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The Best Stretches & Exercises for a Rotator Cuff Tear

by Jaydee Vykoukal, PT, DPT October 20, 2020 0 Comments

Man shoulder pulley

When sustaining a shoulder injury, like a rotator cuff tear, exercises are often required to build strength and make a full recovery. We use our arms constantly throughout everyday activities and it can be easy to continually aggravate or overuse the shoulder joint. Knowing the right exercises will allow you to safely recover the rotator cuff muscles and prevent common injuries. Keep scrolling for the best rotator cuff tear exercises.

Flexibility & Range of Motion Exercises

Keeping your shoulder as flexible as possible and restoring any lost range of motion is important for healing and recovery. Keep proper form and stay attuned to symptoms to avoid irritating the shoulder muscles.

Shoulder Abduction Range of Motion with a Cane

Grab a walking cane or broom stick for this stretch. Place the bottom of the cane in your injured hand and grab the top handle with your good hand. Then, simply use your good arm to guide your sore arm out in a sideways motion. Go as high as is comfortable before returning to the starting position.

Repeat 10-20 times with a 3-5 second hold at the top of each motion. (Note: the video shows shoulder extension backwards- you are modifying the move to go sideways instead.)

Shoulder Distraction Stretch

This one can help improve your tolerance for shoulder range of motion without pinching and provides better mechanics. Do this simple stretch by sitting on a chair. Scoot to the edge of the chair opposite of your injured arm. Then grab the edge of the chair with your hand. Keep your neck relaxed and breathe as you lean your entire body sideways and feel a stretch deep in the shoulder.

Repeat for 10-15 repetitions for a slow count of two in each direction. Do not bend your neck when leaning, keep good posture, and keep it pain free. You can also repeat this stretch with the hand shifted backward and then lean forward to stretch more of the back of the shoulder.

Internal Rotation Stretch

Being able to rotate your shoulder internally is important for tasks like washing your back. Grab a stretch strap or towel for this one. Hold the loop of the strap in your affected arm with the back of your hand touching the bottom of your spine. Hold the other end of the strap above the shoulder (same shoulder as the hand holding it). Use the upper hand to slowly guide the lower hand up your back. Go as high as you can with the goal of reaching your mid-back as tolerated.

Repeat for 5-10 repetitions, hold for up to 5 seconds each time. Make sure you’re keeping good posture and not letting the shoulder slump forward. 

Supine Chest Stretch and External Rotation

Lie on your back with the shoulders at 90 degrees of abduction (perpendicular to the body), knees bent, and feet flat on the floor. With the palms facing down toward your feet, keep your upper arms on the ground as you bring the back of your hands toward the floor. Continue as far as possible or until your hands touch the floor. You will feel a stretch deep in the shoulder and/or chest.

Hold for 30 seconds for 2-3 sets. You can progress to stretching on a foam roller as tolerated.

Shoulder Pulley Overhead Stretch

Grab your shoulder pulley and close it into a door overhead. Grab a seat and place it directly under the pulley against the door to get started. Sit in the chair with the handles in each hand. You can choose whether your palms face each other or forward depending on what’s comfortable for you. Then, simply alternate lifting your arms up overhead as far as possible. With your injured shoulder, let your opposite arm guide you as much as necessary to complete the move relatively pain free.

Repeat slowly and in control for up to 20 repetitions. Hold at the top range for 5-10 seconds with each repetition. Make sure to keep the top of your shoulder relaxed and away from your ear.

Strengthening Exercises

If you have experienced a rotator cuff injury, your muscles are likely very weak due to shoulder pain and avoidance of certain moves. It’s important to start with very basic moves that are pain free. Once they are tolerated, you can slowly progress to more dynamic moves with resistance bands and then even body weight (i.e. planks and push ups).

Keeping good posture and shoulder position are always crucial.  If you struggle with keeping good posture and shoulder positioning, consider the use of

Kinesiology Tape Rotator Cuff Shoulder Taping

Shoulder Isometrics

Isometric strengthening means you are activating the muscles without having to actively move the shoulder. This is a great place to start when active shoulder use is aggravating. Grab a small rolled towel and place it between your bent elbow and the side of your body so that your upper arm (humerus) is parallel with the body. You will use your opposite hand for resistance if possible, otherwise use a wall. Simply match the pressure of your good hand with each move and keep it pain free.

  • External Rotation

    Press your good hand against the back of your palm as if you’re trying to move it toward your belly button.

  • Internal Rotation

    Push against the palm as if rotating the hand away from the body- the exact opposite direction as external rotation.

  • Abduction

    Press the elbow down toward the body and rib cage even further and hold.

  • Flexion

    Make a fist with your injured hand and press it forward into your opposite hand.

Repeat 10-15 repetitions with each exercise for 1-2 sets. Increase tension as tolerated with the goal of moving to band exercises when ready.

Shoulder Resistance Bands

Grab a light to medium resistance band to progress to more active, scapular, shoulder strengthening exercises. Focus on good posture with the shoulders tucked back. Secure the center of the band to a door at the height of your navel to complete the following key exercises for the rotator cuff:

  • Shoulder internal rotation

    Place a towel roll in between your elbow and side. Stand sideways to the band with the injured arm facing it. With one end in your hand, keep the elbow bent as you rotate the shoulder across the body to touch the forearm to your belly.

  • Shoulder external rotation

    Use the towel again. Stand sideways this time with the injured side facing away. With the elbow bent again, pull away from the body as far as is comfortable without losing good form.

  • Shoulder bilateral extension

    Place one end of the band in each hand while facing forward toward it. Then, with your arms resting at your side simply pull the band backwards behind your body. Go as far as is comfortable before returning. Keep the shoulder blades (scapula) tucked back while completing this move.

  • Shoulder abduction

    This move can be the most irritating so start slowly and with a small range. Stand sideways with the injured arm away from the band. Then, pull against the band with the elbow straight as you attempt to lift the entire arm sideways.

    Repeat each exercise for 10-15 repetitions for 1-3 sets. Progress resistance as tolerated

Make sure to combine these exercises with other conservative treatment options for even better results. Check out our article on Rotator Cuff Recovery here.

Rotator Cuff Exercises to Avoid

Avoid overhead and overuse motions when dealing with a  rotator cuff injury. When strength of the shoulder muscles are compromised, the joint is at risk of injury with these shoulder movements. In general, avoid moves that are painful, overhead, or require significant internal rotation (due to risk of impingement). Specific examples include:

  • Overhead throwing
  • Swimming- particularly front and back stroke
  • Lifting heavy weights overhead
  • Sleeping with the arms overhead
  • Lateral arm raises with the thumbs/palms pointing downward
  • Upright rows
  • Triceps dips
  • Any other repetitive shoulder motion to prevent continued overuse

When to Start Rotator Cuff Exercises

The sooner you can start exercising, the fewer issues you will have with stiffness in the future (particularly the risk of frozen shoulder), but you don’t want to force any movement that aggravates the shoulder or makes it feel unstable.

  • After conservative treatment of a partial rotator cuff tear you will probably start exercises within the first week or two.
  • If the tear is severe and surgery is needed, you can still expect to start exercise as soon as possible (within days) with the strict guidance of a physical therapist.

Ultimately, listen to your doctor’s recommendations and go from there.

Benefits of Exercising

The shoulder joint is very dynamic and a rotator cuff injury can make it feel difficult to complete simple tasks like brushing your teeth or hair, getting dressed, bathing, cooking, and more. Restoring shoulder function is so important for quality of life. Here’s what you’ll notice after incorporating these exercises:

  • Decreased shoulder pain with daily activities; particularly reaching, lifting, and sleeping
  • Restoration of shoulder function and joint range of motion
  • Boost in overall healing of rotator cuff tendons 
  • Prevention of long term shoulder pain and other chronic shoulder dysfunction
  • Reduced shoulder impingement symptoms
  • Improved quality of life
  • Less down time due to injury

When to See a Physical Therapist

If shoulder pain persists every time you try to get back to your normal activities, you may want to consider seeing a physical therapist. A PT or sports medicine doctor can help get your pain under control and avoid further injury.

Learn More About Physical Therapy for Rotator Cuff Injuries

Staying Smart with Rotator Cuff Exercises

Gaining back the normal function after a rotator cuff tear starts with conservative treatments, strengthening exercises, along with building flexibility and balance in your shoulder. These exercises are a great place to start. Pay attention to symptoms and always consult your physical therapist or healthcare provider for further medical advice.

Sources:

https://www.webmd.com/pain-management/physical-therapy-rotator-cuff-tear

https://healthmeanswealth.com/upper-body-exercises-that-will-help-you-feel-your-best/

https://rollinghillsmedical.com/shoulder-tendonitis-exercises-to-avoid-fastest-recovery-treatment/#:~:text=Some%20of%20the%20exercises%20that,the%20shoulder%20and%20rotator%20cuff

Rotator Cuff Tear Products

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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