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How can I strengthen my rotator cuff?

Bruce I. Prager, MD
Orthopedic Surgery

The best exercises to strengthen your rotator cuff are done with an elastic band, preferably one with a handle.  You should be able to purchase one at a sporting good store.  Attach one side to a table leg or door handle.  With your elbow at your side and facing 180 degrees away from the table or door, pivot your hand away from your body, keeping your elbow at your waist.   This is called abduction. Do 4 sets of 10-12 reps.  Then do the opposite with your forearm out 180 degrees from your waist and bring the cord into your waist. Do also 4 sets of 10-12 reps.    You can also get 2-5 lb dumbells and do lateral raises up to shoulder height.

While standing on an exercise band and holding the handles, reach your arms out to your sides and bring your hands as high as you can -- but not more than shoulder height. Rotate arms clockwise in small circles (about the size of a cantaloupe) 25 times, then switch direction and rotate arms counterclockwise 25 times.

Edward Phillips
Physical Therapy
Here's how to do standing internal and external rotations to strengthen the rotator cuff muscles of the shoulders:

Reps: 10
Sets: 1-3
Intensity: Moderate to hard
Tempo: 3-1-3
Rest: 30-90 seconds between sets

Starting position: Anchor a resistance tubing to a door at waist level. Stand with your feet hip-width apart. Grasp one handle of the tubing in your right hand with your thumb pointed at the ceiling and your elbow firmly pinning a hand towel at your side. Turn your body so that your right side faces the door, keeping tension on the tubing throughout the exercise.

Movement: This is a two-step exercise. Step 1: Keep your wrist firm as you slowly pull the band in toward your bellybutton like a door closing. Pause, then slowly return to the starting position. Finish all reps. Step 2: Switch hands so that you are grasping the handle with your left hand across your waist, knuckles near your bellybutton, and your left elbow pinning the hand towel at your side. (If necessary, adjust the tension on the resistance tubing by moving a bit closer to or farther away from the door.) Keep your wrist firm as you slowly pull the tubing outward like a door opening. Pause, then slowly return to the starting position. Finish all reps. Turn your body so that your left side faces the door and repeat both steps. This completes one set.

Tips and techniques:
  • Maintain neutral posture with your shoulders down and back.
  • Maintain a firm, neutral wrist.
  • Keep the hand towel under your working elbow as an anchor point.
Too hard? Use lighter resistance tubing.

Too easy? Use heavier resistance tubing.
I like the Cuben Press. 
  • From a seated or standing position, hold a dumbbell in each hand with your shoulders rotated forward. Your arms should be fully extended next to your thighs with only a slight bend at the elbows and with the palms of your hands facing your thighs. This will be your starting position.
  • Begin the movement by lifting the elbows up, as if performing a dumbbell upright row, until they are at shoulder height. Tip: The torso and the upper arm should resemble the letter "T". Exhale as you perform this movement.
  • Once you reach this position, inhale and then externally rotate the dumbbells up while keeping the upper arms in the same level and exhaling. Continue this movement until the forearms are perpendicular to the floor and the hands are pointing towards the ceiling. Inhale once you complete this movement.
  • Now press the dumbbells up over your head as if performing a shoulder press as you exhale.
  • Go back to the initial position as you breathe in by reversing the steps.
  1. Repeat for the recommended amount of repetitions.

Dr. Michael Roizen, MD
Internal Medicine
You can strengthen your shoulder muscles by doing a rotator-cuff rotation exercise using free weights.

Primary muscle groups strengthened: Infraspinatus, teres minor (shoulder girdle muscles and external rotators)

Starting position: Lie on your side on a bench or the floor with a weight in your top hand. Bend the elbow at a 90-degree angle and hold the upper arm against the side of your body with the forearm down across your body. Lie with your head in line with your spine.

Action: Keeping your abdominal muscles engaged, a natural arch in your lower back, and your wrist firm, lift the weight by rotating your shoulder outward while keeping your upper arm against the side of your body. Continue to lift until your forearm is almost perpendicular to the floor.

Tips:

  • Don't use a heavy weight -- start with 1 to 3 pound or 1/2 to 1 kg weights. Think of the exercise more as a warm-up exercise than as a strength-building exercise.
  • Stop the exercise before the muscle feels fatigued.

The rotator cuff and scapular stabilizers need to be both trained in isolation to activate weak muscles and in integration to teach proper stabilization for efficient movement of the shoulder joint.

The following corrective exercises teach the scapula to retract, protract, and depress properly.  Weak shoulders often compensate with elevation putting the shoulder at risk for injuries.

1. Scapular retraction: prone with arms or standing with cables or bands
2. Scapular protraction for activation of the serratus anterior: pushup-plus or dumbbell serratus push
3. Scapular depression: seated pushdowns with no elbow bend pausing at the bottom of the motion or assisted dip machine with no elbow bend
4. External/Internal Rotation: with bands or cables
5. PNF diagonals: with bands or cables

Also tempo of the exercises is extremely important to maximize stability. 
-4 seconds eccentric
-2 seconds isometric
-1-2 seconds concentric

There are two types of exercises that you can use to strengthen your rotator cuff- isolated exercises and integrated exercises.  Isolated exercises are designed to specifically target each of the individual muscles that make up the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis) and are usually performed as rehabilitation or reconditioning exercises when one or more of the rotator cuff muscles has been injured or identified as being weak. Typical isolated exercises recommended for the rotator cuff are shoulder internal and external rotation which can performed with light resistance tubing/bands, cables, or dumbbells if positioned side-lying on a bench/table or the floor. Integrated exercises are designed to strengthen not only the individual muscles that make up the rotator cuff, but also other muscles that stabilize the shoulder blades. Integrated exercises are an excellent way to strengthen the rotator cuff muscles because they require the shoulder and back muscles to work together, just as they do during regular, functional movement. An example of an integrated exercise for the rotator cuff is the ball combo I. Use the technique described below to perform this excersie. Lie on your stomach on top of a stability ball with your legs extended and toes on the floor. Before beginning, extend your arms in front of your body, contract your glutes, and lift your chest off the ball, being careful not to arch your back or jut your head forward.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.