Rotator Cuff Tendonitis: Exercises That Will Make It Worse

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Dealing with rotator cuff tendonitis can be frustrating. You want to stay active, but certain movements can make the pain and inflammation much worse. Understanding which exercises to avoid is a critical step toward recovery. This guide will help you identify problematic movements. Consequently, you can protect your shoulder from further damage and focus on healing.

The rotator cuff is far more than just a set of muscles; it’s a finely tuned biomechanical system essential for optimal shoulder function. Comprising four distinct muscles – the supraspinatus, infraspinatus, teres minor, and subscapularis – and their respective tendons, this group forms a critical cuff around the head of the humerus (upper arm bone) where it meets the glenoid fossa of the scapula (shoulder blade).

Each muscle plays a specific role:

• The supraspinatus is primarily responsible for initiating shoulder abduction (lifting the arm away from the body).
• The infraspinatus and teres minor work synergistically for external rotation (rotating the arm outwards).
• The subscapularis handles internal rotation (rotating the arm inwards).

Together, they provide dynamic stability to the highly mobile glenohumeral joint, ensuring the humerus stays centered in its socket during a vast range of movements, from simple daily tasks to complex athletic maneuvers like throwing or overhead pressing.

Understanding Tendonitis and Its Triggers

When we talk about tendonitis, we’re referring to inflammation of these vital tendons. This inflammation often stems from:

• Overuse: Engaging in repetitive movements without adequate rest or recovery.
• Repetitive Overhead Activities: Sports like swimming, tennis, baseball, or occupations requiring frequent arm elevation (e.g., painting, construction).
• Improper Form: Performing exercises with incorrect mechanics, placing undue stress on the tendons rather than the target muscles.
• Acute Injury: A sudden trauma, though less common for chronic tendonitis.
• Muscle Imbalances: An overreliance on larger, more powerful muscles like the deltoids or pectoralis major while the smaller, stabilizing rotator cuff muscles are weak or neglected. This imbalance forces the tendons to work harder to maintain joint integrity.
• Rapid Progression: Increasing workout intensity, volume, or weight too quickly, without allowing the tendons to adapt.

Continuing to push through pain when tendonitis is present is not only counterproductive but actively harmful. It can:

• Delay Healing: Perpetuating the inflammatory cycle and preventing the body’s natural repair mechanisms from taking hold.
• Worsen the Condition: Leading to chronic pain, increased stiffness, and potentially progressing from simple inflammation to tendinosis (a more degenerative condition of the tendon) or even a rotator cuff tear.
• Compromise Form: As pain forces compensatory movements, potentially creating new muscle imbalances or injuries in other areas.

Therefore, identifying and avoiding exercises that exacerbate shoulder tendonitis is paramount for recovery and long-term shoulder health. The goal is relative rest and activity modification, allowing the inflamed tissues to calm down and begin the healing process, rather than pushing them further into distress. This means understanding which movements put specific stress on the rotator cuff tendons and modifying your training accordingly.

The Danger of Shoulder Impingement

Many problematic exercises share a common issue: they cause shoulder impingement. Impingement happens when the space between the top of your shoulder blade (acromion) and the rotator cuff tendons narrows. This narrowing can pinch or compress the tendons, leading to irritation and pain. When you already have tendonitis, these movements are especially harmful. They repeatedly aggravate the inflamed tissue.

Think of it like rubbing a sore spot over and over. Source Instead of healing, the area becomes more inflamed. The goal of modifying your exercise routine is to create space within the shoulder joint. This allows the tendons to heal without constant irritation. Avoiding exercises that cause impingement is the first and most important rule for a safe recovery. .

Overhead Exercises That Increase Stress

High-Risk Overhead Movement Patterns That Compromise Shoulder Health

The glenohumeral joint experiences maximum stress when the arm is elevated above 90 degrees, particularly during loaded movements that combine overhead positioning with external rotation. This biomechanical vulnerability stems from the subacromial space becoming compressed, creating friction between the rotator cuff tendons and surrounding structures.

Specific Exercises to Eliminate During Recovery

Military Press and Overhead Press Variations

• Behind-the-neck presses place the shoulder in extreme external rotation while under load
• Standing barbell presses can force compensatory movement patterns when mobility is limited
• Dumbbell shoulder presses often encourage asymmetrical loading that stresses inflamed tissues

Pull-Up and Chin-Up Progressions

• Wide-grip pull-ups create excessive abduction and external rotation at the top position
• Kipping or momentum-based variations generate uncontrolled forces through the shoulder capsule
• Weighted pull-ups amplify stress on already compromised supraspinatus and infraspinatus tendons

Overhead Throwing and Ballistic Movements

• Medicine ball slams and throws involve rapid deceleration phases that strain the posterior rotator cuff
• Plyometric push-up variations with hand claps create impact forces during the catching phase
• Kettlebell snatches combine overhead positioning with high-velocity movement patterns

Understanding the Impingement Mechanism

During overhead motion, the acromion process and coracoacromial ligament form a rigid arch above the rotator cuff tendons. When inflammation is present, this space becomes further narrowed, creating a mechanical impingement that perpetuates the injury cycle. The supraspinatus tendon is particularly vulnerable due to its position directly beneath this bony prominence.

Movement Compensations That Worsen Symptoms

• Anterior head posture during overhead exercises reduces subacromial space
• Scapular winging or inadequate upward rotation creates abnormal glenohumeral mechanics
• Thoracic kyphosis limits true shoulder flexion, forcing compensatory movement at the joint

Professional assessment becomes crucial because these movement dysfunctions often require targeted neuromuscular re-education and manual therapy interventions before safe return to overhead training patterns.

Behind-the-Neck Press or Pulldown

When considering exercises for shoulder health, especially in the context of tendonitis or injury prevention, certain movements stand out as inherently problematic due to their biomechanical demands on the glenohumeral joint (shoulder joint). The specific concern with pulling a bar down behind your neck or pressing a weight from behind your head lies in the extreme positions these movements force the shoulder into, directly compromising joint integrity and increasing the risk of impingement.

Here’s a deeper dive into why these movements are best avoided:

The Biomechanical Breakdown of Risk

These exercises push the shoulder into a combination of extreme external rotation and abduction, a position often referred to as the “high five” position, but taken to an unsafe limit.

• Excessive External Rotation and Abduction:
  • Glenohumeral Joint Stress: This position places significant stress on the anterior capsule of the shoulder, the connective tissue that helps stabilize the front of the joint. Overstretching this capsule repeatedly can lead to anterior glenohumeral instability over time.
  • Rotator Cuff Vulnerability: The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis) are crucial for stabilizing the head of the humerus within the shallow glenoid fossa. In this extreme position, their ability to effectively stabilize the joint is compromised, making them more susceptible to strain or tear, particularly the supraspinatus tendon.
• Reduced Subacromial Space:
  • Anatomy: The subacromial space is a narrow tunnel located beneath the acromion (a bony projection of the shoulder blade) and above the head of the humerus. This space houses critical structures, including the supraspinatus tendon, the long head of the biceps tendon, and the subacromial bursa (a fluid-filled sac that reduces friction).
  • Compression Mechanism: When the arm is forced into deep external rotation and abduction (especially when combined with overhead movement), the head of the humerus moves superiorly (upwards) and anteriorly (forwards) relative to the acromion. This significantly narrows the subacromial space.
  • Impingement: This reduction in space directly compresses the structures within it, particularly the supraspinatus tendon. This repeated compression is the primary mechanism for shoulder impingement syndrome, leading to inflammation (tendinopathy or bursitis) and, if left unaddressed, potential fraying or tearing of the tendon.

Specific Exercise Examples and Their Dangers

1. Behind-the-Neck Lat Pulldowns:
   • Movement Pattern: Vertical pulling motion where the bar is pulled down behind the head to the nape of the neck.
   • Intended Target Muscles: Primarily the latissimus dorsi, with assistance from biceps and rhomboids.
   • Risks:
     • Forces the shoulders into extreme external rotation and abduction.
     • Can lead to cervical spine hyperextension as individuals crane their neck forward to avoid hitting the bar.
     • Places undue stress on the anterior shoulder capsule and rotator cuff tendons.
     • For individuals with limited thoracic spine mobility or shoulder external rotation, this movement is particularly dangerous, as the body will compensate by placing more stress on the glenohumeral joint.
2. Overhead Presses from Behind the Head (e.g., Barbell Behind-the-Neck Press, Seated Dumbbell Press from Behind the Head):
   • Movement Pattern: Vertical pressing motion where the weight is lowered behind the head and pressed upwards.
   • Intended Target Muscles: Primarily the anterior and medial deltoids, with assistance from the triceps.
   • Risks:
     • Similar to behind-the-neck pulldowns, this movement forces the shoulders into an extremely vulnerable position of deep external rotation and abduction, but now under load.
     • The compressive forces from the weight significantly amplify the risk of subacromial impingement and rotator cuff injury.
     • Can exacerbate shoulder instability or lead to impingement of the brachial plexus (nerves) in some individuals.
     • Requires exceptional shoulder mobility and thoracic extension to perform safely, which most individuals do not possess.

Safer Alternatives and Best Practices

Instead of risking injury with behind-the-neck movements, focus on exercises that effectively target the desired muscle groups while maintaining a safer, more natural shoulder position.

• For Vertical Pulling (targeting Latissimus Dorsi):
  • Front Lat Pulldowns: Pull the bar down to your upper chest. This allows for a more natural scapular rhythm and reduces stress on the anterior shoulder.
  • Pull-ups/Chin-ups: Excellent bodyweight options. Focus on controlled movement and engaging the lats.
  • Single-Arm Dumbbell Rows / Cable Rows: These horizontal pulling movements complement vertical pulling and are highly effective for back development without compromising shoulder health.
• For Vertical Pressing (targeting Deltoids):
  • Dumbbell Shoulder Press (from the front): Allows for a neutral or semi-neutral grip, providing more freedom for the shoulder joint and reducing internal rotation stress.
  • Barbell Overhead Press (from the front – “Strict Press” or “Military Press”): Pressing the bar from the front of the shoulders upwards. This maintains the humerus in a more neutral position relative to the scapula.
  • Landmine Press: An excellent shoulder-friendly alternative that presses upwards and forwards, working the deltoids in a safer, more natural arc.
  • Arnold Press: While involving rotation, it starts in front and allows for greater control and scapular movement than behind-the-neck presses.

Key Considerations for Shoulder Health

• Prioritize Mobility: Ensure adequate thoracic spine mobility and shoulder external rotation through targeted stretches and mobility drills. Stiffness in these areas often leads to compensatory movements at the glenohumeral joint.
• Strengthen Stabilizers: Incorporate exercises for the rotator cuff (e.g., band external rotations, internal rotations) and scapular stabilizers (e.g., face pulls, Y-raises) to improve overall shoulder stability and control.
• Listen to Your Body: Any sharp pain, clicking, or grinding in the shoulder during an exercise is a clear signal to stop and reassess. Pushing through pain can lead to chronic injury.
• Focus on Form Over Weight: Always prioritize perfect form and controlled movement over lifting heavy weights, especially when dealing with vulnerable joints like the shoulder.

By understanding the biomechanical risks and opting for safer, equally effective alternatives, you can continue to build strength and muscle while safeguarding your shoulder health and preventing the onset or worsening of shoulder tendonitis.

Instead of these, you can perform lat pulldowns or overhead presses in front of your body. This keeps the shoulder in a more stable and less provocative position. Always maintain control and avoid using momentum.

Upright Rows

Understanding the Biomechanical Nightmare of Upright Rows

The upright row’s problematic nature stems from its forced internal rotation combined with shoulder abduction – a movement pattern that creates what exercise physiologists call the “impingement zone.” When you pull the weight upward past 90 degrees of shoulder flexion while maintaining internal rotation, you’re essentially creating a mechanical vice that compresses the supraspinatus tendon and subacromial bursa against the underside of the acromion process.

The Anatomical Collision Course

During the upright row’s ascending phase, several concerning biomechanical events occur simultaneously:

• Subacromial space compression: The space between your humeral head and acromion narrows dramatically
• Rotator cuff tendon grinding: The supraspinatus and infraspinatus tendons get pinched and abraded
• Biceps tendon irritation: The long head of the biceps can experience excessive friction within the bicipital groove
• Anterior capsule stress: The shoulder joint capsule endures abnormal stretching forces

Movement Pattern Breakdown: Why It Fails

The upright row violates fundamental shoulder biomechanics by forcing the arm into what’s known as the “position of impingement” – typically occurring between 70-120 degrees of arm elevation with internal rotation. This position reduces the subacromial space from its normal 9-10mm to as little as 5-6mm, creating a crushing effect on soft tissues.

Key problematic elements include:

1. Excessive internal rotation – The grip forces your shoulders into an internally rotated position
2. High elbow positioning – Pulling elbows above shoulder height maximizes impingement risk
3. Narrow grip width – Creates more severe internal rotation angles
4. Rapid concentric motion – Fast upward pulls increase compression forces

Superior Exercise Alternatives for Shoulder Development

Rather than risking tendonitis with upright rows, consider these biomechanically sound alternatives that target similar muscle groups:

For Posterior Deltoid and Rhomboid Development:

• Face pulls with external rotation: Using cable machine, pull rope toward face while externally rotating shoulders
• Prone Y-raises: Lying face down, raise arms in “Y” position to strengthen posterior deltoids and lower trapezius
• Band pull-aparts: Horizontal pulling motion that promotes healthy scapular retraction

For Middle Deltoid Activation:

• Lateral raises with thumbs-up grip: Maintain external rotation throughout the movement
• Cable lateral raises: Provides consistent tension while allowing natural shoulder mechanics
• Dumbbell shoulder press variations: Promotes functional overhead strength patterns

For Upper Trapezius Training:

• Shrugs with proper scapular mechanics: Focus on elevation and retraction rather than rolling
• Farmer’s walks: Isometric upper trap engagement with functional carrying patterns

Form Modifications That Still Miss the Mark

Even well-intentioned modifications to the upright row – such as using a wider grip, limiting range of motion, or using lighter weights – fail to address the fundamental biomechanical flaw. The internal rotation component remains problematic regardless of these adjustments, making complete exercise avoidance the wisest choice for long-term shoulder health.

Remember: Effective shoulder training should promote external rotation, scapular stability, and balanced muscle development while respecting the joint’s natural movement patterns and anatomical limitations.

Pushing and Dipping Movements to Pause

Certain pushing exercises can also place undue stress on an inflamed rotator cuff. The position of your arms and the load you use are critical factors. You must pay close attention to how your shoulder feels during these movements.

Bench presses, particularly with a wide grip, can strain the front of the shoulder. A very wide grip increases the stretch on the shoulder capsule and can irritate the tendons. Similarly, letting the bar drop too low onto the chest can cause problems. A narrower grip and controlled range of motion are generally safer options. However, you might need to pause this exercise altogether if it causes pain.

The Hidden Dangers of Bodyweight Dips for Shoulder Health

The biomechanical demands of bodyweight dips create a perfect storm for shoulder impingement syndrome and rotator cuff irritation. As you descend into the bottom position, several problematic movement patterns occur simultaneously:

Anatomical Breakdown of the Dip Movement

Forward shoulder protraction occurs when the chest muscles (pectoralis major and minor) pull the shoulder girdle forward, disrupting the natural scapulohumeral rhythm. This forward migration of the shoulder blades reduces the subacromial space – the critical gap between the acromion process and the humeral head where tendons must glide freely.

The internal rotation component is particularly devastating for individuals with existing shoulder dysfunction. As the humerus rotates inward during the descent, the greater tuberosity of the upper arm bone moves closer to the acromion, creating a pinching effect on the supraspinatus tendon and subacromial bursa.

Specific Risk Factors During Dip Execution

• Excessive range of motion: Dropping too low (shoulders below elbow level) maximizes anterior capsule stretch and impingement risk
• Poor scapular stability: Inability to maintain retraction and depression of the shoulder blades throughout the movement
• Inadequate posterior deltoid and rhomboid strength: These muscles cannot counteract the forward pull of overdeveloped chest muscles
• Limited thoracic spine mobility: Compensatory shoulder positioning when the mid-back lacks extension

Superior Alternative Exercises for Chest Development

Modified Push-Up Progressions offer exceptional shoulder-friendly chest training:

1. Incline Push-Ups: Elevate hands on a bench or step to reduce loading while maintaining proper shoulder mechanics
2. Scapular Wall Slides: Perform against a wall to reinforce proper scapular retraction patterns before adding resistance
3. Push-Up Plus: Add a protraction phase at the top to strengthen the serratus anterior and improve scapular control

Controlled Dumbbell Movements provide adjustable resistance with safer joint positioning:

• Incline Dumbbell Press (30-45 degrees): Reduces anterior deltoid stress while targeting upper chest fibers
• Neutral Grip Dumbbell Press: Maintains more favorable humeral positioning compared to pronated grip variations
• Single-Arm Dumbbell Press: Allows for natural scapular movement and identifies strength imbalances

Progressive Loading Strategies

For individuals recovering from shoulder tendonitis, implement these periodization principles:

Phase 1: Pain-Free Range Establishment

• Limit range of motion to pain-free zones
• Focus on isometric contractions at mid-range positions
• Emphasize scapular stabilization exercises

Phase 2: Controlled Movement Integration

• Introduce slow, controlled concentric and eccentric phases
• Maintain strict form over load progression
• Monitor for any return of symptoms during 24-48 hour post-exercise period

Phase 3: Functional Movement Patterns

• Gradually increase range of motion as tissue tolerance improves
• Integrate multi-planar movements that replicate daily activities
• Progress load only when movement quality remains optimal

This systematic approach ensures tissue adaptation without re-aggravating inflammatory processes in the shoulder complex.

The Truth About Rotational Exercises

Rotational exercises are often part of rotator cuff rehabilitation programs. However, performing the wrong ones or using improper form can make your tendonitis worse. The key is control, not heavy weight or aggressive movement. For instance, the “empty can” exercise was once popular for strengthening the supraspinatus muscle. We now know it can actually increase impingement due to the internal rotation of the arm.

When addressing shoulder tendonitis, the goal is to carefully strengthen the rotator cuff and surrounding musculature without exacerbating inflammation or causing further impingement. This requires a nuanced understanding of movement mechanics and muscle activation.

Prioritizing Safer Movement Patterns

Instead of movements that internally rotate the shoulder and potentially pinch the supraspinatus tendon within the subacromial space (like the “empty can” exercise with the thumb pointing down), the “full can” exercise offers a biomechanically superior alternative.

• The “Full Can” Advantage: Performing shoulder elevation in the scapular plane (approximately 30-45 degrees anterior to your body, with the thumb pointing up) allows for better clearance of the greater tuberosity under the acromion. This significantly reduces the risk of subacromial impingement, which is a common contributor to shoulder tendonitis.
  • Target Muscles: Primarily activates the supraspinatus (a key rotator cuff muscle responsible for initiating abduction) and the anterior/middle deltoid.
  • Proper Execution:
    1. Start standing or seated with a light dumbbell in each hand, arms at your sides.
    2. Maintain a neutral spine and gently retract your shoulder blades.
    3. Keeping your thumbs pointed towards the ceiling, slowly raise your arms out to the sides and slightly forward (in the scapular plane) to about shoulder height (90 degrees of abduction).
    4. Focus on controlled movement, avoiding any shrugging or momentum.
    5. Slowly lower the weights back to the starting position.
  • Key Focus: The emphasis should always be on controlled motion through a pain-free range of motion. If you experience any discomfort, reduce the range or the weight.

Mastering External Rotation for Rotator Cuff Health

External rotation exercises are crucial for strengthening the infraspinatus and teres minor, two vital rotator cuff muscles that stabilize the shoulder joint and counteract the powerful internal rotators. However, these small muscles are easily overpowered by larger, more dominant muscle groups.

• Avoiding Compensation:
  • The Trap of Shrugging: When you shrug your shoulders during external rotation, you’re primarily engaging your upper trapezius muscles. This indicates that the resistance is too high, and your body is recruiting stronger, non-target muscles to complete the movement. Not only does this negate the strengthening benefit for the rotator cuff, but it can also exacerbate impingement by reducing the subacromial space.
  • Momentum is the Enemy: Using momentum (swinging the weight or band) bypasses the controlled muscle contraction necessary for effective strengthening and rehabilitation. It reduces the time under tension for the target muscles and increases the risk of sudden strain on vulnerable tendons.
• Optimal External Rotation Technique (Band/Cable):
  1. Anchor Point: Secure a resistance band or cable at elbow height.
  2. Starting Position: Stand sideways to the anchor point, holding the handle with your elbow bent to 90 degrees and tucked firmly against your side. Your forearm should be across your abdomen.
  3. Scapular Stability: Before initiating the movement, gently pull your shoulder blade down and back (scapular depression and retraction) to create a stable base.
  4. Controlled Movement: Slowly rotate your forearm away from your body, keeping your elbow tucked. The movement should originate from the shoulder joint.
  5. Small, Intentional Range: Only go as far as you can maintain perfect form and a pain-free range. For many with tendonitis, this is a relatively small arc of motion.
  6. Slow Return: Control the eccentric (return) phase of the movement, resisting the pull of the band/cable back to the starting position.

The Principle of “Light and Controlled”

For rehabilitating shoulder tendonitis, the mantra “light resistance and perfect form” is paramount.

• Why Light Resistance?
  • Isolation, Not Domination: The rotator cuff muscles are relatively small and designed for stability and fine motor control, not brute strength. Heavy resistance forces larger, more powerful muscles (like the deltoids, pectoralis major, or latissimus dorsi) to take over, which are often already overactive. This perpetuates muscle imbalances and prevents the injured tendons from healing and strengthening effectively.
  • Neuromuscular Control: Light resistance allows for a greater focus on proprioception (your body’s sense of position in space) and neuromuscular control, helping to re-educate the muscles to fire correctly and synergistically.
• The Essence of Perfect Form:
  • Scapular Control: Maintaining proper scapular stability (shoulders down and back, not shrugged) throughout the movement is critical. The shoulder blade provides the stable base from which the arm moves.
  • Elbow Position: For external rotation, keeping the elbow tucked prevents the deltoid from taking over and ensures the rotator cuff is isolated.
  • Pain-Free Range: Never push into pain. Pain is your body’s signal that something is wrong. Work within a comfortable, controlled range.
  • Slow Tempo: Employing a slow, deliberate tempo (e.g., 2 seconds concentric, 1-second hold, 3 seconds eccentric) maximizes muscle activation and minimizes the use of momentum, ensuring the targeted muscles are doing the work.

By adhering to these principles, individuals with shoulder tendonitis can safely and effectively strengthen their rotator cuff, improve shoulder stability, and foster a healthier recovery without risking further injury. Always consult with a healthcare professional or physical therapist for personalized guidance tailored to your specific condition.

Conclusion: Listen to Your Body and Seek Guidance

Understanding the Mechanics Behind Problematic Movements

When dealing with rotator cuff tendonitis, the key lies in recognizing how certain movement patterns create mechanical stress on already compromised tissues. The subacromial space – the narrow area between your shoulder blade and upper arm bone – becomes even more restricted when inflammation is present. This creates a cascade effect where normal movements suddenly become pain-generating activities.

Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscles get compressed against the bony structures of the shoulder joint. During overhead movements, this space naturally decreases, but with tendonitis, the inflamed tissues have less room to glide smoothly, resulting in painful pinching and further tissue damage.

High-Risk Movement Patterns to Eliminate

Overhead Pressing Variations

• Military press and shoulder press movements force the arm into extreme overhead positions
• Behind-the-neck presses combine overhead positioning with external rotation, creating maximum impingement risk
• Handstand push-ups and pike push-ups place the shoulder in compromised positions under load
• Even incline pressing at steep angles (above 45 degrees) can trigger symptoms

Pulling Movements That Compromise Shoulder Position

Upright rows are particularly problematic because they combine:

• Internal rotation of the shoulder
• Elevation of the arm in the scapular plane
• Compression of the subacromial space at the top of the movement

Wide-grip lat pulldowns and behind-the-neck pulldowns force the shoulder into extreme external rotation while under load, stretching the anterior capsule and potentially irritating the biceps tendon.

Dipping Movements and Deep Stretches

Parallel bar dips and bench dips create several problematic mechanics:

• Anterior shoulder stretching beyond normal range of motion
• Internal rotation combined with extension
• Downward pressure on the glenohumeral joint

The deeper the dip, the more stress is placed on the anterior deltoid, pectoralis major, and the joint capsule itself.

Secondary Movements That May Aggravate Symptoms

Throwing and Ballistic Patterns

• Medicine ball slams overhead
• Overhead kettlebell swings
• Tennis serves or volleyball spikes (sport-specific movements)
• Battle rope waves above shoulder height

Loaded Stretching Positions

• Chest flyes with excessive range of motion
• Cable crossovers that pull the arms behind the torso
• Doorway stretches held too aggressively
• Weighted arm circles or dynamic warm-up movements performed too vigorously

The Inflammatory Response Connection

Each time you perform a contraindicated movement, you’re essentially re-injuring the healing tissue. The inflammatory cascade restarts, sending fresh blood flow, immune cells, and inflammatory mediators to the area. This perpetuates the cycle of:

1. Tissue irritation → Swelling → Reduced space → More impingement
2. Pain signals → Muscle guarding → Altered movement patterns → Compensatory stress

Smart Substitutions and Modifications

Instead of complete exercise elimination, consider these joint-friendly alternatives:

• Replace overhead pressing with neutral-grip chest pressing at moderate angles
• Substitute upright rows with face pulls using external rotation
• Exchange deep dips for assisted dips with reduced range of motion
• Swap behind-the-neck movements for front-facing variations

The goal is maintaining training stimulus while respecting the healing process and avoiding positions that compromise the rotator cuff’s ability to stabilize the shoulder joint effectively.

By eliminating these high-risk exercises, you create a better environment for healing. Instead, focus on pain-free movements and consider consulting a physical therapist. A professional can provide a personalized rehabilitation plan. They will help you strengthen the supporting muscles around your shoulder safely and effectively. Ultimately, a strategic approach to exercise is your best path to a full and lasting recovery.