Top Exercises for the Rotator Cuff

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With spring coming to an end, things have been amping up at the facility the past few weeks with many of our college athletes (old and new) starting to make their way back for the summer.   Some are only here for a few weeks before they head off to their designations for summer ball, while others are here for the foreseeable future getting ready for next season.

Nonetheless, to say that we’re expecting to be busy would be an understatement. What’s cool is that we have guys coming in from as far away as Alaska, Colorado, and even Hawaii to spend their summer with us.  With that, however, comes the inevitable conversation explaining why the “band work” routine their coach gave them as their “prehab” mumbo jumbo isn’t necessarily the best option when it comes to rotator cuff work.

In its defense, traditional band work isn’t inherently wrong (or even bad) – it’s just not ideal given that there are far better options in our proverbial “tool box.”

That said, below are a handful of rotator cuff exercises we utilize at Cressey Performance with our baseball guys, and to be perfectly frank, with many of our regular clients as well.  You’re welcome!

Side Lying External Rotation – with arm abducted 30 degrees

Contrary to popular belief, there’s no need to get all fancy with rotator cuff work.   I don’t quite understand where the notion came from, but it seems that there are a lot of coaches and personal trainers who feel that unless there’s a smoke machine or laser show involved, the exercise is useless.

What’s surprising, is that the side lying external rotation – arguably the simplest rotator cuff exercise in existence – is one of the most effective. 

For starters the adducted (arm to the side) position is a far more advantageous since there’s less risk of inducing impingement.  Keep this in mind the next time you’re working with someone coming off a shoulder injury.

Secondly, and most important of all, EMG tests have shown repeatedly that this exercise induces greater activity in the infraspinatus and teres minor, thus demonstrating that keeping it simple can be more effective.  What’s more, with the arm abducted (slightly) – either with a towel or half foam roller – you place even more emphasis on the rotator cuff since you’re taking the deltoids out of the equation.

It’s important to note, though, that you DO NOT need a lot of weight with this exercise – 2-5 lbs will be plenty for most trainees.  More to the point, it’s also crucial that you don’t go to fatigue (not only with this exercise, but ANY rotator cuff exercise), as you’ll often start to use faulty compensation patterns leading to superior migration of the humeral head.  Put another way:  impingement can occur.

So, in short, you’re not going to be using heavy weight with this one.  Sorry.

Standing Shoulder W

Again, keeping with the “simple is better” theme, this is an exercise popularized by physical therapist and Boston Red Sox athletic trainer, Mike Reinold.  Mike has always done a fantastic job of explaining how we’re a very upper-trap dominant society, and as such, are prone to shoulder ouchies. 

The easy fix, then, would be to pay more attention to the LOWER traps, which are woefully weak on most individuals.  In addition to the above, the standing shoulder w exercise provides a lot of bang for our training buck, combining shoulder external rotation, scapular retraction, and posterior tilt, all of which are beneficial for optimal shoulder health.

The video above is pretty self explanatory – the only point I’d like to stress is that you want to make sure you squeeze your glutes during this exercise so as not to compensate with lumbar hyper-extension.

Rhythmic Stabilizations

Lastly, are rhythmic stabilizations.  Many are quick to say that the rotator cuff’s main job is to externally/internally rotate and abduct the shoulder.  While that’s true, unfortunately, we’re not playing Jeopardy, and it’s a bit more complicated than that.

To that end, while the rotator cuff does invariably play a significant role in external/internal rotation, as well as elevation of the arm, you’d be remiss not to recognize that it’s main function is to simply center the humeral head within the glenoid fossa.  Given the more dynamic nature of life (and sport), this makes sense.

Rhythmic stabilizations are a superb rotator cuff exercise to utilize as it forces the muscles of the RC to fire in a more “functional” manner.   You don’t need to go all Mr. Miyagi, either.  Ideally, you’d GENTLY tap the elbow and upper arm for 10-15 seconds per side, and that’s that. 

We like to utilize these as a “filler” exercise during rest intervals.  After performing your main movement, say, deadlifts, kneel down on the floor and have your partner tap each arm for 10-15 seconds.  You COULD do these on your own, but the unpredictive pattern is the key to the exercise.

And I’m Done

And there you have it – a few of the more popular (and effective) exercises we use at Cressey Performance with regards to the rotator cuff.   Again, this isn’t to say that your typical band work is pointless – but rather, it’s just to reiterate that you don’t need high repetition (fatigue inducing) exercises in order to be worthwhile.   Keep it simple, do it RIGHT, and you’re golden. 

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  • Mike A

    How much different is the load placed on the rotator cuff during a quadruped rhythmic stabilization versus one done while pressing the ball against the wall? I generally use the latter to progress to the former.

  • Derek

    I've got subluxation in my shoulder. Would you recommend these or any additional exercises to strengthen the area?

  • Laurent

    Great post!

    How many times per week would your trainees perform said exercices?

    Thanks!

  • Tony Gentilcore

    @ Derek: these exercises would be a nice addition to your programming – particularly the rhythmic stabilizations (and all their varieties).

    @ Mike A: We use both the quadruped and ball-to-wall drills simultaneously. No “real” progression IMO.

  • this is a wonderful post- thank you!

  • AJ

    Any idea which variation is best if you wish to minimize posterior deltoid involvement? For instance, in a client with anterior humeral glide.

    • Tim

      90 degree abduction internal rotation to strengthen subscapularis

  • Joaquin Diaz

    Another great article Tony. I have 2 questions, do you guys use this exercises for warming up the shoulder before a lifting session? I want to know if you recommend direcr rotator cuff work before lifting, like YTWL, band pull aparts, ER…and if is necessary to add ER in every plane, the 15º-30º abducted, 90º abd and ER in sagital flexion.
    Thankss.

    • TonyGentilcore

      You can absolutely use them as a warm-up Joaquin, but I wouldn’t feel doing all those reps in every plane is necessary.

      • Joaquin Diaz

        Nice, thanks. Oh and what i meant with the second question (not working just in the warm up, in general), is, if it’s the same working at 90º or 30º?, maybe different muscles of the RC are activated i don’t know, or you would just stick with one plane?

        • TonyGentilcore

          I like 30 degrees because it’s places the shoulder at an angle where the delts won’t come into play as much. 90 degrees (full shoulder ABduction) is more challenging, and if someone is super weak, may be too much.

          It’s a case by case. But, for throwers, 90 degrees is going to have the most carry over to their sport.