If you’ve ever struggled to grab something off of a high shelf, brush your hair, or play a game of fetch with your dog outside, it’s possible you’ve felt the effects of some rotator cuff pain. This is a group of four muscles that are key for shoulder joint function. “They work together to position the ball of your shoulder into its socket, so that it can move while remaining stable,” explains Gina Clark, PT, DPT, a physical therapist at Hinge Health.

Rotator cuff pain or injury can make everyday activities (especially those that require reaching and throwing) more challenging. But your rotator cuff muscles are strong and resilient. There’s a lot you can do to keep them healthy, recover from injuries, and prevent shoulder issues in the future. And targeted shoulder stretches and strengthening exercises are key. Here, learn more about what our Hinge Health physical therapists recommend.

Rotator Cuff: Common Injuries

Your shoulder is made up of three bones: your upper arm bone (or humerus), your shoulder blade, and your collarbone. The muscles and tendons of your rotator cuff form a covering around the head of the upper arm bone and attach it to your shoulder blade.

Here are some of the most common issues that affect the rotator cuff: 

• Tendinitis. This is inflammation of the tendons, which is where your rotator cuff muscles attach to the shoulder bone, says Dr. Clark. This usually occurs when you do a lot of overhead reaching, pushing, or lifting, or start a new sport with a lot of overhead activity (like swimming, tennis, golf, or even weightlifting) without incorporating the right amount of stretching and targeted shoulder exercises.

• Impingement. This condition occurs when the rotator cuff muscles in the shoulder become squeezed, which can lead to irritation, inflammation, and pain in the muscles and tendons. It also tends to be related to repetitive overhead movements.

• Rotator cuff tear. This can be because of an acute injury or it can happen gradually because of age-related changes.

Rotator Cuff Injuries: A Hinge Health Perspective

If you have a sore shoulder, you may assume rest is best, especially if you think your rotator cuff pain is due to playing a sport like tennis or softball. But that can actually do more harm than good. 

“Movement is the best medicine to reduce pain, strengthen surrounding tissue, and improve function,” says Dr. Clark. So instead of avoiding movement altogether, try to modify your activity levels to find your movement sweet spot — the point between doing too much and too little. If you play tennis regularly, for example, this might mean avoiding competitions for a little while, or playing for shorter periods of time to start.

Furthermore, research shows that a regular exercise program can help people with rotator cuff issues reduce pain and improve quality of life. 

Your doctor or physical therapist can show you some basic stretching exercises to do at home. Just keep in mind that exercise shouldn’t cause more than a mild level of pain. If you feel a really sharp pain, try modifying the activity to be easier. If you continue to have trouble, stop and consider finding a healthcare provider to work with.

Exercises and Stretches for Rotator Cuff Injuries and Pain

When you have rotator cuff pain, range-of-motion and strengthening exercises are key. “Range of motion work helps maintain joint mobility and the flexibility of shoulder muscles and tendons,” says Dr. Clark. Shoulder strengthening exercises help restore functional use of your shoulder and arm and prevent future injury. 

There are a few considerations to keep in mind. While you want to move your rotator cuff muscles, you should modify any movement or activity that is causing you unacceptable levels of pain or causing your pain to increase for longer than 24 hours. For example, if overhead activity hurts, try to lift objects close to your body, and limit lifting to below shoulder level. Or, with pushing exercises at the gym, change your bench presses to modified push ups on your knees. Or if you are a swimmer, try the sidestroke or breaststroke if the crawl is too painful.

These rotator cuff injury exercises recommended by Hinge Health therapists are a great starting point. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to Minimize Rotator Cuff Injuries

Rotator cuff injuries can be frustrating, so it’s great that there are plenty of steps you can take to help deal with them, especially if you already play a sport or do activities that raise your risk of developing them. They include:

• Exercises. It’s important to keep your shoulder muscles strong, especially if you’ve already had a rotator cuff injury. It’s good to perform exercises like those that you do in a certain sport, or in everyday life. Stretching is also important to keep your shoulders flexible and increase your range of motion. The rotator cuff exercises mentioned above are an excellent way to start. A physical therapist can also work with you to help you come up with a strengthening and stretching plan. (You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.) 

• Tweak your lifting technique. Contrary to popular belief, lifting heavy objects is not inherently bad or dangerous. Your body is designed to lift. But if you have a history of rotator cuff problems, it might help to tweak how you lift heavy objects to help minimize injury. When you lift something heavy, you could try keeping it close to your body and limit your lifting to below shoulder level, advises Dr. Clark.

• Stand on a stepstool when you have to reach for something. This will help you avoid reaching or having to do overhead motions for a long period of time.

• Adjust your sleeping style. Ultimately, the best sleeping position is the one that’s most comfortable to you. But you could consider changing your sleep position, especially if you tend to wake up with shoulder pain. If you’re a side sleeper, hug a pillow in front of you or prop it behind your shoulder so there is not as much strain on the rotator cuff muscles, says Dr. Clark.

When to See a Doctor

Most cases of shoulder pain and rotator cuff issues can be addressed at home with exercises and other conservative measures. If you notice the following, however, you might want to make an appointment to see your physician or a physical therapist, advises Dr. Clark:

• You are physically unable to lift your arm up over your head without using the other hand to help you

• You have loss of strength or weakness in your arm — for example, you can’t lift a plate out of the cupboard, or can’t pour yourself a cup of coffee

• You have pain that interferes with sleep

• You experience sudden and intense pain after a fall or injury

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Athwal, S. & Armstrong, A. D. (2022, June). Rotator Cuff Tears. OrthoInfo — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears/

2. Armstrong, A. D. (2021, July). Shoulder Impingement/Rotator Cuff Tendonitis. OrthoInfo — American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis/

3. Christensen, B. H., Andersen, K. S., Rasmussen, S., Andreasen, E. L., Nielsen, L. M., & Jensen, S. L. (2016). Enhanced function and quality of life following 5 months of exercise therapy for patients with irreparable rotator cuff tears – an intervention study. BMC Musculoskeletal Disorders, 17(1). doi:10.1186/s12891-016-1116-6

4. Simons, S. M. & Roberts, M. (2021, April). Patient education: Rotator Cuff Tendinitis and Tear (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/rotator-cuff-tendinitis-and-tear-beyond-the-basics