The rotator cuff is a group of muscles in the shoulder that do not get the proper credit that they deserve. The average person doesn’t even know it by the correct name. There isn’t a week that goes by in my clinic without hearing a patient call it the “rotator cup.” In all seriousness though, the shoulder is an inherently unstable joint, and it is actually comprised of three joints moving simultaneously together. The job of the rotator cuff muscles is critical for optimal shoulder health and stability.
Rotator cuff exercises should be considered an integral part of any whole-body exercise program as they can often prevent and/or limit the occurrence of future shoulder injuries. Today, I will discuss the Top 6 rotator cuff exercises that are beginner-friendly, so this is the perfect place to start on your shoulder pain journey!
Table of Contents
What is the Rotator Cuff?
The rotator cuff is a group of muscles located in the shoulder. It consists of four muscles that are all relatively small in size. Their names are the supraspinatus, infraspinatus, teres minor, and subscapularis. Each of them originates from the scapula (shoulder blade) and projects outward around the head of the humerus (upper arm bone) inserting onto the bone.
Two of them are located on the backside, one over the top side and the largest one sits on the front side. All four of them insert onto the outside of the humerus bone underneath where the Deltoid muscle is located. Think of them as inserting into the area where someone might be given a flu shot into the shoulder.
What Job Does the Rotator Cuff Perform?
Even though the four rotator cuff muscles are small in size, they all share a highly demanding and important job. The primary purpose of the rotator cuff is to stabilize the shoulder joint. In addition to that, these muscles also help to rotate and move the arm in different directions.
The primary shoulder joint is called the glenohumeral joint (where the humerus bone meets the scapula). The glenohumeral joint is a ball-in-socket joint. It’s a fairly shallow joint, similar to a golf ball sitting on a tee.
Since the joint is relatively shallow, the shoulder is inherently unstable. It requires help and assistance from the rotator cuff, as well as other structures to stabilize the joint. The shoulder is prone to dislocation due to the shallow nature of the joint.
When the rotator cuff is engaged, the muscles are in a prime position to pull the head of the humerus (the ball) into the glenoid (the socket). As the arm is moved, like when someone is reaching, the rotator cuff is engaged to apply a constant pulling force to keep the humerus spinning smoothly within the socket.
This allows the arm to move freely throughout a wide range of motion.
How do the Rotator Cuff Muscles and Tendons Become Injured?
There are several different types of shoulder injuries that may involve the rotator cuff muscles. However, overall there are two general ways that the rotator cuff muscles and tendons are injured:
Traumatic injuries
Degenerative and overuse injuries
Rotator Cuff Traumatic Injuries
Traumatic injuries in the rotator cuff occur suddenly when a large, quick force is applied to one or more of the muscles. This will often result in a partial or full-thickness rotator cuff muscle tear. Some common causes of traumatic rotator cuff tears are falling onto an outstretched arm, throwing an object, trying to lift a heavy object, and trying to push or pull a heavy object.
The common theme with traumatic injuries is that typically there is a quick force applied and that the arm is usually in an extended position. This position causes immense stresses to be placed directly through the rotator cuff muscles as they are trying to stabilize the joint.
Degenerative and Overuse Injuries
Degenerative and overuse injuries in the rotator cuff occur gradually and without any sudden stand-out moment when the injury occurred. These types of injuries are usually caused by repetitive stresses being placed upon the rotator cuff. As mentioned previously, the rotator cuff is comprised of four relatively small muscles. These muscles are activated throughout the entire time that the arm is moving. They are constantly working.
Remember that the rotator cuff muscles all originate from the scapula and insert onto the humerus (upper arm bone)?
Over time as people age, they tend to lose motor coordination. They eventually lose the ability to isolate and engage these scapular muscles. These scapular muscles are the foundational structure that helps it stabilize as it moves in coordination with the arm throughout its full, available range of motion.
To understand and differentiate different types of shoulder pain along with potential treatment options, check out my full, in-depth guide, “Understanding Shoulder Pain.”
Shoulder Blade (Scapular) Stabilizer Muscles
The shoulder blade stabilizer muscles include the lower trapezius, middle trapezius, serratus anterior, and rhomboids. They are very large and strong muscles that primarily retract and depress the scapula. They are many times larger than the much smaller rotator cuff muscles. These scapular stabilizers come from the spine and rib cage and attach to the scapula.
Their primary job is to stabilize and anchor the scapula during arm movements.
When educating patients about these shoulder blade muscle stabilizers, I tend to describe the foundation of a house. If someone knows how to engage their shoulder blade stabilizers, then their house is built with a strong, concrete foundation. Those stabilizer muscles will hold the scapula tight in this anchored position and reduce the overall force that gets placed upon the much smaller rotator cuff muscles in the shoulder when that person is performing activities such as reaching, lifting, and carrying.
All of the force generated through the arm will not solely be placed through the rotator cuff, but rather be shared by the larger scapular stabilizers as well.
However, if someone has poor coordination and/or scapular weakness, and cannot activate those stabilizer muscles, then his or her house is built on a weak, sand foundation. Much of that force will be applied directly through the rotator cuff muscles themselves.
Eventually, this will result in an overuse injury such as rotator cuff tendinitis, shoulder bursitis, subacromial impingement, or even a partial tear in one of the rotator cuff muscles. This is where strengthening exercises can help.
It is critical to perform both rotator cuff exercises, as well as shoulder blade (scapular) exercises to promote optimal shoulder health!
How to Engage Shoulder Blade Stabilizers During Rotator Cuff Exercises?
I’ve found that the easiest way to instruct someone on activating the shoulder blade (scapular) stabilizers is to first have them shrug both shoulders towards the ears. Once they have both shoulders nearly touching their ears, I then ask them to pull both shoulders down and back towards the spine. This is the opposite motion that they just performed.
They should feel a squeeze in the shoulder blade retractors and depressors (middle trapezius, lower trapezius, rhomboids). I usually instruct them by asking them to imagine as if they were trying to squeeze a pencil and hold it between the shoulder blades.
This retracted and depressed position of the shoulder blades is the “anchored position” that should be set before performing any shoulder or rotator cuff strengthening exercise.
It takes some practice getting the movement down correctly and most people struggle with “feeling it” until they have practiced it numerous times.
How to Prevent Rotator Cuff Injuries?
The biggest injury prevention strategy for preventing rotator cuff injuries in the future is by setting aside a couple of days per week for rotator cuff and scapular muscle strengthening exercises. Some people may think that performing general arm and shoulder strengthening would be enough to prevent rotator cuff injuries. However, unfortunately, they would be wrong.
Sometimes, performing the wrong arm exercises can actually begin to cause shoulder impingement within the joint space and actually lead to increased rotator cuff pain. It is critical to spend time focusing on proper rotator cuff and scapular strengthening exercises to promote optimal shoulder health.
Stretching of the shoulder can also be important for those with stiff and tight shoulders as it can often lead to subacromial impingement syndrome.
How to Advance Rotator Cuff Exercises?
As with most of my patients, when someone is first starting a new rotator cuff exercise program, they must begin slowly and with caution. The rotator cuff muscles are small, as I’ve mentioned many times already, so it does not take much to fatigue them. As a beginner when strengthening these muscles, start off with light weights (i.e. 1 lb, 2 lbs, 3 lbs, etc.).
It is better to start lighter weights and increase gradually to 5 lbs or 10 lbs dumbbells (for advanced individuals) rather than start heavy and end up with rotator cuff irritation. If using resistance bands, begin with a band that has gentle resistance rather than a stronger one.
Pro Tip: Before starting any rotator cuff or scapular strengthening exercise, initiate the movement by first pulling the shoulder blade/s (scapula) down and back towards the spine to set a strong foundation before initiating the actual exercise movement. This will take time and repetition to perform correctly. Doing this movement in front of a mirror can help as it is easy to see the shoulders simultaneously drop down and back as if you were trying to squeeze your shoulder blades together.
Should You do Rotator Cuff Strengthening Exercises Every Day?
Yes, you can and I do recommend doing these rotator cuff exercises for beginners every day when first starting with your shoulder strengthening program. This is okay because the resistances/weights that you will be using and the muscle fatigue is kept relatively low at this point.
After you have gained strength and can advance the resistances/weights, then you should reduce the frequency to 3-4x/week, allowing for rest days in between. These rest days are great to focus on shoulder stretching.
Favorite Shoulder Strengthening Equipment
I often recommend the following products for my patients to use at home when starting with rotator cuff strengthening.
Light Pair of Dumbbells
- These are nice dumbbells that are coated with neoprene for extra grip. Choose based on your initial strength level. I recommend starting with 1-5 lbs. Remember, these are small muscles and can be easily fatigued with isolation strengthening.
9.3- 5 LB DUMBBELL (SET OF 2)
- GREAT FOR EXERCISE AND STRENGTH TRAINING
- STEEL WITH VINYL EXTERIOR
- HEXAGON-SHAPED ENDS PREVENT ROLLING AWAY
- NON-SLIP GRIP
- Resistance Cords
- This is a great set from 4KOR that includes 5 pairs of resistance cords from 7 lbs to 30 lbs of resistance. It includes door anchors, which are critical for at-home use. I also like these types of resistance cords because they have protective nylon sleeves, which prevent them from snapping wildly when they wear out and break (which is guaranteed to happen eventually).
9.1- 4KOR STRENGTH BAND SYSTEM
- 5 RESISTANCE LEVELS
- NYLON PROTECTIVE SLEEVES
- TRAVEL BAG INCLUDED
- FULL BODY WORKOUT
- STACKABLE RESISTANCES
The 6 BEST Rotator Cuff Exercises for Beginners!
Make sure that you pull both scapulas (shoulder blades) “down and back” towards your spine to set them in the proper anchored position as described earlier in this article.
Straight Arm Pulldown
- Use this: 4KOR Fitness Resistance Cord System
- Starting Position: draw the shoulders down and back while squeezing the shoulder blades together. Hold this position while imaging that you are trying to squeeze a pencil between the two shoulder blades. Keep both elbows straight and palms facing down throughout the entire movement.
- Perform: 3 sets x 10-15 reps (1x/day)
Horizontal Rows
- Use this: 4KOR Fitness Resistance Cord System
- Starting Position: draw the shoulders down and back while squeezing the shoulder blades together. Hold this position while imaging that you are trying to squeeze a pencil between the two shoulder blades. Begin with both elbows straight and palms facing each other.
- Perform: 3 sets x 10-15 reps (1x/day)
Internal Rotation with Band
- Use this: 4KOR Fitness Resistance Cord System
- If this exercise is painful and/or limited with motion, replace this exercise with the Internal Rotation Step-Out Isometric below.
- Perform: 3 sets x 10-15 reps (1x/day)
External Rotation with Band
- Use this: 4KOR Fitness Resistance Cord System
- If this exercise is painful and limited with motion, replace this exercise with the External Rotation Step-Out Isometric below.
- Perform: 3 sets x 10-15 reps (1x/day)
Side-lying External Rotation with Dumbbell
- Use this: Light Pair of Dumbbells
- Ensure that your scapula (shoulder blade) is properly anchored by pulling it “down and in” towards your spine.
- Hold the scapula in this anchored position for the entirety of the exercise
- Perform: 3 sets x 10-15 reps (1x/day)
Side-lying Flexion with Dumbbell
- Use this: Light Pair of Dumbbells
- Ensure that your scapula (shoulder blade) is properly anchored by pulling it “down and in” towards your spine.
- Raise the weight in front of you in an arc motion.
- Ensure that the weight stays above the plane of the body throughout the motion
- Perform: 3 sets x 10-15 reps (1x/day)
