The Best Non-Operative Rotator Cuff Tear Exercises

Edwards P, Ebert J, Joss B, Bhabra G, et al. Exercise Rehabilitaiton in the non-Operative Management of Rotator Cuff Tears: A Review of the Literature. The international Journal of Sports Physical Therapy. 2016;11(2): 279-295

At some point everyone has had some type of shoulder pain. You don’t have to be an athlete to have shoulder pain. Heck! The older you get sometimes you can just wake up with it!

Rotator cuff tears are common and there are several types. Partial thickness tears are more common than full-thickness tears. As we age just the wear and tear on our shoulders can cause a chronic tear and is degenerative in nature.

So what causes rotator cuff tears???

Poor posture, trauma, joint laxity and just plain ol’ weakness!

I dont want to go into diagnosing here because that where you should go see your primary care doctor or physical therapist to have them do a full evaluation to make sure you are headed in the right direction. Mis-diagnosis (or what I like to call a google diagnosis) can lead to improper treatment and often times worsen the condition.

I want to focus on exercises for early intervention of rotator cuff tears that are atraumatic and full-thickness.

The primary focus of these exercises are to decrease pain, increase function and improve activities of daily living.

In rotator cuff treatment of tears in the initial phase we “PROTECT” the injury while correcting what may have caused the tear in the first place. For example, posture, joint laxity, poor movement patterns and etc.

Of course there are thousands of exercises I wanted to give you my favorite exercises.

Door way Stretch

I always start with some light stretches to help prep the muscle to move better. Place your arm in a door way with elbow at 90 degrees then shoulder at 90 degrees and lean forward until you feel a stretch on the front side of your shoulder. This should not hurt, if it does you skip this one.

Posterior Capsule stretch

The posterior capsule is a band of ligaments on the back side of the shoulder that help to stabilize the shoulder. It can often become stiff with repetitive high tension overhead activities like throwing or weightlifting. It can often become stiff from disuse. The easiest version if you can’t lay on the floor is bringing your arm across your body. The other version is more aggressive is lying on your arm as your arm is across your body in the face down position. This stretch improves the ability for your arm to raise over your head and reach to your back pocket.

Prone T

Prone means laying face down. You can perform this on your bed if you can not get on the floor. This exercise focuses on your scapular muscles that are more like the “power” muscles of your shoulder. You will need a small steel plates or light dumbells. Its important to protect the muscle so we do this by the position of your hand. Lying face down your palms should be facing the floor. The focus of this exercise is to squeeze your shoulder blades. Initiate the movement by squeezing your shoulder blades then lift your arms off the floor. Hold for 10 seconds repeat with 5 seconds rest for total 2 minutes. Use this nifty small timer to help you stay on track with Tabata time setting.

Prone I

This is another scapular exercise. Make sure to squeeze your shoulder blades and your palms facing the floor. Try and keep your shoulders down and actively reach towards your feet. Perform for 10 seconds rest for 5 seconds for a total of 2:00. This is a good burner! You should feel the burn between your shoulder blades. If you have pain squeeze your shoulder blades Smore!

Side-lying external rotation

You will need a small dumbell. You should go light with weight ranges from 1-15 lbs. maximally. If you can perform more than 3 x 15 maximally then you need to go heavier. You must lay on your side to do this exercise. I can’t tell you how often I see people do this standing with dumbells. It works a totally different muscle! Keep your arm at your side and rotate out. Again, keep your shoulder blade squeezed back and don’t sling the weight. The slower you go the better for strengthening.

Banded external rotation with flexion to 90 degrees

You will need a light resistance band loop. Remember if there is pain skip this exercise. Place the band around your wrists, keep your elbows at your side and drive your wrists out to externally rotate your shoulders then flexion/raise your shoulder up to where your upper arm is parallel to the floor. Perform 5 sets of 5 reps. These should be difficult no painful.

Lawn Chair progression of shoulder flexion

Lawn chair progression is because it simulates the angles of a lawn chair. The easiest with starting flat on your back and raising your arm up as far as you can tolerate in the pain free range of motion. The next progression would be at a 30 degree angle doing the same exact exercise. Then progress to 45 degrees then 75 degrees and eventually to standing. Flexion is bringing your arm straight up in front of you all the way up to your ear. Remember to stay in a pain free range of motion.

If your looking for one-on-one guidance please feel free to contact me through email or submitting your information in the contact section. You can also find video’s of this exercise on my You Tube Channel.