Shoulder pain can significantly limit a person’s ability to perform daily care and work activities. If you think about it, almost everything that we do throughout the day requires the use of our shoulders and arms. As a clinician, my favorite joint to treat in the body is the shoulder because I feel that people are the most appreciative when they can get back to performing their daily activities without having to endure constant, nagging shoulder pain.
Long-term studies have confirmed that shoulder pain is the 3rd most common musculoskeletal condition, so this is obviously a big problem for lots of people. Oftentimes, shoulder pain is caused by injuries to the rotator cuff muscles and tendons. Rotator cuff stretches can help effectively relieve shoulder pain if performed correctly. Today, I will discuss the 8 BEST rotator cuff stretches for quick shoulder pain relief that I routinely teach my patients who are suffering from this type of shoulder pain.
Table of Contents
What are the Rotator Cuff Muscles?
The rotator cuff is comprised of four relatively small muscles (Supraspinatus, Infraspinatus, Subscapularis, and Teres Minor). All four of these muscles originate from the shoulder blade (scapula). Each of them wraps around the humeral head and inserts into the upper humerus bone (upper arm bone). The primary job of the rotator cuff muscles is to help stabilize the ball and socket shoulder joint and to help move your arm in different directions. If you haven’t yet read my article on understanding types of shoulder pain, head on over to that article to get a much more in-depth breakdown.
Shoulder Pain with Reaching, Lifting and Carrying Activities
Most of the time, we first become aware of shoulder pain when we first begin to feel shoulder pain with active arm movements. Reaching outwards away from the body, lifting objects, and overhead reaching are typically the most aggravating to the rotator cuff muscles.
As the arm extends away from the body, the increased distance of the hand away from the body causes increased demand and stress on the rotator cuff muscles as they try to stabilize the shoulder joint. If there is any injury to one or more of the rotator cuff muscles (either via simply irritation such as rotator cuff tendinitis or if there is a rotator cuff tear present), then this increased demand on the rotator cuff muscles will cause a sudden increase in shoulder pain.
On the other hand, however, if you keep your arms close to your sides, there is very little demand placed on the rotator cuff muscles and you would probably only feel a constant, dull, ache-type pain in the shoulder.
Why Do I Have Shoulder Pain at Night When Sleeping?
One of the strongest predictors of a rotator cuff injury is when someone has shoulder pain when lying on the shoulder at night. This is due in part because of a few reasons:
- The rotator cuff is placed on stretch in the side-lying position and when lying supine (on your back) with the arm extended down to your side. When irritated tissue (muscle or tendon) is stretched for long periods of time it will produce pain.
- The rotator cuff has usually been aggravated throughout the day as we perform our normal daily activities that place stress through the irritated tissues, and the pain culminates at the end of the day.
- We simply have nothing else to distract us at night when trying to quiet our minds to sleep, so our minds focus in on the painful area.
Strategies to Reduce Rotator Cuff (Shoulder) Night Pain
Luckily, there are some strategies that can help reduce rotator cuff-related nighttime shoulder pain.
- Place an ice pack on the shoulder for 10-15 minutes right before bed. Be sure to have a layer of material in-between the ice pack and the skin to prevent ice burn (yes this is a real thing). I usually recommend placing the ice pack in a pillowcase.
- Place a pillow in your armpit area, so that the pillow is supporting your arm and shoulder. This can be beneficial because it supports the weight of the arm and allows the rotator cuff muscles to relax. If you toss around a lot at night, then try placing your arm INSIDE the pillowcase, so the pillow will move around with you in case you move in the night.
- Try sleeping in an incline position such as taking a few pillows and creating a small ramp on your bed to sleep on or simply sleep in a recliner chair.
- Consider taking an NSAID (non-steroidal anti-inflammatory before bed) to help reduce some of the pain and inflammation, however, you will need to check with your medical doctor beforehand to ensure that it is safe and necessary for you to take these types of over-the-counter medications.
What Exercises Can I Do for Shoulder Pain Relief?
Physical therapy rotator cuff exercises can basically be broken down into two categories:
Rotator Cuff Stretches
- Stretches are important to reduce shoulder pain, especially in the acute phase when shoulder pain is typically worse and the shoulder would not be able to tolerate strengthening exercises yet.
Rotator Cuff Strengthening Exercises
- Strengthening exercises are critical for long-term shoulder health. Be sure to check out my article on the BEST physical therapy rotator cuff and scapular strengthening exercises.
How Do Rotator Cuff Stretches Help?
Regardless of whether a patient has a shoulder injury from rotator cuff tendinitis, rotator cuff tears, subacromial impingement syndrome, shoulder bursitis, etc., treatment should initially begin with a mixture of passive and active rotator cuff stretching.
Whenever the rotator cuff muscles and tendons become irritated, they begin to tighten up as a protective mechanism. The stretching helps to relax the already tight and irritated rotator cuff muscle/s, improve blood flow within the injured tissue, and improve tolerance to loading the tissue with light resistance.
Physical therapy stretching should continue daily to help reduce shoulder pain and improve the pain-free shoulder range of motion.
The BEST Rotator Cuff Stretches for Shoulder Pain Relief!
Supine Wand Flexion Stretch
- Hold a light stick, golf club, baseball bat, etc. with approximately 6 inches between the hands
- Imagine that your non-painful shoulder is the “driver” and the painful shoulder is the “passenger” going along for the ride.
- It is important to focus on the relaxation of the painful shoulder and to allow the non-painful shoulder to do most of the work throughout the movement
- Slowly raise the bar overhead and pause for 3-5 seconds at the onset of either pain or stretch
- Slowly lower the bar back towards the waist
- Perform: 10-15 reps, 2-3x/day
Supine Wand External Rotation Stretch
- Hold a light stick, golf club, baseball bat, etc. while lying on your back. The elbow on your painful shoulder side will be bent to 90 degrees while holding the tip of the wand.
- The other elbow on your non-painful shoulder side with be straight and you will grasp near the end of the wand while holding it near your opposite hip pocket.
- Slowly lift the wand with the non-painful arm (Right in the picture) while rotating the opposite hand (Left in the picture) towards the floor
- This will cause a rotation of the painful shoulder side (Left) since the elbow is bent to 90 degrees.
- Think of the Left shoulder as a door hinge and it is rotating the door open
- Pause for 3-5 seconds at the onset of pain or stretch in the painful shoulder
- Return the non-painful hand back to the opposite hip pocket
- Perform: 10-15 reps, 2-3x/day
"Sleeper" Internal Rotation Stretch
- Lie on your side with the painful shoulder side down.
- Pull the shoulder and shoulder blade downwards (towards your butt), so that the shoulder is NOT elevated towards the ear.
- Understand that this stretch is targeting the joint capsule, which is fibrous tissue, not a muscle. As a result, this stretch will not produce a normal muscle type stretch feel, so don’t expect to feel that type of stretch with this one.
- THIS STRETCH IS DONE CORRECTLY WHEN A DULL, ACHE TYPE STRETCH IS FELT ON THE BACKSIDE OF THE SHOULDER (THE SIDE TOUCHING THE FLOOR).
- Perform: 2 x 1 minute holds. 1x/day
Doorway Pectoralis Stretch
- This stretch can be performed while standing in a doorway or while facing a corner (as seen in the picture).
- Perform: 2 x 1 minute holds. 1-2x/day
Overhead Pulley Flexion Stretch
- Use this: Atemi Sports Shoulder Pulley
- Similar to the wand stretches, the non-painful shoulder will be the “driver” that pulls down and lifts the other arm upwards. The painful shoulder will be the “passenger,” so do your best to keep it relaxed.
- Move the arms in a forward motion in front of you until the painful shoulder is elevated overhead.
- Pause for 3-5 seconds at the top where the onset of pain or stretch is felt in the painful, injured arm.
- Perform: 3 minutes. 2-3/day
Overhead Pulley Abduction Stretch
- Use this: Atemi Sports Shoulder Pulley
- Move the arms in an outward motion to your sides until the painful shoulder is elevated overhead.
- Pause for 3-5 seconds at the top where the onset of pain or stretch is felt in the painful, injured arm.
- Perform: 3 minutes. 2-3/day
Shoulder Wall Walks
- Stand an arm’s length away from a wall with your elbow bent slightly.
- Use the pads of your fingers to climb up the wall in front of you. If done correctly, the hand will be lifting the arm up the wall, which will prevent the rotator cuff muscles from working too much and will keep the shoulder pain low until the stretch is felt at the top.
- Plant the hand at the top, then slowly glide the hand back down the wall using friction to control the descent.
- Perform: 1-2 minutes. As needed throughout the day
Shoulder Pendulums Exercise
- Pendulums are a super helpful means for temporary rotator cuff pain relief. They can be used at any time throughout the day or night
- I recommend that they be used whenever the rotator cuff is “acting up,” and the painful, nagging type of feeling is beginning to build. Many people wake in the middle of the night with this nagging-type pain, so pendulums would be perfect to do at the edge of the bed
- Ensure that the arm is completely relaxed as it hangs down towards the floor. Shift your body weight forward and back slowly as the body leads and the arm passively follow
- Perform: 1-2 minutes. As needed throughout the day
How Do I Advance These Rotator Cuff Stretches?
When you first begin with these shoulder stretches, you will likely notice the onset of pain quickly within the movements. And that’s okay as I mentioned above that you need to STOP when you first feel pain or stretch.
However, if you keep up with the stretches every day, you should notice a gradual improvement of shoulder range of motion prior to the onset of pain. Meaning that you will notice that you can get a bit further through the motion before you feel pain.
This means that the flexibility of the rotator cuff muscles/tendons is improving, and the irritability of the tissues is decreasing.
Continue with these stretches for several weeks until the pain has fully subsided in the shoulder. Also, don’t forget to add rotator cuff strengthening exercises into your daily routine as well as long-term shoulder health will require these stabilizer muscles to be strong.
How Long Does it Take for the Rotator Cuff Muscles and Tendons to Heal?
Well, it depends. I’m sure that’s not the answer that you were hoping for, however, there are a couple of concepts that we must understand first.
If someone has rotator cuff tendinitis (muscle/tendon inflammation with no tearing), there is a good chance that the rotator cuff will heal as long as the aggravating activities are stopped. This allows for the natural healing process to occur as the rotator cuff will no longer be under repetitive stress from the activity/activities. If all of the proper precautions are taken (i.e. stopping the aggravating activities), then normal tendon healing should take about 4-6 weeks.
If someone has a partial-thickness rotator cuff tear, it is still possible for natural healing to occur. However, it depends on the severity of the tear, how many of the rotator cuff tendons are torn, and a variety of other factors.
As to how long it could take for the rotator cuff tendons to heal from a partial tear, I’ve seen mild tears heal in 6-8 weeks, but if someone has moderate to severe shoulder pain, it can take anywhere from 2-4 months. Once someone suffers a partial tear of the rotator cuff, the tendon will always be torn unless it is surgically repaired. It does NOT heal back together. Though, just because it is torn does not mean that it will always be painful.
For those who are unfortunate enough to have a full-thickness rotator cuff tear/s, they usually end up requiring surgery. Someone with a full-thickness tear usually cannot raise the arm above shoulder height due to both weakness and pain.
Understand that the tear within the tendon will not heal back together once it’s torn. It is possible for the shoulder pain to decrease eventually, but it’s not likely. The tendon will always be torn and there will likely always be some weakness present in that shoulder. However, sometimes in the elderly population, those with full-thickness tears do not end up having surgery because they don’t require heavy use of the arm anymore with manual labor, etc.
Recommended Equipment
- SHOULDER RECOVERY AT HOME
- ROTATOR CUFF EXERCISE PULLEY
- OVER DOOR PULLEY SYSTEM
- FROZEN SHOULDER EXERCISER
- INCLUDES INSTRUCTION GUIDE
