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"Building Shoulder Strength: 5 Essential Rotator Cuff Exercises"

I think when Physical Therapists talk about the rotator cuff (or some patients call it the rotary cup;) people imagine maybe a sleeve or cup shape of muscles. Four muscles stabilize the humerus while you move your arm. These muscles allow you to move your arm overhead, behind your back, and in front of you without pain. When the rotator cuff muscles are weak or injured, you feel the pain, especially with quick movements. Often people will notice it while putting on a jacket, reaching to the back seat of their vehicle or even lifting a bag of groceries.

The rotator cuff muscles which can be remembered by the acronym S.I.T.S. are Supraspinatus, Infraspinatus, Teres Major, and Subscapularis. For a detailed description of each muscle and its functions, watch this video:

There are many injuries of the rotator cuff that are collectively called Rotator Cuff Syndrome. This is why you need to see a Physical Therapist to evaluate what kind of injury and to be able to treat it appropriately. Some of these are acute strain or tear, tendonitis, bursitis, degenerative supraspinatus tear, bone spurs, acromial types, and more.

Physical Therapy will have a different focus at the different stages of recovery. An acute or recent injury will be a slower progress than in later stages of healing and a small tear versus a massive tear can have a significant difference in the time of healing. Rehabilitation after Arthroscopic Rotator Cuff Repair has three phases that can last 6 months or more. A small tear might be 4-6 months, medium tears 6-8 months, and large tears 8-12 months.

A good idea is to be actively strengthening your rotator cuff to prevent injury and to be able to do your daily, work and sports activities without limitation. Let's get into 5 essential rotator cuff exercises. There are many variations to these exercises and progressions depending on an individual's specific needs. For example, an overhead athlete would need to progress to significantly more challenging exercises. This again would require a Physical Therapist to assess specific needs and readiness for progression.

Number One: Press down or press up.

It is important to do Scapulothoracic muscle strengthening to position the shoulder complex correctly. Muscles worked here are the lower trapezius, latissimus dorsi, teres major, pectoralis major, subscapularis, infraspinatus, and teres minor.

You will want to sit on a chair, bench, or treatment table. hands will be on raised surfaces firm on each side, push-up handles, or at least hands on the surface you are sitting on. You will start with slightly bent elbows and as you squeeze your shoulder blades down towards your pockets, your chest will rise and your elbows will straighten You will hold this position at least 3 seconds. Gradually you will work up to doing 10 reps.

Number Two: 30-30-30 rotator cuff strengthening.

This exercise is important because it prevents shoulder blade winging out, it is the functional arc of the shoulder, protects the anterior-inferior capsule of the shoulder, pre-stretches the external rotators to improve length-tension curve, holding the towel to the side recruits the external rotators, comfortable to perform internal and external rotation and improves the subacromial joint space.

Begin with a towel roll near your armpit. You will need a resistance band or tubing attached to a secure device or looped securely around the opposite door knob. The towel will help you obtain the first 30 degrees from your side (abduction). Your arm will be forward 30 decreases in scaption or flexion. The last 30 degrees will be in a diagonal tilt. You may begin with 2-3 sets of 10 reps and build from there.

Number Three: Prone on Elbows on Dyna Discs

This exercise is used for Neuromuscular control to improve shoulder stabilization. Proper exercise technique is critical to avoid mechanical impingement of the shoulders. This exercise is to train to maintain a position with good control. There are several types of exercises in this category that may be used.

Position yourself on the floor, best with a padded surface. Place an equally inflated dyna disc under each elbow. Best to start resting on your knees and progress gradually to your toes position. Squeeze your shoulder blades towards the hips. Hold 3-5 seconds. Do sets of 5-10 reps depending upon your ability.

Number Four: Prone Ys, Is, and Ts (Lower trapezius, extension, retraction)

If you have a stability ball sometimes called a Swiss ball and feel stable while on one, this is one place to start. You can do this lying prone (face down/on your front) on a foam block or prone on a treatment table, bench, or on the floor.

Number Five: Overhead Press with resistance bands

To maximize rotator cuff strength, you must work other shoulder muscles. The rotator cuff muscles do not work completely work in isolation, other muscles contribute to the dynamic stabilization. A comprehensive program working on isolation and multiple-direction movement. I always start hands-on with patients with any shoulder exercise to ensure proper mechanics and give feedback for an individual to be empowered to know proper mechanics as well.

You can start by standing with both feet on the center of the band, hip-width apart. Bring the handles of the band above your shoulders so that the elbows are bent 90 degrees. Press your arms straight up, keeping your shoulders down. Slowly lower back above shoulders. This exercise has many variations using a kettlebell for more control work, dumbbells, and barbells.

Go to my website to contact me and let's get started. You do not need to be limited or believe your shoulders cannot get better. Go to

Karen Baltz Gibbs, PT, DPT, CSCS, CMP, LMT, Owner Garage Training & Rehab Gym.

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