Healthy Shoulders

As a physical therapist by day, I often see a lot of individuals come through my clinic with painful shoulders. I work with mostly healthy people, athletes and generally active individuals. The most common question I get from this group is, “I do not understand how my shoulder is weak because I lift weights/swim/play tennis.”

Unfortunately, for most of us, what we do when we lift weights, or especially participate in an overhead sport, we are not targeting the rotator cuff strength in isolation. To have specific muscles get strong, you have to work them, specifically. Your general press, push up, curl, etc etc is definitely not going to isolate the rotator cuff and help it stay strong. Additionally, if you rely on upper body strength via a sport, you are not isolating muscle groups for strength, but generally conditioning the upper body.

The rotator cuff is important because it adds dynamic stability to the shoulder. The way the rotator cuff essentially works is to keep the head of our upper arm bone centered into the socket of our shoulder (the socket is a component of our shoulder blade). When the rotator cuff is weak, it allows poor mechanics around the shoulder, and then subsequently, leads to pain. The better the rotator cuff functions, the less chance of shoulder dysfunction and pain. Additionally, keeping the rotator cuff conditioned will also make you perform better. You’ll eventually be able to lift heavier, hit or throw harder, swim faster. So… why wouldn’t you want to put a little more effort into strengthening your cuff?

You don’t need a ton of exercise to keep the rotator cuff strong, so just try adding in these few exercises into your usual routine! Keep in mind when you strengthen the rotator cuff, you should use LIGHT weights, but perform more VOLUME (this means doing around 3 sets of 15ish reps).

Sidelying External Rotation

Start by laying on your side with a small towel rolled up under your arm. This is important because it helps increase the activation of our target muscles. Grab onto a light weight (I usually use around 2 pounds, definitely no more than 5). Pull your shoulder blade back towards the spine and rotate your hand away from your stomach. Be sure to keep the elbow bent to 90 degrees (right angle). Perform 3 sets of 10-15.

Standing External Rotation with Band

Stand with a tube tied to a stationary object. Grab your towel roll and place it under your arm pit. Pull the shoulder blade down and back and rotate your hand away from your body. Keep the elbow bent to 90 degrees! This is similar to the previous exercise, but using a band can change the concentric and eccentric phases of the exercise slightly. The most important thing to remember is if you are performing “shoulder external rotation” with your elbow essentially by your side, if you are standing you MUST USE BANDS. A free weight in your hand when standing WILL NOT work the rotator cuff. With a light band, perform 3 sets of 10-15.

Standing 90/90 External Rotation

Stand with band in hand. The band should essentially be a direct line in front of your body. Start by elevating your elbow in line with your shoulder and your forearm should remain parallel to the ground to start with. Roll shoulder blade down and back. Then, you’ll rotate at the shoulder and move your forearm vertical to the position seen above. Slowly control the forearm back to start and do not let the elbow “droop.” This exercise is especially important for throwing, serving, swimming and performing presses. Again, use a lighter band and perform 3 sets of 10-15 reps.

Standing Bent Over “T”

Flex at the hip and come into a bent over position. Ensure your core is tight to protect your low back. While holding onto lighter weights (3-5 pounds), keep the elbows straight and bring arms out perpendicular to your body. Ensure you squeeze the shoulder blade together at the top. Perform 3 sets of 10-15 reps.

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