So your shoulder hurts and it’s getting worse by the day. All of a sudden, combing your hair comes with a small bite of pain. Odds are, you’re dealing with some sort of rotator cuff tear or injury.
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Welcome to the club. Rotator cuff issues are common, an unfortunate side effect from the wear and tear of daily life. More than 2 million Americans visit their doctor every year because of rotator cuff pain.
So what stretches and exercises can you do to keep your shoulder working without making you wince? Physical therapist Kelly Kinsey, MSPT, AT, has some ideas.
Can you exercise with a rotator cuff tear?
Let’s start with the basics: A partial or complete tear of a rotator cuff muscle can make it difficult to just raise or move your arm. Expect to feel a general weakness in your joint. Your range of motion may be less than ideal, too.
But that doesn’t mean workouts are a definite no-go. Two key factors determine how much you’ll be able to do after injuring your rotator cuff — the severity of your injury and your ability to tolerate pain.
“Some people can exercise with a tear and some people can’t,” says Kinsey. “That’s the truth of it. There isn’t just one answer.”
The good news? Converting that bum shoulder into a healthier wing to keep your fitness routine on track is very doable. Roughly 8 out of 10 people with partial rotator cuff tears get better using options like:
- Rest (and maybe an arm sling) to give your overused shoulder much-needed downtime.
- Nonsteroidal anti-inflammatory drugs to limit pain and swelling.
- Steroid injections to ease pain and swelling.
- Physical therapy (PT) for rebuilding range of motion and strength.
“Over a month or two, particularly with physical therapy, people are often able to get back to where they feel comfortable,” says Kinsey. “It’s a slow and gradual process.”
Here’s where that PT process often begins.
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Range of motion exercises for rotator cuff tears
The first step in treating an injured rotator cuff is restoring the range of motion. “We start them with very basic exercises to rebuild flexibility within the joint,” explains Kinsey. “Movement first. Strength later.”
Here are three stretches to keep your shoulder limber for day-to-day activities.
Over-your-head stretch
This stretch uses both arms, allowing your good shoulder to help your bad one. You’ll need a light cane or rod. “This stretch helps you better reach overhead, like when you’re putting away dishes,” says Kinsey.
- Lie flat on the floor or your bed, your arms straight at your sides. Hold the cane/rod with both hands near your hips.
- Keeping your arms straight, slowly bring the cane/rod up in an arc-like trajectory.
- Continue the motion until the cane/rod goes over your face and (ideally) touches down above your head.
- Return to starting position. Repeat five times.
Up-the-back stretch
This stretch also uses both arms (aka, the buddy system) and a light cane or rod. The idea is to improve flexibility reaching behind you, making it easier to put on a coat, fasten a bra or simply scrub your back in the shower.
- Start in a standing position, your arms at your side. Hold the cane against your body behind you. (It’ll probably start near the top of your butt.)
- Slowly slide the cane/rod up your back, bending your elbows as it travels up. Go as high as feels comfortable.
- Return to starting position. Repeat five times.
Bent-arm stretch
“This is another classic early exercise we give people that have an injured rotator cuff to get movement in the joint,” says Kinsey.
- Lie down with your arms at your side and elbows bent at a 90-degree angle, like the letter L. Hold a cane/rod in your hands. (You should be looking at your fingers clasping the cane/rod.)
- Rotate your arms up and over your head, maintaining the 90-degree bend in your elbows. Go as far as you can. If you reach the floor behind your head, great! If not, that’s OK, too.
- Return to starting position. Repeat five times.
Strengthening exercises for rotator cuff tears
Once your range of motion improves, treatment moves toward strengthening your shoulder joint. A rotator cuff tear won’t heal on its own, but building up surrounding muscles takes some stress off the injured area.
The process needs to be slow and progressive. “There’s the potential for a small tear to become a larger tear,” notes Kinsey. “Don’t push through the pain with the idea that it’s adding strength. You may do more harm than good.”
So if your range of motion has returned in your shoulder, consider these strength-building moves.
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Standing shoulder row
You’ll need a rubber exercise band for this maneuver, which helps set a solid base for your rotator cuff.
- Attach the band to a door or some other sturdy spot. While standing, hold the band with both hands. Move back until your elbows are straight and there’s slight tension in the band.
- Pinch your shoulder blades while slowly pulling back on the band. Bend your elbows as you pull, keeping your arms close to your body. Your goal should be to get your elbows to a 90-degree bend, with your forearms parallel to the floor.
- Return to starting position. Repeat five times.
V arm raise
This exercise will engage the most number of muscles in your shoulder girdle while also being safe to do.
- Begin in a standing position. Stretch out your arms and bring your hands together to create a V shape. Keep your thumbs pointed up.
- Slowly raise your arms up the ceiling, maintaining the V shape. (Just lifting the weight of your arms is enough at the start. Later, feel free to add a 1- or 2-pound weight, or pull a can out of the pantry.)
- Return to the starting position. Repeat five times.
Wing flap
This exercise starts with just using bodyweight. Once you can do it easily and with no pain, consider holding a 1- or 2-pound weight.
- Lie on your side, with your uninjured shoulder down and your injured should up. Your injured arm should be resting on your body, with your elbow bent at 90 degrees.
- Rotate your arm up toward the ceiling, keeping your elbow bent. (Be careful not to go too far. Aim for creating no more than a 60-degree angle with your arm.)
- Return to your starting position. Repeat 10 times.
Exercises to avoid with an injured rotator cuff
If you’re a fitness buff trying to work through your rotator cuff issues at the gym with free weights, you’ll quickly learn to avoid lifting anything straight over your head. (It’ll hurt … and probably a lot).
But a few lifts that put added strain on your bad shoulder might surprise you. The list includes:
- Deadlifts. “These heavy weights are basically pulling your arm out of your socket,” says Kinsey. “It’s a lot of tension on the rotator cuff.”
- Shrugs. Another example of weight pulling down on your shoulder.
- Squatting. Resting the bar across your shoulders and your arm positioning stresses the rotator cuff.
If you truly can’t stay away from the gym, Kinsey offers this advice: Work your legs. “Focus on a different area for a little bit,” she says. “Just give your shoulders a break.”
