Among all the exercise related injuries, the three that rise above the rest occur in the knees, shoulders, and back. Injuries at these joint locations are typically not the type you can work through. They often require surgery, pain medication, and physical therapy. So not fun. As ACL tears and herniated discs can be quite painful and will typically set you back for months on end, many individuals report tears within the shoulder-joint as one of the most painful injuries experienced. This area of the shoulder is often referred to as the rotator cuff, which is actually a group of muscles and tendons that support the stability of the humerus (your upper arm) within the Glenohumeral joint (shoulder socket). Even WITH surgery, large tears here often don't heal properly.
The muscles of the rotator cuff include the Supraspinatus (above the scapular spine), Infraspinatus (below the scapular spine), Subscapularis (underneath the scapula), and Teres Minor. They are referred to as the rotator cuff partly because their function aside from stabilizing the humerus within the shoulder-joint, is to rotate the upper-arm internally and externally. When these muscles are neglected, they compromise the stability of the shoulder and often create friction that prevents the humerus from moving easily within the socket. When unaddressed, this lack of space often results in nerve impingement, a partial tear, or full tear, wherein the tendon can be torn completely off the bone. So not fun.
Causes As the cause of rotator cuff injuries can derive from the overuse of the shoulder-joint, they are more commonly a product of poor posture within the confines of every day life. In particular, it is the internally rotated orientation of the shoulder as a result of poor posture, and or weak posterior muscles, that eventually cause wear and tear on the tendons within the shoulder socket and degrade the stability of the shoulder over time. Exercises that require pressing movements (such as bench press and overhead shoulder press) only exacerbate the degradation.The scary thing is, this degradation often goes under the radar because the process happens gradually and is often pain free until it is too late and a tear occurs.
Most of the activities we do day to day such as holding and looking at our phones, sitting for long periods, typing on the keyboard, and driving, will more often than not put the shoulder in an internally rotated state when proper posture is not emphasized. Lets address how to fix this!
How to fix
These exercises are often neglected, as I hardly see anyone do them at the gym. The average gym goer that DOES know of them usually know of their existence simply because they have already injured themselves and have undergone physical therapy. The movements below will help strengthen the muscles mentioned above, warding off injuries. They can be done with a band or a cable machine. Weights will also work (requiring much different form) but I recommend starting with bands or cables first, making sure your form is right before progressing. Rep count should be from 5-12 reps for 3-5 sets. These can also be done as a warmup before going on to more compound movements such as bench press or lat pull downs.
1. External rotation (horizontal):
2. External rotation (vertical):