Lifting with a Rotator Cuff Injury: What You Need to Know
A rotator cuff injury is one of the most common shoulder issues among lifters, athletes, and active individuals. Whether you’re an experienced weightlifter, a weekend warrior, or someone who enjoys functional training, shoulder pain can be a major setback. Since the rotator cuff plays a crucial role in shoulder stability and movement, an injury to this area can make even the simplest lifts feel uncomfortable or even impossible.
The good news? A rotator cuff injury doesn’t have to mean the end of your lifting routine. While it may take some adjustments and patience, you can still train effectively without worsening your condition. The key is modification, proper recovery, and smart programming. With the right approach, you can maintain your strength and mobility while allowing your shoulder to heal properly.
Here we’ll cover what a rotator cuff injury is, which exercises to avoid, safer alternatives, and the best strategies for recovery. Whether you’re dealing with mild discomfort or a more serious injury, this article will help you navigate training while keeping your shoulder health a top priority.
What Is a Rotator Cuff Injury?
The rotator cuff is a group of four small muscles that stabilize the shoulder joint and facilitate arm movement. These muscles—supraspinatus, infraspinatus, teres minor, and subscapularis—play a crucial role in shoulder stability, especially during lifting exercises.
Common causes of a rotator cuff injury include:
Overuse or repetitive strain (e.g., frequent overhead pressing, bench pressing, or throwing motions)
Poor lifting mechanics (e.g., improper shoulder positioning or lack of scapular control)
Acute trauma (e.g., falling on an outstretched arm or a sudden heavy lift)
Muscle imbalances and weakness (especially between the front and back of the shoulder)
Symptoms of a rotator cuff injury can vary but often include:
Pain when lifting your arm overhead or reaching behind your back
Weakness in the shoulder, particularly with pressing or rotating motions
Clicking, popping, or grinding sensations
Pain at night or when sleeping on the affected shoulder
History and Recent Discoveries in Rotator Cuff Injuries
Rotator cuff injuries have been recognized in medical literature for centuries, with early references dating back to the 19th century. However, significant advancements in understanding these injuries have come in the last few decades. Studies in sports medicine and orthopedic research have led to improved diagnostic techniques and more effective rehabilitation strategies.
One of the key discoveries in recent years is the role of degenerative changes in rotator cuff injuries. Research published in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT, 2020) indicates that age-related changes in tendon composition play a crucial role in injury susceptibility. This means that not all rotator cuff injuries are caused by acute trauma—many occur gradually due to repetitive stress and weakening of the tendon tissue.
A major shift in treatment philosophy is the focus on eccentric strengthening exercises as a primary method of rehabilitation. Studies have demonstrated that controlled eccentric loading—where the muscle lengthens under tension—can help stimulate tendon repair and improve shoulder function. This method is now widely incorporated into physical therapy protocols for both acute and chronic rotator cuff injuries.
Can You Still Lift with a Rotator Cuff Injury?
Yes—but with caution. The key is modification and proper load management to avoid further irritation. Lifting through pain or ignoring symptoms can worsen the injury and lead to a longer recovery time.
When lifting with a rotator cuff injury, it is crucial to eliminate or modify movements that put excessive strain on the shoulder joint and replace them with safer alternatives. Here’s how to approach your training:
Movements to Avoid:
Overhead Pressing (Military Press, Push Press, Snatch, etc.) – These movements place significant stress on the rotator cuff and should be avoided until pain-free movement is restored.
Heavy Bench Press and Dips – The bottom position of both exercises puts excessive load on the injured shoulder.
Behind-the-Neck Lat Pulldowns and Pull-ups – These place the shoulder in an externally rotated and vulnerable position.
Upright Rows – This movement internally rotates the shoulders, increasing the risk of impingement.
Heavy Isolation Work (Lateral Raises with Poor Form, Front Raises, Heavy Fly’s) – These movements can put excessive strain on the injured area when performed with improper control.
Safer Alternatives:
Neutral-Grip Pressing (Dumbbells or Swiss Bar Bench Press) – A neutral grip reduces stress on the rotator cuff and allows for more natural shoulder mechanics.
Landmine Press – A great alternative for pressing movements that limits shoulder strain while still building strength.
Incline Dumbbell Press (Light to Moderate Weight) – Reducing range of motion and using a neutral grip can help alleviate shoulder discomfort.
Cable and Banded External Rotations – These directly strengthen the rotator cuff and improve shoulder stability.
Face Pulls, Banded Pull-Aparts, and Reverse Flys – These exercises help reinforce proper shoulder mechanics and prevent imbalances.
Controlled Rows (Seated Cable Rows, Single-Arm Dumbbell Rows, Chest-Supported Rows) – Strengthening the upper back muscles supports shoulder stability and reduces stress on the rotator cuff.
Lower Body Work (Squats, Deadlifts, Hip Thrusts, Step-Ups, etc.) – Keeping the lower body strong while avoiding upper body strain can help maintain fitness during recovery.
How to Support Recovery
Healing a rotator cuff injury requires patience and consistency with rehab exercises. Here’s how to optimize recovery:
Incorporate Rotator Cuff Strengthening – Exercises like banded external rotations, side-lying dumbbell rotations, and scapular stability work can help.
Prioritize Mobility and Stability – Controlled shoulder mobility drills and scapular control exercises improve joint function.
Manage Inflammation – Ice, anti-inflammatory foods, and proper rest can help reduce pain and swelling.
Avoid “Pushing Through” Pain – Pain is a signal; respect it. Modify movements as needed to prevent further injury.
Consider Professional Help – If pain persists, working with a physiotherapist or sports chiropractor can provide a personalized recovery plan.
Example 3-Day Workout Plan for Strength Training with a Rotator Cuff Injury
This plan focuses on full-body strength while incorporating all three planes of movement (sagittal, frontal, transverse) to ensure balanced development.
Day 1: Lower Body & Core (Sagittal & Frontal Plane Focus)
Bulgarian Split Squats – 3x10 per leg
Romanian Deadlifts – 4x10
Lateral Lunges – 3x10 per leg
Glute Bridges – 3x15
Cable Woodchoppers – 3x12 per side
Day 2: Upper Body & Rotational Stability (Frontal & Transverse Plane Focus)
Landmine Press – 3x10 per arm (Keep your core engaged and press slightly forward instead of straight up to reduce shoulder strain.)
Chest-Supported Rows – 4x10 (Maintain a neutral spine and focus on squeezing your shoulder blades together.)
Side-Lying External Rotations – 3x12 per side (Use light resistance and move slowly to avoid compensation.)
Single-Arm Farmer’s Carry – 3x20 meters per side (Keep shoulders level and engage your core to avoid excessive tilting.)
Seated Cable Rotations – 3x12 per side (Control the motion to prevent jerking movements.)
Day 3: Full-Body & Functional Stability (All Planes of Movement)
Trap Bar Deadlifts – 4x6-8 (Maintain a neutral spine and engage your lats to stabilize your shoulders.)
Lateral Step-Ups – 3x10 per leg (Keep knee aligned with toes and drive through the heel to avoid excessive knee stress.)
Rotational Medicine Ball Slams – 3x12 per side (Engage your core and rotate through the hips, not just the arms.)
Seated Cable Rows – 3x10 (Focus on a full range of motion and controlled retraction of the shoulder blades.)
Banded Pallof Press – 3x15 per side (Keep your arms extended and resist rotational pull to engage stabilizing muscles.)
This plan ensures that all three planes of motion—sagittal (front-to-back movement), frontal (side-to-side movement), and transverse (rotational movement)—are incorporated for a well-balanced approach to strength training and injury recovery.
Lifting with a rotator cuff injury requires smart training adjustments and a focus on recovery. While some movements may be off-limits for a while, you can still maintain strength and fitness by modifying exercises and emphasizing rehabilitation. Listen to your body, make gradual progress, and prioritize shoulder health to return stronger and pain-free.
https://journals.sagepub.com/doi/full/10.1177/23259671211006100?utm_source
https://www.jospt.org/doi/10.2519/jospt.2015.5941?utm_source
Hope that helps,
Happy Exercising!
Robyn