a dining room table works well for this exercise. Lie on your tummy with one arm hanging off the side. Start with your arm hanging straight down, then draw your shoulder blade down towards your hips. Whilst maintaining this position gently pull your shoulder back towards the ceiling, into a tucked position. During these two movements, the arm should still be hanging straight down. Maintain this tucked position and slowly raise your elbow up to just below shoulder height. Make sure that your forearm is vertical and your upper arm is at 90 degrees to your side. Slowly lower your arm back to the starting position and repeat.
Complete 3 sets of 10-15 repetitions.
4. Ball on the Wall
The final exercise is more challenging as it works on scapula control while on a unstable surface. Begin by leaning forwards onto a wall with one arm on a ball. Your hand should be position at shoulder height.
Start with your elbow straight, then slowly lower yourself towards the wall, controlling the bend in your elbow. Once you’re close enough to the wall, slowly push yourself back up into the starting position.
Progressions of this exercise include holding the ball in different positions or moving the ball around in small circles.
Do 3 sets on each arm until fatigue.
The exercises above are good examples of rotator cuff and shoulder stability exercises. There are many more exercises available and can be tailored for each individual person. It is important to note that performing rotator cuff exercises in isolation is not the most effective approach, but to train other muscles associated with the shoulder enables you to gain the most benefits. If you experience any shoulder pain or think that your scapular stability can be improved, head to your physiotherapist to seek some professional advice and get your shoulder accurately assessed and managed.