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Shoulder (rotator cuff): returning to sport step by step

Pain at the front or side of the shoulder, especially when raising the arm, throwing or swimming, sometimes at night when lying on it.

Shoulder joint

Why it happens

Repeated overhead movements (swimming, volleyball, tennis, climbing), rapid increase in volume, lack of strengthening of the shoulder and back.

Coming back in four stages

  1. 1

    Gentle mobility and activities without overhead movement, pain-free.

  2. 2

    Strengthening of the rotator cuff and shoulder blades prescribed or approved by your physiotherapist.

  3. 3

    Sport movements with small range and light load (a few slow lengths, short passes), short sessions.

  4. 4

    Full range and intensity gradually, explosive movements (smash, serve, fast crawl) last.

Move on to the next stage after 2 sessions in a row with discomfort of 2 out of 10 or less and no pain the next day. Each stage usually lasts 1 to 2 weeks, depending on your healthcare professional’s advice. For the shoulder, lifting the arm overhead must stay pinch-free the next day before you move on.

Movements to postpone

  • gestes au-dessus de la tête from stage 4
  • contacts from stage 4

Strengthening exercises

  • 12

    External rotation with band

    from stage 1 of the plan

    Elbow against the body, bent to 90 degrees, rotate the forearm outwards then return slowly.

    To start: 3 sets of 12, 3 seconds back, every other day.

    Variations, mistakes and progression
    Easier
    No band, or lying on your side without weight.
    Harder
    Stronger band, then with the arm out at 90 degrees.
    Common mistakes
    • Lifting the elbow away from the body.
    • Turning the trunk to help.
    Moving on
    When 3 × 15 is easy with no shoulder pain.
  • 12

    Scapular retraction (band row)

    from stage 1 of the plan

    Band anchored in front of you, pull the elbows back bringing the shoulder blades together, return over 3 seconds.

    To start: 3 sets of 12, 3 seconds back, every other day.

    Variations, mistakes and progression
    Easier
    No band, just bring the shoulder blades together.
    Harder
    Stronger band, with a 2-second hold at the back.
    Common mistakes
    • Shrugging the shoulders to the ears.
    • Pulling with the hands rather than the shoulder blades.
    Moving on
    When 3 × 15 with a medium band is easy.
  • 12

    Wall slide

    from stage 2 of the plan

    Forearms against the wall, slide them upwards pressing gently, shoulder blades moving, in a pain-free range.

    To start: 2 sets of 10, slowly, once a day.

    Variations, mistakes and progression
    Easier
    Go less high, in the pain-free zone.
    Harder
    With a band around the wrists, pushing outwards.
    Common mistakes
    • Shrugging the shoulders on the way up.
    • Arching the back to go higher.
    Moving on
    When you can reach up with straight arms, pain-free and without shrugging.
  • 12

    Prone Y raise

    from stage 3 of the plan

    Lying face down, arms in a Y, lift them a few centimetres, thumbs up, hold 2 seconds.

    To start: 3 sets of 10, 2 seconds at the top, every other day.

    Variations, mistakes and progression
    Easier
    Arms in a T, or one arm at a time.
    Harder
    With a small water bottle in each hand.
    Common mistakes
    • Lifting the head and arching the neck.
    • Going too high at the cost of a pinch in the shoulder.
    Moving on
    When 3 × 12 is easy with a small weight.
  • 12

    Wall push-ups

    from stage 3 of the plan

    Hands on a wall, do slow push-ups keeping the shoulder blades steady; lean more over the weeks.

    To start: 3 sets of 10, slowly, every other day.

    Variations, mistakes and progression
    Easier
    Feet closer to the wall.
    Harder
    Feet further away, then hands on a table (incline push-ups).
    Common mistakes
    • Letting the shoulder blades wing out.
    • Elbows flared too wide.
    Moving on
    When 3 × 15 is easy with your feet far from the wall.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

When to stop and see a professional

Sudden loss of strength, inability to raise the arm, shoulder deformed after a fall, or pain radiating into the arm with numbness: see a doctor.

Rehab’s advice

First avoid overhead movements and explosive efforts. Increase the number of repetitions before the load or the speed.

What the Rehab plan does for this injury

The plan starts at 30% of your previous training volume and builds up to 80%, with a consolidation week every three weeks. If your discomfort reaches 5 out of 10, it stops and refers you to your doctor or physiotherapist.

In which sport?

General information, currently being reviewed by healthcare professionals. It replaces neither a diagnosis nor the advice of your doctor or physiotherapist.