4 Myths of Rotator Cuff Exercises

Rotator cuff exercises are some of the most commonly performed exercises for both rehabilitation and corrective exercises. Considering the excessive mobility of the shoulder joint and crazy demands we place on the shoulder, it is no wonder that over 20% of the adult population has been shown to have some degree of rotator cuff tears!  Furthermore, as we age and the stresses applied become cumulative, the prevalence of rotator cuff tears increases.

My past article on 3 Myths of Scapular Exercises was so popular, that I thought a similar article on myths of rotator cuff exercises was in order.

Below are some of my favorite myths of rotator cuff exercises, there are probably more than 4, but this is a start!

 

4 Myths of Rotator Cuff Exercises

Rotator Cuff Exercises Are Not Functional

Rotator Cuff Exercise - Mike Reinold

A very popular trend right now is an emphasis on “functional” training, and rightfully so in my mind. However, I have heard many people imply that performing isolated rotator cuff exercises is not functional, and even worthless! Oh, how I couldn’t disagree more.

I have mentioned this recently in presentations, but our shift to “functional” training may be swaying too far in one direction, which tends to happen in a cyclical fashion. If you’ve been out in the real world for more than a decade, you know what I mean. We appear to be in a very “functional movement” cycle right now.

I think this is awesome. Our professions have made really exciting progress in our understanding of how the human body functions. By understanding and applying concepts of functional movement patterns, we truly can help people move better and perform better.

However, we can’t forget the basics. I often comment on some of the many studies that have been published on ACL rehabilitation that compare a traditional strength program with a program that emphasizes neuromuscular control. These studies always tend to show that BOTH groups do well and improve their functional status. But I always say, why choose one? If both work well in isolation, imagine what a combined approach would yield!

Saying that rotator cuff exercises are worthless is a bold statement. I understand that the cuff’s main role is to stabilize, I have taught this endlessly throughout my career. But, I can’t help but think that a weak muscle can’t stabilize. How are we going to efficiently perform a functional movement pattern if we have underlying weakness and muscle imbalances?

Stick with the rotator cuff exercises when weakness is present. Get strong, then get functional, otherwise you may just be creating disadvantageous compensatory patterns.

 

You Get Enough Rotator Cuff Work During Other Exercises

While it is certainly true that the rotator cuff fires during all upper body strengthening exercises, how the cuff functions during different activities is important to understand. The cuff is active during activities to maintain stability of the shoulder joint. This does involve activity of the cuff, but not at levels that will produce strength gains.

I have seen very strong and powerful weightlifters and athletes have terribly weak rotator cuffs. It always catches up to them.

 

If You Use Heavy Weights Your Cuff Shuts Off and Larger Muscles Take Over

Myths of Rotator Cuff ExercisesThis is one of my favorites. You’ve probably heard this one before. The magic number seems to be 5, right? If you lift any weight over 5 pounds, your rotator cuff magically shuts off and your big muscles like your deltoid take over.

Have you ever taken a step back and thought about that?

I think I know where this came from. Imagine you had a pretty weak rotator cuff during an exercises such as side lying external rotation. You can comfortably perform the exercise with 3 pounds. If I were to give you a 15 pound weight, I bet your form would be awful and you would just sling your arm back using your posterior deltoid and trapezius muscles. That is obviously not good, any time you overload a weak muscle you will get compensation. That applies to every muscle in the body.

But that doesn’t mean that you can’t slowly work your weight up to over 5 pounds as you get stronger. Why would you stop at 5 pounds? What if that isn’t challenging anymore? What is the point of that? Would you stop loading your squat at a certain weight and just sit there forever?

I routinely get patients into weight over 5 pounds when working the rotator cuff, some even in double digits. If you are compensating and using larger muscle groups, you may just not be strong enough for that weight.

 

Use the Same Weight During All Rotator Cuff Exercises

This one cracks me up and I am absolutely guilty of this myself! When we give someone a shoulder program to perform, why do we tell them to use the same weight for every exercise? Would you do this anywhere else in your body?  Today we are going to squat, lunge, and deadlift with the same weight… Sounds funny, right?

Challenge each muscle during each exercise. If a weight is too light for one exercise, go up. Don’t get stuck in the habit of using the same weight for every exercise or you will almost certainly not be maximizing your gains for each muscle group. Remember, the goal is to get stronger.

 

So there are 4 myths of rotator cuff exercises that you should consider.  What do you think about these myths?  Do you think there are more?  Like I said, there are probably more, but these at least came to my mind when I think about rotator cuff exercises.

 

 

 

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15 Responses to “4 Myths of Rotator Cuff Exercises”

  1. Mike you bring up a good point about the push for everything “functional.” I agree it is great we are progressing in our progression but functional training cant be the end all be all. Here is my take on performing rotator cuff exercises in isolation. With overuse training our group (http://www.ncbi.nlm.nih.gov/pubmed/17318892 http://www.ncbi.nlm.nih.gov/pubmed/21688311) has been finding that the supraspinatus tendon begins to express more cartilage like proteins instead of tendon proteins. This is all done in the rat rotator cuff model. We find increased gene expression of col II and SOX 9. I think that during overuse the tendons are experiencing increased shear and compression loads which begin to lead the tissue into a cartilage phenotype. We have also shown that rest (http://www.ncbi.nlm.nih.gov/pubmed/18459028) does recover this by eliminating the shear and compression loads. However, athletes don’t just want to rest so I think by performing isolated rotator cuff exercises we can return the tendon to a tendon phenotype but creating pure tension loads and eliminating the shear and compression. This is one situation that the exercises need to be performed in isolation and not in a functional approach.

    • Stephen, this is awesome stuff! Can you email me? Would like to discuss further!

      • Could this be a reason that rotator cuff repairs don’t always take? That the tendon after repair is expressing too much cartilage-like proteins instead of tendinous protein, thereby not allowing it to handle the compressive and shear forces applied to it following surgery? Or would the immobilization period following the repair, the “rest” period allow enough time for the reversal of the protein? Stephen – would you then be looking at following repetitions based for tendon at 100 to 1,000 reps when doing RTC exercises to target the return of tendon phenotype?

        Thanks for your consideration!

        Kevin

  2. I come from a personal training and kinesiology background and I’m actually shocked at how often the rotator cuff is ignored in personal training regimes. I completely agree with all 4 myths here and have seen 2 and 3 commonly used by personal trainers.

  3. It has never made sense to me that there should be an upper weight limit to cuff exercises. But because it’s always so widely preached I’ve never been able to figure out a logical strength progression and have actually just stopped at about 5lbs. Imagining I have a ‘healthy’ cuff that I’m trying to train as prehab, when do I increase weight and how? Even a 1kg increase seems like quite a big jump (or am I letting the preachers whisper scary things in my ear?)

    Would be interested in your opinion on this.

    • If it is easy, then go up!

      • Well my lower arm extensors have become very sore and inflamed through work – tennis elbow tenditinitis. After one steroid injection I have now overcome the problem by eccentric loading of lower extensors using progressive weight overload. Until I increased the weight I saw no improvement at all!

  4. Do you think an excercise that could work for rehab or that people could start with could be doing the alphabet while the arm is at 90° in front or on the side of you. If you want to add weight you can do it with a basket-ball against the wall? Afterward you can add more weight for progression.

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  6. Thanks Mike for your excellent points as per usual! My philosophy is Isolate then integrate then coordinate! . The pendulum in the fitness industry really swings too far in one direction and we forget the other methods that also brought results. As McGill states ” it depends” . Thanks Mike!

  7. Spot on, Mike! Keep up the good work!

  8. Great post Mike. With regards to heavy weight for supraspinatus specific ex, any concerns for hypertrophy given the small subacromial space that it runs through? In your opinion, should we stick with lower weights/higher reps?

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