Exercises to Treat Rotator Cuff Injuries

Pendulum circles and isometric shoulder rotations are types of exercise used early in physical therapy to treat shoulder injuries. These no-impact exercises help restore the range of motion in the muscles and joint that make up the rotator cuff.

The rotator cuff can be damaged due to overuse or a traumatic injury such as a fractured collarbone (clavicle). A torn rotator cuff, in which the tendon tissue is either ruptured or severed, is common in sports that require overhead movements, such as throwing or reaching.

Because every injury is different, it is important to work with your healthcare provider and physical therapist to design a program appropriate to your injury and fitness level. Rehab exercises are designed to return an athlete to optimal performance as quickly and safely as possible.

A man getting physical therapy for his shoulder
 Nicola Katie / Getty Images

How to Do Pendulum Circles

Pendulum circles can be done at home with either a chair or table. As you progress and your injury improves, you can incorporate a lightweight (two to five pounds) to help build strength.

To do a pendulum circle:

  • Bend forward 90 degrees at the waist, using your uninjured arm to support yourself on a chair or table.
  • Let the injured arm hang loosely toward the ground.
  • Using the weight of your arm, start making small circles like a pendulum, keeping your arm loose and circling from the shoulder. Let the momentum of your arm move you effortlessly for 10 circles.
  • Stop and repeat in the opposite direction for 10 circles, keeping the movement smooth and controlled.
  • Repeat for five repetitions in each direction, increasing the number of repetitions as you get stronger.

How to Do Isometric Shoulder External Rotation

Isometrics are a type of exercise in which the joint angle and muscle length do not change during contraction. They are done in static positions, often working against one muscle against the next or pressing a body part against a fixed object such as a wall.

An isometric shoulder external rotation is an exercise that can help strengthen the teres minor and infraspinatus muscles of the rotator cuff. To perform an external rotation:

  • Stand perpendicular to a wall about six inches away with the injured shoulder positioned toward the wall.
  • Bend your elbow 90 degrees, making a fist, and press the back of your fist into the wall as if you were rotating your arm outward. (You can pad your hand with a towel if needed.) Gently press into the wall for about five seconds without moving the shoulder and release.
  • Repeat for 10 to 15 repetitions.

How to Do an Isometric Shoulder Internal Rotation

The isometric shoulder internal rotation is the yin to the previous exercise’s yang. To do this correctly:

  • Face an outward corner of a wall and position the injured shoulder near the corner.
  • Bending your elbow 90 degrees, make a fist and press the inside of your fist against the wall as if rotating your arm inward. (Again, you can pad your hand with a towel, if needed.) Gently press for five seconds without moving the shoulder and release.
  • Repeat for 10 to 15 repetitions.
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By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.