Are you dealing with shoulder pain when pressing weights overhead, tucking in the back of your shirt, or maybe when placing a glass in your kitchen cabinet? All of these examples could be indicative of an injury to your rotator cuff – a group of muscles that helps to stabilize your arm (humerus) within the socket of your shoulder joint (glenohumeral joint).

The primary action of the rotator cuff is to create a compressive and downward force that allows the arm to stay centered into the socket without placing any unwanted stress on other tissues that surround it. The space above the arm is called the subacromial space, and within this space, there are tendons, bursa, and the labrum of your shoulder. This is a common area to have pain, especially for somebody who does not have a well functioning rotator cuff.

When these muscles are weak or are not coordinating properly there can be excess movement of the humerus up into this space, which can ultimately cause shoulder pain. This is the primary reason why having a strong rotator cuff is such a key component of maintaining healthy shoulders. 

What 4 muscles make up the rotator cuff?

Remember, together all the muscles of the rotator cuff work together to stabilize the humerus within the joint, which is their primary role. However, they each also have separate actions that influence movement at the shoulder.

 

Supraspinatus: This muscle attaches across the top of the scapula and goes through the subacromial space to attach to the greater tubercle of the humerus. It works to externally rotate and abduct the arm. More often than not, this muscle is the culprit of most people’s issues. 

 

Infraspinatus: This muscle attaches to the backside scapula and wraps around to attach to the greater tubercle of the humerus. It works to externally rotate and adduct the arm. 

 

Teres Minor: This muscle attaches to the outer side of the scapula and wraps around to attach to the greater tubercle of the humerus. Its primary action is to externally rotate the arm.

 

Subscapularis: This muscle originates on the front side of the shoulder and wraps around to attach to the lesser tubercle of the humerus. Its primary action is to internally rotate the arm. 

A strong rotator cuff is extremely important for shoulder health when swimming, lifting, swinging a racket, spiking a volleyball, and just about every task throughout your day that involves your shoulder, therefore, spending time working on improving strength and stability in this area can be helpful for anyone!

When there is weakness in the muscles or pain that inhibits muscles from working properly, excess movement of the humerus can result, which leads to unnecessary force being placed on the structures above. A common analogy used to visualize what the rotator cuff is doing is imagining a golf ball on a tee. The rotator cuff’s role would be similar to that of your hand stabalizing the ball on the center of the golf tee. 

“What if an MRI says I have a rotator cuff tear”?

The good news is that conservative treatment can be extremely effective for the large majority of people that have a rotator cuff tear present on imaging. There are of course some tears that may need surgery depending on the severity, however, most rotator cuff injuries respond very well to physical therpay.

Additionally, studies have shown that there are many people who are functioning at extremely high levels (ie. professional baseball players) that have rotator cuff tears, however, they have absolutely zero symptoms! Therefore, the findings on an MRI may not be the true cause of what is creating your symptoms or even prevent you from getting back to doing the activites that you love to do pain-free. 

 

“So How Do I Treat A Rotator Cuff Tear”?

As for almost all soft-tissue injuries, movement is medicine and will be helpful in allowing the tissue to heal. In order to avoid significantly losing range of motion and strength in your shoulder, as simple as it is, you need to use it. However, when you are in pain, this suddenly becomes less simple as it can be challenging to find movements that are not painful and to know if you are doing more harm than good.

The main goal will be to identify ways that you are able to move your arm and exercise while causing minimal discomfort, remembering that movement in appropriate doses will be very helpful in taking a step toward a healthy shoulder. Below are a few exercises to get you started depending on your current level.

Beginner – level exercises:

External rotation into wall

 

Internal rotation walkout

Banded scaption isometric

Intermediate – level exercises:

Sidelying external rotation

90 deg. IR walkout

Dumbbell scaption raise

Advanced – level exercises:

Banded ER at 90 deg.

Bottoms up KB press

Loop band ER + flexion 

Conclusion:

These exercises are just a few of many that may be helpful for you and your rehab. If you are someone who is dealing with shoulder pain, seeking out a physical therapist so that you can be thoroughly assessed is always recommended.

Each injury and rehab journey is unique and individualized treatment is always preferred in order to maximize your care and be as specific as possible to treating the issue at hand. However, the goal of this blog is to provide you with more insight into what may be going on, as well as provide you with a general course of action to help get you moving in the right direction so that you can get back to doing the activities that you love to do without being limited by pain.

Are you struggling staying active, keeping up with your workouts or even just doing every day tasks due to shoulder pain?  Let’s chat about how we can help you get a gameplan to get back to performing at a high level without limitations due to pain.

Disclaimer: The information provided in this blog is for educational purposes only and should not be considered a substitute for professional medical advice or treatment. Always consult with a qualified healthcare professional before starting any exercise program, especially if you have a pre-existing medical condition or injury.