We know the feeling; a deep, dull ache in your shoulder, difficulty when reaching behind your back or above your head, weakness in your arm, and the inability to sleep well. When you feel like you’ve lost some range of motion, experience pain, or find yourself doing things differently because of a tweak in your shoulder, the cause could be injury or overuse of your rotator cuff.

The rotator cuff has four muscles, the infraspinatus, supraspinatus, subscapularis, and teres minor, whose main job is to create stability in your shoulder joint. The shallow ball and socket of the shoulder allow for a greater range of motion, decreasing its stability. Without these muscles working together optimally, the shoulder joint would easily dislocate with the simplest of movements. In contrast, our hip joints are a deep ball and socket with a lot of stability and limited movement.

Not only do these muscles together provide stability to the shoulder joint, but they are also individually responsible for specific movements:

  • Infraspinatus is the main external rotator of the shoulder that is used when reaching back, like when you cock your arm to throw a ball or extend back to grab the seatbelt.
  • Supraspinatus is the primary abductor of the shoulder for the first 30 degrees of abduction, such as when you reach to grab your coffee off of the desk next to you.
  • Subscapularis is the main internal rotator of the shoulder that helps when doing things like throwing a ball or putting on your seatbelt.
  • Teres Minor externally rotates the shoulder but does its most work trying to prevent anterior dislocation of the shoulder or keeping the arm bone from moving forward into your pectoral muscles.

Because these muscles are responsible for many movements, hurting them can be pretty easy. Overuse injuries from repetitive overhead work or heavy lifting are the number one cause of muscle damage. The second most prevalent damage is due to trauma from falls, accidents, or an overstressing event like going too hard at boxing.

What can you do to prevent injuries to the rotator cuff?

Training your muscles is foundationally important as it will help the rotator cuff muscles to become stronger and more supportive of strength training for the other, sometimes more popular arm exercises of the deltoids, pectorals, biceps, triceps, and latissimus dorsi. If the shoulder joint muscles aren’t well-trained, your workout won’t be as optimized as it could be, and you risk doing more damage to your shoulder joint and muscles.

Another way to prevent injury is to build these muscles using three easy exercises outlined below. You can use a band or cable machine to train the internal and external rotation and the first 30 degrees of abduction.

Using a body blade tool can also promote better functionality of these muscles during static (at rest) or dynamic (during activity) ranges of motion.

A wobble board or exercise ball is another great tool for training the stability of these shoulder joint muscles.

If you damage these muscles, you should first be examined by a professional, such as a chiropractor, physical therapist, or medical doctor, to determine which muscle(s) is injured and begin a treatment plan. They’ll likely advise you to scale back on any activities that could reinjure or further injure your rotator cuff. You’ll want to continue moving your shoulder in a pain-free range of motion to prevent frozen shoulder. To manage the pain, you can wear a brace or sling, apply heat and ice, or take medication to help for the first 1-2 weeks post-injury. As you heal, you can slowly reintroduce your normal activities by adding more range of motion and ultimately increasing weight to strengthen these muscles.

Finally, a little PEACE & LOVE is important to strengthen and stabilize these muscles.

Protection: Avoid activities and movements that increase pain during the first few days after injury.

Elevation: Elevate the injured limb higher than the heart as often as possible.

Avoid anti-inflammatory: Anti-inflammatory medications reduce tissue healing so avoid taking them and avoid icing.

Compression: Use an elastic bandage or tape to reduce swelling.

Education: Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role.


Load: Let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase load

Optimism: Condition your brain for optimal recovery by being confident and positive.

Vascularization: Choose pain-free cardiovascular activities to increase blood flow to repairing tissues.

Exercise: Restore mobility, strength, and proprioception by adopting an active approach to recovery.

When the rotator cuff muscles are unable to be repaired through any of these interventions or treatments, surgery may be required. Scheduling a consultation with a surgeon may be the next step to fixing the issue.

Keep your rotator cuff muscles strong and agile by exercising and training them. In the event of an injury, give us a call and we can develop a treatment plan to get you pain-free and in full range of motion.