Strained rotator cuff muscles causing shoulder pain are nothing special for bodybuilders and other athletes since most of them experience rotator cuff injuries sooner or later. If you’ve ever suffered from a rotator cuff injury you already know how painful, annoying and hindering it can be. Not only does it stop you from working out but also everyday activities and motions are painful and can develop into a real challenge. Regular Joes with a sedentary lifestyle are also likely to experience such injuries because they’re not used to any physical stress. Since our shoulder joints are surrounded by many ligaments and tendons they’re also prone to injuries.
What is The Rotator Cuff?
The rotator cuff consists of 4 small muscles (supraspinatus, infraspinatus, teres minor and subscapularis) and is probably the most neglected muscle group because they don’t appear 
as impressive as a big biceps or a wide thick back. But truth be told the rotator cuff possess the power to wipe out all efforts you put in building an impressive amount of muscle mass. How it does that? By hindering you from lifting weights since you won’t be able to work out with heavy weights or even work out at all. Remember that your shoulder is involved in most upper body exercises and not giving your rotator cuff the attention it deserves may pay back some day.
Rotator cuff injuries can be caused under several circumstances like overuse without proper recovery (weight lifting, swimming, tennis, baseball etc.), sudden impact (e.g. a high velocity movement you’re not used to like throwing) or imbalance (too much pressing movements, too few pulling movements). Especially people focusing too much on exercise like the bench press and overhead pressing movements are likely to suffer from a rotator cuff injury. Always make sure you do enough pulling and rowing movements to keep a balance.
Usually rotator cuff injuries don’t happen over night or suddenly but in a slow creepy manner. At first there might be a little pinch during certain exercises which most athletes wouldn’t take serious since it’s nothing. Yeah, nothing but the beginning of the end and I’m not exaggerating when I say this. If you neglect to do something right away it will aggravate as time goes by until you’re not able to even raise your arm anymore. Other symptoms are the feeling of weakness, stiffness and some clicking noise.
In most cases certain rehabilitation exercises and rest are a proper cure for injured rotator cuff muscles but in some severe cases steroid injections to reduce inflammation and pain. Extreme cases like a torn rotator cuff need surgery or even a shoulder replacement, which would be a last resort and only for persons suffering from ongoing pain or arthritis.
Rotator Cuff Exercises and Treatment
Well, now that you know what the rotator cuff is and what causes injury it’s time for some exercises that help strengthen the rotator cuff muscles and stabilizing the shoulder joint.
For immediate treatment of a rotator cuff injury you should stick to the R.I.C.E. method (appropriate for all muscle i.e. soft tissue injuries. which stands for:
- Rest
- Ice
- Compression
- Elevation
It’s absolutely crucial to take care of the injury as soon as possible. The first 48-72 hours are vital for complete and quick recovery so don’t miss this opportunity for preventing further aggravation.
When doing these exercises always keep in mind that you’re not training for muscle growth but for treatment and prevention of a serious injury. These exercises shouldn’t cause you any pain and thus you should use a light weight staying away from muscle failure, most of the time. Don’t be ashamed of using 5-8 lbs dumbbells. Perform rotator cuff exercises in a slow controlled manner, using the greatest range of motion pain-free possible. Do about 12-15 reps per set. In addition also your posture benefits from rotator cuff training as your shoulders will be pulled back leading to a straight back and a bigger appearing rib cage because your chest sticks out more.
1. Side Lying External Rotator
This is my favorite exercise and I always do some of these to warm up my rotator cuffs before every workout except for legs. Grab a light dumbbell with your right hand and lie on your left side with your right arm next to your body and your elbow bent to 90°. In this position your right hand should rest on your upper stomach, palms facing down. Now slowly raise your right hand above at least shoulder level keeping your right upper arm close to your body and your elbow at 90° angle. Then slowly lower your hand. Do the same for your other side.
The side lying external rotation activates all 4 muscles of the rotator cuff and it’s probably the best to do.
2. Propped External Rotator with Shoulder Horn
Also a great exercise which I do using a shoulder horn. The shoulder horn is a fancy gadget which locks your shoulders and arms so it basically isolates the muscles of the rotator cuff. Grab some dumbbells and slide your arms into the horn, then just raise your arms until perpendicular to the floor. This is really a no-brainer exercise.
3. Propped External Rotator on Knee
Sit on a bench with one foot on the seat so you can rest your elbow on your knee. Because your elbow should be angled to 90° your upper arm remains parallel while your forearm is perpendicular to the floor. Now slowly lower your arm until parallel to the floor and rotate it back to vertical.
That’s pretty much it. The above exercises are great to strengthen and rehabilitate rotator cuff muscles. Internal rotator exercises usually aren’t required because most of the time the muscles involved in the external rotation are weak and underdeveloped.
Stretching Exercises:
Proper stretching is also an important part in treatment and prevention of rotator cuff injuries since the internal rotators often tend to shorten (due to imbalance) leading to tightness and bad posture.
Make stretching a permanent feature after your rotator cuff training and hold each stretch for 30-45 seconds.
1. Chest Stretch
You can do this stretch one arm at a time or both together and all you need is a door jamb or corner where you can lean against. Raise your arms until parallel to the floor and again, keep your elbows angled to 90°. Then place your forearms against the door jamb and lean forward while squeezing your shoulder blades together. This stretch is greatly appropriate for people with forward-shoulder posture and desk jobs. If you work a desk job then just stand up once an hour and do the stretch.
2. Back Stretch
For this stretch you need a solid vertical bar or something similar because you have to grasp both hands around it. Stand about one foot (30cm) away from the bar and bend your hips pushing your butt back until arms are straight. Let your head relax between your upper arms. You should feel a good stretch in your lats, lower back and shoulders.
Rotator Cuff Training – How to Do It Properly
You already know about the exercises and stretches but how often and when should you do them? This also depends on whether you’re currently suffering from an injury or you want to include rotator cuff training for injury prevention.
If you want to strengthen your rotator cuff muscles for injury prevention I’d recommend you train them about 2-3 times a week after your regular gym workout. You’ll only need like 10 minutes to train your rotator cuff muscles properly so don’t be like “no, that would take me too long” and just do it. Also make sure you squeeze your shoulder blades together when working your back, especially when doing rowing exercises.
If you’ve to take a break from working out in the gym then it’s probably appropriate to do the routine 4-5 times a week.
Actually I used the routine below when I had a little injury which was fine after 5-6 weeks of rotator cuff training. Nowadays I do 2-3 sets of any of the below exercises before upper body workouts and I don’t have any problems at all doing exercises which caused pain 3 years ago.
Sample Workout:
Side Lying External Rotator – 2 Sets 12-15 Reps
Propped External Rotator on Knee – 2 Sets 12-15 Reps
Propped External Rotator Shoulder Horn – 1 Set 12-15 Reps
If you don’t have a shoulder horn don’t worry, just do another set of any exercise.
Don’t get tempted to increase weights too quickly because this can cause aggravation even though you feel like everything’s good.
