Keeping Your Rotator Cuff Healthy and Pain-Free | STACK

Become a Better Athlete. Sign Up for our FREE Newsletter.

Keeping Your Rotator Cuff Healthy and Pain-Free

June 20, 2011

Must See Sports Injuries Videos

The rotator cuff consists of the muscles and tendons in the shoulder. Four major muscles [subscapularis, supraspinatus, infraspinatus and teres minor] work together with their tendons to connect the upper arm with the shoulder blade, holding the ball of the humerus firmly in the socket of the scapula. This anatomical structure gives the shoulder more range of motion than any other joint in the body.

Rotator cuff injuries are fairly common, usually caused by falling, lifting or repetitive motion, especially overhead motion. Injury-inducing activities include repeatedly throwing an object overhead or placing items on high shelves. Injuries are more common among people whose jobs or hobbies place heavy demands on their shoulders, and among individuals with poor posture, or rounded and hunched shoulders. Also, studies show that as we age, our risk of a rotator cuff injury increases.

How do you determine whether you’ve damaged your rotator cuff or simply irritated it from an intense workout? The Mayo Clinic describes a few symptoms:

  • Pain and tenderness in the shoulder, especially when reaching overhead, reaching behind the back, lifting, pulling or sleeping on the affected side
  • Shoulder weakness
  • Loss of shoulder range of motion
  • Inclination to keep your shoulder inactive

The most common symptom is pain—the kind that, unlike workout-induced soreness, continues for days and flares up when you use the shoulder, even for simple things like combing your hair or putting on a jacket. With a severe rotator cuff injury, such as a large tear, the pain is continuous, in some cases radiating down the arm.

Rotator cuff injuries can result from any type of irritation or damage to your rotator cuff muscles or tendons, including:

Tendinitis. Tendons in the rotator cuff become inflamed due to overuse or overload. In some people, the space for the rotator cuff becomes narrowed due to the shape of their shoulder bones.

Bursitis. The fluid-filled sac [bursa] between your shoulder joint and rotator cuff tendons becomes irritated and inflamed.

Strain or Tear. Left untreated, tendinitis weakens a tendon, leading to chronic strain or tearing. Stress from overuse also can cause a shoulder tendon or muscle to tear.

Normal Wear and Tear. Most young athletes don’t have to worry about this, but the risk increases after age 40. Normal wear and tear on the rotator cuff can cause a breakdown of fibrous protein [collagen] in the tendons and muscles, making them more prone to breakdown and injury. With age, deposits may form within the cuff, or bone spurs might pinch or irritate the rotator cuff.

Poor Posture. When you slouch your neck and shoulders forward, the space occupied by your rotator cuff muscles becomes smaller. This can allow a muscle or tendon to become pinched under the shoulder bones, especially during overhead movements and activities.

Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.

Lifting or Pulling. Lifting an object that's too heavy or doing so improperly—especially overhead—can strain or tear your tendons or muscles. Likewise, pulling something that is too heavy can cause injury.

Repetitive Stress. Repetitive overhead movement of the arms can stress rotator cuff muscles and tendons, causing inflammation and eventual tearing. This often occurs in athletes, especially baseball pitchers and tennis players.

At times, some of these causes can produce a severe problem. By following the guidelines below, you should be able to handle minor problems before they become major concerns. If you think you've irritated your rotator cuff, try these steps:

Rest Your Shoulder. Stop doing what caused the pain and avoid painful movements. Limit heavy lifting or overhead activity for four to seven days, until your shoulder starts to feel better. If pain continues after a week, you may need to see a doctor.

Apply Ice and Heat. Icing the shoulder reduces inflammation and pain. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for 15 to 20 minutes at a time—but do not put ice directly on the skin [it might cause frostbite]. Ice every couple of hours the first day or two. After two or three days, when the pain and inflammation have subsided, apply hot packs or a heating pad to the shoulder area to help relax sore and tightened muscles. Limit heat applications to 20 minutes.

Take Pain Relievers. Over-the-counter, nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, can help reduce pain. Acetaminophen [e.g., Tylenol] is another effective pain reliever. Before taking any kind of medication, however, even over-the-counter drugs, you should consult your doctor.

Keep Your Muscles Limber. After a few days, do some gentle stretching exercises to limber up your shoulder muscles. Total inactivity stiffens joints. In addition, favoring your shoulder and not moving it for long periods of time can lead to “frozen shoulder,” a condition in which your shoulder becomes so stiff you can barely move it.

Once your injury heals and range of motion is restored, resume your exercise program at a moderate level. Don’t expect to start at the same level you had attained before the injury. You’ve been relatively inactive, so it will take time to get back to where you were. Second—and more important—it might have been the intensity and volume of work you were doing that caused the problem in the first place. Continue the program with caution. Include daily shoulder stretches and a balanced shoulder-strengthening program to prevent a recurrence of the injury. Have a trainer show you specific exercises that can help strengthen, stabilize and improve the rotator cuff.

If you follow these guidelines and the pain persists, see your doctor as soon as possible.


Mark Roozen
- Mark Roozen, M.Ed.,CSCS,*D, NSCA-CPT, FNSCA, is the Director of Performance at Day of Champions Sport Camps. He recently was a member of the Cleveland Browns...
Mark Roozen
- Mark Roozen, M.Ed.,CSCS,*D, NSCA-CPT, FNSCA, is the Director of Performance at Day of Champions Sport Camps. He recently was a member of the Cleveland Browns...
Must See
Dashon Goldson: "You Just Gotta Have Heart"
Views: 3,175,981
How to Perform the Euro Step With Iman Shumpert
Views: 83,204
Patrick Willis' Homegrown Off-Season Workout
Views: 1,222,351

Featured Videos

Dwight Howard Ab Workout Views: 62,466
John Wall Elbow-to-Elbow Shooting Drill Views: 186,478
Elite Performance with Mike Boyle: Build Explosive Power With Contrast Training Views: 17,723
Load More


STACK Fitness

Everything you need to be fitter than ever

STACK Conditioning

Sport-specific conditioning programs

Coaches and Trainers

Tips and advice for coaches and trainers


Latest issues of STACK Magazine


Women's sports workout, nutrition and lifestyle advice


Gaming, entertainment and tech news

Basic Training

Military-style training for athletes


Find the latest news relevant to athletes

Most Popular Videos

Colby Lewis's Post-Game Band Splitter Routine
Views: 8,349,368
Dwight Howard Stays in the Gym All Night
Views: 3,988,602
Allyson Felix Explains How To Choose a Coach
Views: 8,690,610
Charging Ground Balls With Skip Schumaker
Views: 29,529
Antonio Brown Juggles 3 Footballs
Views: 1,175,033

Load More
More Cool Stuff You'll Like

The Future of Sports Injury Rehabilitation

3 Causes of Recurring Hamstring Injuries

How to Bench Press With a Shoulder Injury

Connective Tissue: The Key to Preventing ACL Injuries

6 Steps for Recovering From a Season-Ending Injury

Prevent ACL Injuries With This Hamstring-Focused Workout

3 Ways to Prevent the Most Common Hockey Injury

5 Things You Can Do to Prevent Muscle Injuries

4 Strategies to Prevent Tommy John Surgery

2 Ways to Fix Anterior Pelvic Tilt

7 Ways to Fix Back Pain

Predicting the Impact of DeMarco Murray's Hand Injury

The 8 Most Dangerous Exercises for Your Shoulders

How to Treat Piriformis Syndrome

10 Ways to Fix Back Pain

The Secret Weapon Powering Stephen Curry's Resurgence

6 Ways to Prevent Common Sports Injuries

Achilles Tendon Ruptures: Prevention and Recovery

Eliminate Elbow Pain with These 3 Methods

Impressive Advances in ACL Rehab

Quarterbacks: 4 Tips to Keep Your Throwing Shoulder Healthy

Pectoral Tendon Ruptures and Injury Prevention

Outsmart Injury With These 4 Predictive Tests

Sports Hernias: What You Need to Know

6 Simple Tips to Prevent Knee Injuries

8 of the Most Ridiculous Off-Field Athlete Injuries of All Time

Tips for Working Out With a Hand or Arm Injury

Evan Gattis's Protection-Enhanced Catcher's Helmet

STUDY: Imaginary Exercise Helps You Recover Faster From Injury

Why Strengthening This Muscle May Fix Knee Pain

Basketball Players: Prevent Ankle Sprains With These 3 Exercises

5 Bodyweight Exercises to Prevent Baseball Injuries

How to Keep Your Feet Healthy On and Off the Field

How to Train With Running Blisters

Avoid Low-Back Pain With These 7 In-Season Exercises

What You Need to Know About Tiger Woods' Back Injury

Bulletproof Your Body with 5 Easy Injury Prevention Exercises

4 Sports Massage Techniques to Relieve Tight Muscles

How to Prevent Injuries With 3 Yoga Poses

How to Prevent Baseball Injuries During the Off-Season

Coaches: Prevent Injuries With the Recovery Management Tool

5 Exercises to Prevent ACL Tears

5 Tips to Intelligently Train Through Lower Back Pain