Physical therapy exercises for rotator cuff tendonitis

If you've had a rotator cuff tear, physical therapy will be important to help you regain shoulder strength and range of motion.

Here are examples of several typical exercises and stretches you may encounter on your road to recovery.

1. Pendulum swing

Stand to the side of a table, steady chair, or railing and place the hand of your uninjured arm on the object for stability.
Gently lean forward without rounding the back and allow the affected arm to dangle freely. Then, lightly move this arm forward and back.
Starting in the same position, move your arm in and out (side-to-side).
Starting in the same position, move your arm in small circles. Start in a clockwise motion, then reverse and do it counterclockwise.
Repeat the exercise with the other arm.

See Rotator Cuff Injuries: Symptoms

2. Crossover arm stretch

Stand up straight and relax your shoulders. Take a few deep breaths if you need to relax.
Stretch the affected arm across your chest, but below your chin; reach as far as possible.
The healthy arm helps by holding the elbow area of the affected arm.
When performing this exercise, you should feel a stretch—not pain.
Repeat the exercise with the other arm.

Watch: Video: Crossover Shoulder Stretch

3. Standing row

This exercise involves a stretch band, tied at the ends to make a three-foot loop.
Attach one end of the loop to a steady object like a doorknob and face it.
Hold the other end in one hand, and stand far back enough so there is little or no slack in the band.
With your arm bent at the elbow at a 90-degree angle and close to your body, pull the elbow back.
Repeat the exercise with the other arm.

See Rotator Cuff Injuries: Causes and Risk Factors

4. Internal rotation

Like a standing row, this exercise involves a stretch band tied at the ends to make a three-foot loop.
Attach one end of the loop to a steady object like a doorknob; stand to the side and hold the band in the hand of your affected arm.
Bend your elbow to a 90-degree angle and keep it close to your body. Then, bring the forearm over the midsection of the body.
Repeat the exercise with the other arm.

5. Posterior stretch

Stand up and relax the shoulders.
The hand of the uninjured arm holds the elbow region of the injured one.
The hand of the injured arm crosses the body and rests on the opposite shoulder.
The hand of the uninjured arm lightly pushes the affected arm up and over the body, eliciting a stretch.
Repeat the exercise with the other arm.

Your physician or physical therapist will typically specify the types of exercises and number of repetitions to fit your needs and goals. He or she will also instruct you in the correct exercise technique, as well as pain management approaches. For example, icing immediately after stretching helps calm inflammation; your health care provider can show you how best to apply ice or a cold pack.

See Rotator Cuff Injuries: Initial Treatment

As with any exercise program, work with closely with your doctor and/or physical therapist to make sure you're doing the correct exercises with the right form. You want to ensure you are performing the recommended stretches and exercises correctly; adjustments may be needed if you feel pain. As a general rule, exercising should not be overly painful. If you experience pain stop and consult with your health care provider before continuing.

See Rotator Cuff Injuries: Diagnosis

The rotator cuff has an important role: securing your upper arm bone (humerus) and enabling shoulder movement. Following your prescribed physical therapy program can help restore your shoulder to normal function after a tear, and get you back to the activities you enjoy!

See Soft Tissues of the Shoulder

Learn more:

See Rotator Cuff Injuries

See Rotator Cuff Injections

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Introduction

Here are some examples of exercises for you to try. The exercises may be suggested for a condition or for rehabilitation. Start each exercise slowly. Ease off the exercises if you start to have pain.

You will be told when to start these exercises and which ones will work best for you.

How to do the exercises

Pendulum swing

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slide 1 of 16, Pendulum swing,

If you have pain in your back, do not do this exercise.

Hold on to a table or the back of a chair with your good arm. Then bend forward a little and let your sore arm hang straight down. This exercise does not use the arm muscles. Rather, use your legs and your hips to create movement that makes your arm swing freely.
Use the movement from your hips and legs to guide the slightly swinging arm back and forth like a pendulum (or elephant trunk). Then guide it in circles that start small (about the size of a dinner plate). Make the circles a bit larger each day, as your pain allows.
Do this exercise for 5 minutes, 5 to 7 times each day.
As you have less pain, try bending over a little farther to do this exercise. This will increase the amount of movement at your shoulder.

Posterior stretching exercise

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slide 2 of 16, Posterior stretching exercise,

Hold the elbow of your injured arm with your other hand.
Use your hand to pull your injured arm gently up and across your body. You will feel a gentle stretch across the back of your injured shoulder.
Hold for at least 15 to 30 seconds. Then slowly lower your arm.
Repeat 2 to 4 times.

Up-the-back stretch

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slide 3 of 16, Up-the-back stretch,

Your doctor or physical therapist may want you to wait to do this stretch until you have regained most of your range of motion and strength. You can do this stretch in different ways. Hold any of these stretches for at least 15 to 30 seconds. Repeat them 2 to 4 times.

Light stretch: Put your hand in your back pocket. Let it rest there to stretch your shoulder.
Moderate stretch: With your other hand, hold your injured arm (palm outward) behind your back by the wrist. Pull your arm up gently to stretch your shoulder.
Advanced stretch: Put a towel over your other shoulder. Put the hand of your injured arm behind your back. Now hold the back end of the towel. With the other hand, hold the front end of the towel in front of your body. Pull gently on the front end of the towel. This will bring your hand farther up your back to stretch your shoulder.

Overhead stretch

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slide 4 of 16, Overhead stretch,

Standing about an arm's length away, grasp onto a solid surface. You could use a countertop, a doorknob, or the back of a sturdy chair.
With your knees slightly bent, bend forward with your arms straight. Lower your upper body, and let your shoulders stretch.
As your shoulders are able to stretch farther, you may need to take a step or two backward.
Hold for at least 15 to 30 seconds. Then stand up and relax. If you had stepped back during your stretch, step forward so you can keep your hands on the solid surface.
Repeat 2 to 4 times.

Shoulder flexion (lying down)

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slide 5 of 16, Shoulder flexion (lying down),

To make a wand for this exercise, use a piece of PVC pipe or a broom handle with the broom removed. Make the wand about a foot wider than your shoulders.

Lie on your back, holding a wand with both hands. Your palms should face down as you hold the wand.
Keeping your elbows straight, slowly raise your arms over your head. Raise them until you feel a stretch in your shoulders, upper back, and chest.
Hold for 15 to 30 seconds.
Repeat 2 to 4 times.

Shoulder rotation (lying down)

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slide 6 of 16, Shoulder rotation (lying down),

To make a wand for this exercise, use a piece of PVC pipe or a broom handle with the broom removed. Make the wand about a foot wider than your shoulders.

Lie on your back. Hold a wand with both hands with your elbows bent and palms up.
Keep your elbows close to your body, and move the wand across your body toward the sore arm.
Hold for 8 to 12 seconds.
Repeat 2 to 4 times.

Wall climbing (to the side)

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slide 7 of 16, Wall climbing (to the side),

Avoid any movement that is straight to your side, and be careful not to arch your back. Your arm should stay about 30 degrees to the front of your side.

Stand with your side to a wall so that your fingers can just touch it at an angle about 30 degrees toward the front of your body.
Walk the fingers of your injured arm up the wall as high as pain permits. Try not to shrug your shoulder up toward your ear as you move your arm up.
Hold that position for a count of at least 15 to 20.
Walk your fingers back down to the starting position.
Repeat at least 2 to 4 times. Try to reach higher each time.

Wall climbing (to the front)

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slide 8 of 16, Wall climbing (to the front),

During this stretching exercise, be careful not to arch your back.

Face a wall, and stand so your fingers can just touch it.
Keeping your shoulder down, walk the fingers of your injured arm up the wall as high as pain permits. (Don't shrug your shoulder up toward your ear.)
Hold your arm in that position for at least 15 to 30 seconds.
Slowly walk your fingers back down to where you started.
Repeat at least 2 to 4 times. Try to reach higher each time.

Shoulder blade squeeze

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slide 9 of 16, Shoulder blade squeeze,

Stand with your arms at your sides, and squeeze your shoulder blades together. Do not raise your shoulders up as you squeeze.
Hold 6 seconds.
Repeat 8 to 12 times.

Scapular exercise: Arm reach

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slide 10 of 16, Scapular exercise: Arm reach,

Lie flat on your back. This exercise is a very slight motion that starts with your arms raised (elbows straight, arms straight).
From this position, reach higher toward the sky or ceiling. Keep your elbows straight. All motion should be from your shoulder blade only.
Relax your arms back to where you started.
Repeat 8 to 12 times.

Arm raise to the side

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slide 11 of 16, Arm raise to the side,

During this strengthening exercise, your arm should stay about 30 degrees to the front of your side.

Slowly raise your injured arm to the side, with your thumb facing up. Raise your arm 60 degrees at the most (shoulder level is 90 degrees).
Hold the position for 3 to 5 seconds. Then lower your arm back to your side. If you need to, bring your "good" arm across your body and place it under the elbow as you lower your injured arm. Use your good arm to keep your injured arm from dropping down too fast.
Repeat 8 to 12 times.
When you first start out, don't hold any extra weight in your hand. As you get stronger, you may use a 1-pound to 2-pound dumbbell or a small can of food.

Shoulder flexor and extensor exercise

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slide 12 of 16, Shoulder flexor and extensor exercise,

These are isometric exercises. That means you contract your muscles without actually moving.

Push forward (flex): Stand facing a wall or doorjamb, about 6 inches or less back. Hold your injured arm against your body. Make a closed fist with your thumb on top. Then gently push your hand forward into the wall with about 25% to 50% of your strength. Don't let your body move backward as you push. Hold for about 6 seconds. Relax for a few seconds. Repeat 8 to 12 times.
Push backward (extend): Stand with your back flat against a wall. Your upper arm should be against the wall, with your elbow bent 90 degrees (your hand straight ahead). Push your elbow gently back against the wall with about 25% to 50% of your strength. Don't let your body move forward as you push. Hold for about 6 seconds. Relax for a few seconds. Repeat 8 to 12 times.

Scapular exercise: Wall push-ups

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slide 13 of 16, Scapular exercise: Wall push-ups,

This exercise is best done with your fingers somewhat turned out, rather than straight up and down.

Stand facing a wall, about 12 inches to 18 inches away.
Place your hands on the wall at shoulder height.
Slowly bend your elbows and bring your face to the wall. Keep your back and hips straight.
Push back to where you started.
Repeat 8 to 12 times.
When you can do this exercise against a wall comfortably, you can try it against a counter. You can then slowly progress to the end of a couch, then to a sturdy chair, and finally to the floor.

Scapular exercise: Retraction

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slide 14 of 16, Scapular exercise: Retraction,

For this exercise, you will need elastic exercise material, such as surgical tubing or Thera-Band.

Put the band around a solid object at about waist level. (A bedpost will work well.) Each hand should hold an end of the band.
With your elbows at your sides and bent to 90 degrees, pull the band back. Your shoulder blades should move toward each other. Then move your arms back where you started.
Repeat 8 to 12 times.
If you have good range of motion in your shoulders, try this exercise with your arms lifted out to the sides. Keep your elbows at a 90-degree angle. Raise the elastic band up to about shoulder level. Pull the band back to move your shoulder blades toward each other. Then move your arms back where you started.

Internal rotator strengthening exercise

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slide 15 of 16, Internal rotator strengthening exercise,

Start by tying a piece of elastic exercise material to a doorknob. You can use surgical tubing or Thera-Band.
Stand or sit with your shoulder relaxed and your elbow bent 90 degrees. Your upper arm should rest comfortably against your side. Squeeze a rolled towel between your elbow and your body for comfort. This will help keep your arm at your side.
Hold one end of the elastic band in the hand of the painful arm.
Slowly rotate your forearm toward your body until it touches your belly. Slowly move it back to where you started.
Keep your elbow and upper arm firmly tucked against the towel roll or at your side.
Repeat 8 to 12 times.

External rotator strengthening exercise

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slide 16 of 16, External rotator strengthening exercise,

Start by tying a piece of elastic exercise material to a doorknob. You can use surgical tubing or Thera-Band. (You may also hold one end of the band in each hand.)
Stand or sit with your shoulder relaxed and your elbow bent 90 degrees. Your upper arm should rest comfortably against your side. Squeeze a rolled towel between your elbow and your body for comfort. This will help keep your arm at your side.
Hold one end of the elastic band with the hand of the painful arm.
Start with your forearm across your belly. Slowly rotate the forearm out away from your body. Keep your elbow and upper arm tucked against the towel roll or the side of your body until you begin to feel tightness in your shoulder. Slowly move your arm back to where you started.
Repeat 8 to 12 times.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Can PT help rotator cuff tendonitis?

Physical therapy can be very successful in treating rotator cuff tendinitis, tendinosis, and shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include: Pain management.

How can I heal my rotator cuff tendinitis fast?

How is rotator cuff tendinitis treated?.

Ice. Putting ice bags or cold packs on the shoulder reduces inflammation and pain. ... .

NSAIDs. These aspirin-like drugs (Motrin, ibuprofen, Nuprin, Naprosyn, Advil, Aleve, etc.) ... .

Steroids. If other treatments do not work, steroid treatment may be used to reduce inflammation and pain..

What is the best exercise for shoulder tendonitis?

Bend over at the waist and let the arm hang down passively. Using your body to initiate movement, swing the arm gently forward and backward and in a circular motion. Do this pendulum exercise for several minutes, 3 to 5 times per day. Use this exercise as a warm-up activity before stretching.

How long is physical therapy for rotator cuff tendinitis?

Every case is different and your physical therapist will devise a treatment plan that is specific to the severity of your condition and your goals. For a mild case or shoulder tendonitis, you can expect therapy to last for approximately six to eight weeks, whereas a more severe case could take up to 12 weeks to treat.