Are band internal and external rotation exercises your “go to” for client rotator cuff health? With the prevalence of adult general population rotator cuff tears exceeding 22% (Minagawa, 2013), clients interested in fitness longevity cannot afford to ignore rotator cuff health. Typical rotator cuff band exercises, however, may not be the best solution for creating sustainable shoulder stability. Take a moment to discover why band exercises fall short of the goal, and learn 5 effective shoulder stabilization alternatives.
Where band rotator cuff exercises fall short
1. Limited functional carryover: Clients typically hold their upper arm close to the body as they rotate the upper arm in or out against the band’s resistance. Most rotator cuff injuries, however, occur near end range when the client reaches away from the body. The exercise range and the injury prone range do not match. The strength of the close range does not carryover to functional stability when reaching away from the body.2. The band is too heavy: Rotator cuff muscles are small. Most bands exceed 5 pounds when stretched. When the weight is too heavy for the desired rotator cuff recruitment, other muscles like deltoids take over. Targeting deltoids can facilitate physique and overall strength goals. Deltoids, however, do not make good shoulder stabilizers.
3. Bands break: While some very lightweight bands can be used to effectively target the rotator cuff, they lack durability. The risk of bands breaking while clients are using them introduces liability concerns. The risk can be decreased with frequent band inspection and replacement, but this adds to recurrent equipment costs.
5 shoulder stability exercises to try instead
1. Yoga dolphin pose. Yoga dolphin pose is like downward dog with the forearms on the ground. Here’s how dolphin pose can be leveraged for overhead rotator cuff stability:
a. Cue the client to actively press the forearms into the floor to create space between the shoulders and ears.b. Keep the ears between the upper arms.c. Instead of holding the pose, shift weight slightly forward and back 10x. Then, repeat the weight shifting side to side.
2. Reverse plank. When an arm extends behind the body with speed or load, the rotator cuff and surrounding shoulder capsule become extremely vulnerable to injury. The reverse plank helps build the rotator cuff’s safe zone for shoulder extension. Here’s how to cue the reverse plank for shoulder stability:
a. Hands can face almost any direction. Training multiple hand directions helps support the multi-angle shoulder stabilization goal.b. Cue the client to squeeze their glutes, then cue the client to actively press the fingertips and palms into the ground. These cues facilitate active shoulder stabilization as the client lifts the hips.c. Start by holding the position for 5-30 seconds. Once the client can hold for 30 seconds, add the weight shift component from the yoga dolphin pose.
3. High plank knee to elbow. If clients experience a FOOSH (fall on outstretched hands), the rotator cuff is in a vulnerable position. The high plank elbow to knee exercise helps build forward reach stability capacity. Try these cueing tips:
a. In the high plank, actively press all fingers and the thumb side of the palm into the ground.
b. Try to “hide the heart,” by pulling the heart into the spine. This cue helps engage key shoulder stabilizers. c. Perform a variety of elbow to same knee and elbow to opposite knee repetitions to fatigue. For advanced clients, vary the speed while minimizing side-to-side hip shift.
4. Side plank hip abduction. Reaching sideways with an outstretched arm also creates great shoulder vulnerability, particularly if speed or load are involved. The side plank with dynamic lower body movement, such as repeated hip abduction, helps train the rotator cuff stability for this challenging position. Try these cues to maximize rotator cuff stability during the side plank:
a. The side plank can be performed on the forearm or the hand. Training both positions will facilitate different muscle recruitment patterns. Varying muscle recruitment patterns can enhance stability.b. Cue for straight body alignment from the head to the shoulders to the hips to the heels.c. Have the client perform a dynamic movement with the top leg, such as repeated hip abduction to upper body fatigue. For advanced clients, challenge their coordination and shoulder endurance with leg sequences such as scissor or rainbow motions.
5. Kettlebell overhead walks. Walking while holding a light kettlebell overhead in one hand requires total body coordination with dynamic shoulder stabilization. Use these checkpoints in your cueing:
a. Turn fitness watches around so the clock face is on the front side of the wrist. This prevents the kettlebell from cracking the watch face.b. The kettlebell begins in front of the shoulder, as if near the top of a biceps curl. This is also the exit position for the kettlebell. Make sure that clients understand the start and end position before adding weight.c. Once the kettlebell is overhead, keep the elbow and head straight.d. Knuckles should face the ceiling throughout the walk.e. Novice clients should start with a very light object like a tennis ball (instead of a kettlebell). Intermediate clients can hold the handle while the bell rests on the back of the wrist. Advanced clients can hold the kettlebell inverted.f. Start with a shorter distance than the client is likely capable of, remembering that they need to safely bring the kettlebell down prior to fatigue. Progress distance and speed over time.
Summary and next steps
The above 5 exercises provide multi-directional, multi-speed, multi lever-length proprioception and endurance to support functional rotator cuff stability capacity. Adults over age 30 are particularly susceptible to rotator cuff injuries that can sideline their fitness for months, years or lifetimes. If you train adults over 30, sprinkle the above exercises into the weekly training plan, scaling as appropriate, to help your clients build shoulder stability for fitness longevity.
Dr. Meredith Butulis, DPT, OCS, CEP, CSCS, CPT, PES, CES, BCS, Pilates-certified, Yoga-certified, has been working in the fitness and rehabilitation fields since 1998. She is the creator of the Fitness Comeback Coaching Certification, author of the Mobility | Stability Equation series, Host of the “Fitness Comeback Coaching Podcast,” and Assistant Professor the State College of Florida. She shares her background to help us reflect on our professional fitness practices from new perspectives that can help us all grow together in the industry. Instagram: @doc.mnb
