by Salvatore Palermo

Stretches and strengthening the shoulder can help overhead athletes avoid rotator cuff injuries

What’s the rotator cuff and how is it generally injured?

The rotator cuff is comprised of four small muscles and their tendons that connect the upper arm bone to the shoulder blade. The main function of the rotator cuff is to keep the shoulder joint stable.

Individuals who constantly lift their arms above their heads, from construction workers to athletes, are the most vulnerable to rotator cuff injuries. In sports, overhead athletes like baseball pitchers, football quarterbacks, tennis players, lacrosse players, volleyball players, and swimmers, are more likely to develop rotator cuff injuries. When the rotator cuff is injured, it can cause pain, loss of shoulder motion, shoulder weakness, and the inability to lift the arm or reach behind the back.

Download: Stretching and Strengthening Your Shoulders (PDF)

The most common rotator cuff injuries are strains, tendinitis, impingement, and tears.

  • Strains, or pulled muscles, are common because the small muscles of the rotator cuff can overstretch easily when moving quickly.
  • Tendinitis is an overuse injury caused by repetitive movement, which leads to inflammation of the rotator cuff muscle tendons. This can often happen to athletes, like baseball pitchers and swimmers, who repeatedly lift their arms overhead.
  • Impingement occurs when the rotator cuff muscles are unable to stabilize the upper arm. The rotator cuff muscles become weakened and the upper arm bone pinches the rotator cuff tendons against the underside of the shoulder. This can often happen to athletes, like baseball pitchers and swimmers, who repeatedly lift their arms overhead. Impingements can lead to rotator cuff tears.
  • Tears, like sprains, are also common. Tears generally developed because of a traumatic event (like falling or landing on your shoulder) or long-term overuse (brought on by aging or repetitive motion).

How to Protect your Shoulder: Stretch and Strengthen

Download: Stretching and Strengthening Your Shoulders (PDF)

Preventing rotator cuff injuries begins with good stretching. Stretching every day helps to improve the muscle’s ability to stretch further and bounce back without tearing. You’ll want to focus on stretching your chest, upper back, shoulders and arms. Stretches include the Doorway Stretch, Horizontal Shoulder Stretch, the Towel Stretch, the Pendulum Stretch and the Chicken Wing Stretch.

Towel Stretch

Pendulum Stretch

Strengthening exercises are critical in preventing and reducing the chances of rotator cuff injuries, especially in overhead athletes. Exercises that target internal and external rotation of the shoulder are best since the rotator cuff internally and externally rotates the shoulder.

Internal Rotation with Raised Arm

Internal Rotation with a Neutral Arm

Shoulder Balance Exercise

“Y” Raise

Returning to Sport after a Rotator Cuff Injury

Impingement and tendinitis generally recover more quickly than tears. Tears, depending on their severity and if you get surgery, can take four months to a year to return to full strength.

Allowing time for proper healing is important — an athlete who returns to sport too soon risks injury to the same shoulder, as well as to other areas of the body due to compensation and altered mechanics. Resumption of activities should be gradual. Once given the go-ahead by their physician as well as a physical therapist and/or athletic trainer, an athlete should ease into play.

In general, athletes can return to play when:

  • Their shoulder is pain free.
  • They have full range of motion.
  • The shoulder is strong and stable.
  • Their sport-specific activities and biomechanics are normal.

Taking care of your shoulder by keeping it strong and stretching it out can help reduce your chances of getting a rotator cuff injury. If you think you’ve injured your rotator cuff, you should check in with your athletic trainer, physical therapist and/or doctor to determine what you’ve done, if you need imaging or specialists, what the treatment is, and how you can speed your recovery.

Learn more about how to protect your shoulders and rotator cuffs from injury. Download PPT’s Stretching and Strengthening Your Shoulders Worksheet.

Salvatore Palermo. LAT, ATC, is an athletic trainer with Performance Physical Therapy at Ponaganset High School.