Shoulder pain is widespread more so among people that train than the general population. Why? Simply because people that don’t train generally don’t stress (or test) their shoulder joints and muscles enough to warrant a painful response. Let’s put it this way; if you don’t train or play sport, it’s unlikely you’ll frequently be lifting objects above your head. However, in the gym and sport that is a typical movement pattern, so logic decerns that it’s more likely that those that use their shoulders more often and under load are more exposed to injuries through performing the movement more. Sedentary populations experiencing shoulder pain is more commonly associated with a sudden increase of movement requirements or chronic postural issue creating stress on the shoulder joint and surrounding muscles, nerves and fascia. 

The rotator cuff (the muscles that support and stabilise your shoulder joint) primary role is to maximise movement and stability in unison. At times this doesn’t always go to plan especially for those that have a history of shoulder injuries, aren’t prepared for the level of activity they’re participating in, or the overall training load is too great for that individual. Rotator cuff related pain or injuries limit your ability to use your arm in movements such as lifting your arm above your head, the activity of daily living tasks such as brushing your teeth, eating food, getting dressed. 

The shoulder rotator cuff is comprised of four muscles:

  1. Supraspinatus
  2. Infraspinatus
  3. Teres minor
  4. Subscapularis

While separate muscles capable of producing particular actions. The rotator cuffs primary role is to work as one cohesive unit having the stability of the shoulder joint. Any movement that requires your shoulder to move or you to hold and brace a weight involves your rotator cuff. 

Traditional exercises to strengthen the rotator cuff have involved banded external and internal rotator cuff movements or the isolated secondary function of each rotator cuff muscle. In our clinical practice, we like to focus on the primary role of the rotator cuff muscles, which is stability, and we train them as a group. How we do, this is with progressive stability challenging exercises. You’d start with isometric exercises to build static stability and then progress through exercises that work multiple planes of movement at a time using a moderate load but movements that have a high stability demand. By doing it this way, we’re able to train the stability function and basic movement pattern of the shoulder rotator cuff. Meaning when you no longer have pain, the transition from a rehabilitation phase into a return to activity phase is seamless.