The rotator cuff muscles are the most widely referenced and most misunderstood group of muscles in the body. Anyone with the slightest discomfort of the shoulder girdle self-diagnose as “Oh, I’m pretty sure its just my rotator cuff”, without the slightest clue as to what that entails, how to treat it, or in this case- how to prevent it.
The rotator cuff is consistent of four muscles that attach the scapula to the head of the humerus. These muscles assist and stabilize the shoulder in the motions of abduction, internal and external rotation, and their inactivity and imbalance are the underpinnings of the large percentage of shoulder injuries. Due to the freedom of movement of the shoulder joint (glenohumeral joint) the strengthening of these four muscles becomes paramount when seeking to prevent injuries, as well as strengthening the prime movers of the shoulder as a whole.
THE FOUR MUSCLES OF THE ROTATOR CUFF:
- Supraspinatus: As we discussed in the article The Best Delt Exercise You’re Not Doing! the spuraspinatus acts primarily as an abductor of the shoulder in the initial 30 degrees, and does so most efficiently when the humerus is moved within the plane of the scapula.
- Infraspinatus/Teres Minor: The reason that these two muscles are grouped together is because they both act as external rotators of the shoulder and cannot be isolated completely from each other when performing the action of external rotation. The infraspinatus is most active when the shoulder is at a neautral position, whereas the teres minor activates more when the arm begins to abduct to 90 degrees.
- Subscapularis: The subscapularis is the largest of the rotator cuff muscle and it is the only one which lies on the anterior aspect of the scapula. The primary internal rotator is active throughout a range of abduction- however its internal rotational capabilities are assisted greatest when the shoulder is in a neutral position (0 degrees abduction) and isolated more at a 90 degree abducted position.The subscapularis is often overpowering in relation to its external counterparts, as people spend the majority of their day with a static internally rotated shoulder- as discussed in Prehab volume 1: static shoulder stretching . Add to that, most “gym bro’s” love for the bench press (a loaded internal rotation) and you have a recipe for severe imbalance and predisposition for injury.
Before we get into the progression I want to highlight one of the most common mistakes I see when attempting to activate the rotator cuff. For whatever reason, people think that rotator cuff training is exempt from the one true law of the gym. Gravity.
Too often I see well-intentioned gym-goers attempting to activate their rotator cuffs by flapping their arms into external/internal rotation in both neutral and 90-degree abduction with 5lb weights in their hands. When in fact they are primarily activating their biceps (by keeping elbow at 90-degrees) , posterior delt ( when externally rotating) and pecs/lats (when internally rotating).
This basic rotator cuff progression will teach you how to properly load the muscles of the rotator cuff. Note that this is merely a starting point, and won’t be getting into the realm of dynamic negative acceleration or any other sport specific applications of rotator cuff training.
To start I’m going to outline the three mediums in which we will be training the rotators with:
Resistance bands: light, inexpensive and portable the resistance band allows for on-the-go anytime rotator work. And is our best starting point.
Cables: A staple in any gym, cable machines allow for a constant resistance throughout the movement, without inducing too much instability. A perfect stepping stone to our final progression:
Free weights: make sure to keep the weights light <10 lbs at most. Often 2.5lbs-5lbs will do the trick. Anymore than that you will begin to recruit larger muscles to complete the motions.
The progression will also include two different joint positions in progression
0 degrees abduction, also known as a neutral shoulder, is the most stable joint position to train your rotator cuff muscles, and for that it will be our starting point
90-degree abduction in scaption: This position has your elbow elevated to shoulder height, and shoulder in 30 degrees transverse flexion (scaption).
PHASE ONE: BAND PROGRESSION:
Now that we’ve outlined the parameters of the progression we are merely going to fill in the blanks.
Phase 1.1: Banded Internal/External Rotation in Neutral: The biggest factors of this initial phase are the thickness of the band, as well as the location of where you anchor it. The bands tension should be light, and allow a full range of motion under tension. And should be anchored at parallel to the lifters hand at an 90-degree angle at the
Phase 1.2: Banded internal/ external rotation in 90-degree abduction in scaption: keeping the same band, raise the anchor point to the height of the shoulder.
PHASE TWO: CABLE PROGRESSION:
Phase 2.1: cable internal/external rotation in neutral: keep the weight light! As we discussed before, too much weight will call upon more capable muscles in order to complete the motion. Internal rotation will especially be aided by prime movers (pecs and lats)
Phase 2.2: cable internal/external rotation in 90-degree abduction in scaption: just like the band, raise the cable up to a shoulder height position.
PHASE THREE: FREE WEIGHT PROGRESSION:
Phase 3.1: Free weight internal /external rotation in neutral: For this progression, we need to harness our inner Isaac Newton, and not fall into the trap that the majority of people do when attempting to load rotators without a consideration for gravity. Now, this progression is to be done in neutral, but in a side lying position. The internal rotation is to be done with the involved shoulder on the bench. The external rotation is to be done with the involved shoulder up.
Phases 3.2: free weight external rotation in 90-degrees abduction: Abiding to the strict laws that Sir Isaac Newton has set forth for us in the gym we must support the arm in order to recruit the rotator cuff, and not mindlessly flap our arms in the air, relying on the delts to complete the motion of rotation. I prefer resting my abducted arm on the top of a incline bench. This offers support , which mitigates the deltoids need to support the arm in the abducted position as you initiate external rotation from an internal starting position.
You might have noticed that we did not progress internal rotation into phase 3.2. This was not a mistake, the activation of the subscapularis not dependent on the degree of abduction at the shoulder unlike infraspinatus and teres minor, also people tend to be dominant in internal rotation to begin with.
There you have it, your ground floor of rotator cuff training. Make sure to start each progression with a minimum of 15 reps per arm working up to as high as 30 reps in order to establish a feel for the muscles. It sounds time consuming I know, but consider it as an investment in your health.