Exercises are a very important part of treatment for a rotator cuff disorder. If pain, weakness, and stiffness in your shoulder are related to problems with your rotator cuff, a doctor will usually first recommend nonsurgical treatment. Exercises, combined with periods of rest, ice, and heat and taking nonsteroidal anti-inflammatory drugs (NSAIDs), resolve most rotator cuff problems. If the pain in or function of your shoulder does not improve with these methods, surgery or other treatment may be considered.

You need to avoid certain motions and everyday activities that make your problems worse, such as reaching into the backseat of your car or stretches that pull your arms toward your back. Be careful when you begin your exercises. Slow down or stop activity if necessary.

Exercises also play a role when your rotator cuff is treated surgically. You will work with your doctor and physical therapist to plan an exercise program that helps you regain as much strength and flexibility in your shoulder as possible.

Exercises that help rotator cuff disorders include:

• Stretches and range-of-motion routines to help restore flexibility.
• Strength-building routines to help stabilize the shoulder.

Be sure to consult with your doctor or physical therapist before you start any exercises for rotator cuff disorders. After the exercises listed below are approved, your results will depend on your commitment to using the correct technique and doing the exercises as often and for as long as your doctor recommends. But do not continue exercises that cause pain. Talk to your doctor to see if you are doing the exercises properly. If you are doing them correctly and yet are experiencing pain, you may need modified exercises or other treatment.

Exercises can help relieve shoulder pain related to rotator cuff disorders. Stretching and strengthening exercises can help you properly use your shoulder to minimize further damage. Exercises can also improve strength and flexibility of related muscles and tendons.

Most rotator cuff disorders are resolved with exercises that are combined with other home treatment methods, such as rest, ice, heat, and nonsteroidal anti-inflammatory drugs. If exercise and other home treatment methods do not sufficiently relieve painful symptoms or improve strength and range of motion, your rotator cuff may have a complete tear that needs surgery, or you may have another condition.

Before you start these exercises, consult your doctor or physical therapist. It is important to be consistent and do the exercises every day.

But stop exercising and call your health professional if you are not sure you are doing them correctly or if you have any pain. Any discomfort you feel during exercise should not last more than 2 hours after you finish, and pain should not wake you up at night.

Clicking and popping during exercise are not necessarily cause for concern, but a grinding sensation may point to another problem.

If your shoulder is sore after you exercise, ice it.

Stretching exercises

If you have had surgery to repair a rotator cuff tear, you will not usually begin any active exercises until at least 3 to 6 weeks after surgery. Active exercise might be allowed right away after surgery for tendinitis. Be sure to follow your surgeon's advice on when exactly these exercises are appropriate. In addition, most people wear an immobilizing sling or shoulder brace after surgery. You will need to ask your doctor about getting help taking it off before you exercise and replacing it at the end of the session. A friend, family member, or physical therapist may be able to help you if your doctor approves.

You should master the stretching exercises and be able to put your shoulder through its full range of motion before you begin strengthening routines. Do the stretching exercises 5 to 10 times a day.

For any of the following exercises where your arms start at or stretch from your sides, the motion should be on a diagonal about 30 degrees to the front of where your arms would make a T if you were to raise them 90 degrees from your sides.

The list below links to specific stretching exercises with pictures and instructions.

• Posterior stretching
• Up-the-back stretch
• Overhead stretch
• Pendulum swing
• Wall climbing:
  • To the side
  • To the front

Strengthening exercises

Start strengthening exercises only after you have your doctor's approval. Usually these exercises are started gradually as soon as you can do the stretching routine without pain. But these and other similar exercises usually should not be done until at least 6 to 8 weeks after surgery.

For any of the following exercises where your arms start at or stretch from your sides, the motion should be on a diagonal about 30 degrees to the front of where your arms would make a T when raised 90 degrees to the side.

The list below links to specific strengthening exercises with pictures and instructions.

• Arm raises to the side
• Shoulder flexor and extensor
• Internal rotator
• External rotator

Scapular strengthening exercises

The shoulder blade (scapula) is one of the main bones of the shoulder joint. It stabilizes the shoulder from the back side. If the scapula doesn't move well, it puts a lot of pressure on the rotator cuff and related muscles, which can cause strain. In addition, if the scapula is not moving properly, there is an increased risk of impingement in the subacromial space.

Scapular exercises can help you keep or improve strength around the shoulder blade to help with rotator cuff function.

The list below links to specific scapular strengthening exercises with pictures and instructions.

• Scapula protraction:
  • Wall push-ups
  • Arm reach
• Scapula retraction

For more information about exercises for rotator cuff problems, talk to:

• Your doctor.
• A physical therapist.
• An occupational therapist for job-related activities.