A Complete Guide on How to Prevent Rotator Cuff Injuries

Danh NgoPain Relief Division, Shoulder Pain

Rotator cuff injuries are both common and debilitating. One study found that in a sample of 664 subjects over 20% of them had full-thickness rotator cuff tears. Certain activities such as manual labor and pitching baseballs can put individuals at more risk from rotator cuff injuries.

But even a fall or lifting a box overhead can lead to rotator cuff injury. Let’s take a closer look at the rotator cuff, the types of injuries it’s prone to, and what you can do to bullet-proof your rotator cuff against injury.

What Is Your Rotator Cuff

The rotator cuff is made up of four muscles and tendons. It’s responsible for keeping the ball of your upper-arm bone inside the socket of your shoulder. It also plays a role in rotating and raising your arm.

The four muscles of the rotator cuff each have an important role.


This is the largest muscle of the rotator cuff. It’s a thick triangular muscle. Its main function is to stabilize the shoulder joint and externally rotate the humerus (upper arm bone).


The supraspinatus is responsible for holding the humerus in place and keeping your upper arm stable. It is also used to help lift your arm. The supraspinatus is the most commonly affected muscle in rotator cuff injuries. 


The subscapularis connects the humerus to your shoulder blade. It’s responsible for most of the movements of your arm including rotation, lowering, and holding it out straight.

Teres Minor

The Teres Minor is the smallest muscle of the rotator cuff. It extends between the head of the humerus and the shoulder blade. Its primary function is to aid with rotating the arm away from the body.

Rotator Cuff Injury Symptoms

Symptoms of a rotator cuff injury can differ depending on their severity and on the individual. The most common symptoms include:

  • Pain that is brought on by certain activities such as trying to lift something over your head
  • Pain that is brought on from sleeping on the side of your injury
  • Cracking and grinding sounds when you move your arm
  • Limited motion and discomfort when trying to move your arm
  • Muscle weakness

It’s important to have a rotator cuff injury identified by a healthcare provider to ascertain the level of damage and establish adequate treatment/rehabilitation. 

Common Causes of Rotator Cuff Injuries

The rotator cuff is a complex system of muscles and tendons responsible for a lot of movement. However, it is quite weak. Injury of the rotator cuff is usually attributed to tissue degeneration, shoulder impingement, and trauma.

Tissue Degeneration

Over time, as people age or overuse their shoulders the tissues of the rotator cuff can degenerate. This is more common in people whose occupations involve frequently raising and lowering their arms, such as painters and decorators. 

Over time small tears develop in the rotator cuff. This makes the rotator cuff weaker and eventually increasingly prone to larger tears. These larger tears are responsible for serious injury and can occur without any notable trauma. 

Shoulder Impingement 

When raising your arm, the tendons of the rotator cuff pass through a narrow space at the top of your shoulder (subacromial space). At the top of this space is a bone called the acromion. Shoulder impingement occurs when the rotator cuff tendon catches on this bone. 


You can injure your rotator cuff with a single injury. The most common causes are trying to break your fall when you have an arm outstretched or lifting heavy weights. Any activities that put strain or force on the shoulder can cause a rotator cuff injury.

How to Prevent Rotator Cuff Injuries

Rotator cuff injuries can be incredibly debilitating and can even make it impossible to work so learning how to prevent them is a must. Sadly some occupations can make you more prone to rotator cuff injuries than others, but that doesn’t mean you can’t look after it!

Maintain Good Posture

If you tend to slouch you could be putting your rotator cuffs at risk. When you slouch forward with your head and shoulders you affect the natural movement of the shoulder blade. This can lead to shoulder impingement.

You should also be aware of how you sleep. Sleeping on your side can put pressure on the shoulder joint especially if you sleep on your side with your arm stretched out overhead. 

Nutrition & Supplements

There are a few do’s and dont’s for looking after muscles, joints, and the body in general:

  • Consume adequate protein to make sure the body recovers from physical activity
  • Don’t smoke as smoking will decrease blood flow to the rotator cuff
  • Take supplements such as fish oils, turmeric, and glucosamine to promote healthy joints
  • Reduce intake of fatty and processed foods to help reduce inflammation

Generally speaking, the healthier you are the healthier your rotator cuff is going to be. But because the rotator cuff is naturally quite weak given its importance and function, strengthening the rotator cuff with specific exercises is your best bet when it comes to preventing rotator cuff injuries.  

Rotator Cuff Injury Exercises

There are several different exercises to strengthen your rotator cuff, and the great news is that most of them can be done at home. Here are three simple ways to help strengthen your rotator cuff.

Arm Reach

An arm reach is simple and you can do it without any equipment. Simply lie down flat on your back. Extend your arms and legs and engage your abdominal muscles. Then reach one arm towards the ceiling until your shoulder blade comes off the floor. Hold your arm here for 5-10 seconds and then return it to the floor. Repeat each side 5-10 times.

Lying Down External Rotation

For this, you’ll need a light weight, but you can use a can of food or a bottle of water. Lie down on your side and hold the weight in your upper hand. While keeping the upper arm against your body bend the elbow to 90 degrees. Let the weighted hand rest towards the floor in front of you.

Now, while keeping the elbow tucked into your body, lift the weighted hand towards the ceiling by rotating the arm at the shoulder. Slowly lower it back down to the floor and repeats this 10-15 times on each side. 

Doorway Stretch

Position yourself in a doorway so that you are holding both sides of the door frame just below shoulder height. Then lean forwards with a straight back so that you feel a stretch across the front of your shoulders. The more you lean forward the deeper the stretch, but it should never be painful.

This stretch is also a great way to correct posture if you naturally slouch forwards. Hold each stretch for 30 seconds and repeat 3-5 times.

Keep Your Rotator Cuff Healthy

By following this guide you’ll be able to prevent rotator cuff injuries as best as possible. Unfortunately, if you do a lot of work with your arms overhead or you’re a baseball pitcher then your rotator cuffs are at more risk than others. However, by exercising them regularly and giving them adequate rest if you start feeling any discomfort you should be able to keep them healthy.

For more tips on living a healthy and injury-free lifestyle be sure to take a look at the rest of our page. 

We have a variety of rehab options for you to choose from. Check out our sports medicine services and schedule a telephone consultation today.

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Danh Ngo PT, DPT, OCS, SCS

Doctor of Physical Therapy

Board Certified Specialist in Orthopedic and Sports Medicine

Onbase University Certified Pitching Specialist

Certified Advanced Movement Specialist – RockTape

Certified Mobility Specialist – Rocktape

Mind Body Health Results Coach

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