By:Dr. Matt Butler, DC
Exercises to Strengthen the Rotator Cuff Muscles in the Shoulder
There are many excellent exercises that can be performed to focus on the rotator cuff. These exercises consist of movements that must be performed with perfect form to ensure that the proper muscles are being isolated. We place a heavy emphasis on strengthening the scapular (shoulder blade) stabilizers; weakness of these muscles will result in a shoulder blade that tilts downward, further contributing to instability of the
shoulder. It is also important to note that the rotator cuff is an endurance type of muscle group, and therefore requires the use of lighter weights and high repetitions. I typically start my patients with 3 sets of 15 repetitions, and will progress to 5 sets of 30 repetitions depending on the particular exercise being performed.
The following are a sample of some of my favorite exercises for rotator cuff strengthening:
Sidelying External Rotation…Lie on side with arm resting on stomach and a small rolled up towel under the arm. Slowly rotate arm upwards and stop when forearm is in a position just above horizontal. This exercise can be initiated using a 2-3 pound dumbbell.
Prone Horizontal Abduction…Lie on stomach with arm hanging over side of table and the thumb facing forward. Slowly raise arm straight out to the side and stop when arm is parallel to the body (going higher can cause excessive strain to the front of the shoulder).
Prone Elevation in the plane of the Scapula…Begin in the same position as in the exercise above, except rotate your hand so the thumb is rotated 45° out to the side. Slowly raise arm in a plane 45° forward and stop arm just below parallel to the body (going higher can cause impingement of the rotator cuff).
Prone Row with External Rotation…Begin in the same position as above, except rotate your hand so the thumb is facing towards the body. Perform a rowing motion with the elbow in the same plane as the shoulder, and stop when the elbow is even with the shoulder. After achieving this position, rotate the arm upwards until the forearm is just below parallel with the body. Next, rotate the forearm back down to the previous position, and then lower the arm back down to the starting position.
Prone Row with External Rotation…Begin in the same position as above, except rotate your hand so the thumb is facing towards the body. Perform a rowing motion with the elbow in the same plane as the shoulder, and stop when the elbow is even with the shoulder. After achieving this position, rotate the arm upwards until the forearm is just below parallel with the body. Next, rotate the forearm back down to the previous position, and then lower the arm back down to the starting position.
Horizontal Abduction with Thera-tubing…Stand facing toward the attachment site of the tubing, with the arm extended straight out in front of you. Slowly pull arm backwards and out to the side, keeping the arm at shoulder height. As you perform this motion, try to pinch the shoulder blade backwards/inwards.
Rows with Thera-tubing…Hold ends of tubing in each hand. Perform rowing motion backwards, keeping elbows elevated at least 60° away from body. When elbows are approximately ½ of the way to the body, complete the motion by pinching the shoulder blades together.
Standing Elevation in the plane of the Scapula…Stand with dumbbells in your hands, with hands rotated 45° out to the side. Slowly raise arms at 45° angle approximately ¾ of way above head.
It must be stressed that all exercises performed with dumbbells must be performed with light weights (2-3 pounds); using heavy weights will strengthen the larger muscle groups more (deltoids, lats) resulting in a possible muscular imbalance.
These are just a small sample of exercises that can be performed. While all of these are very good at isolating the rotator cuff, not all may be appropriate to perform initially during the program.