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October 7, 2018

Two Tips for Rotator Cuff Strengthening in Yoga

The rotator cuff (RTC) is a well-known group of muscles that are important in stabilizing the shoulder, basically no matter the activity. When it comes to keeping the arm bone centered in the “socket”, these are the guys for the job.

The larger the weight or force that an arm lifts, the more important the job of the RTC becomes.

You might think that on the yoga mat we don’t lift much weight. Oh, but we do (even though it’s not the same as lifting external weights). Downward Facing Dog supports at least half your body weight through the arms. The arms in Handstand handle 100% of your body weight.  And the faster we move through an asana practice (for example: the vinyasa), the greater the forces on any given joint that is supporting your body weight.

Shoulder (including Rotator Cuff) Injuries in Yoga

I don’t have hard data, but shoulder injuries in yoga are fairly common. I’d guess they are about as likely as if yogis were lifting heavy external weights. Here are some of my theories as to why:

  • Significant amount of time in weightbearing through our upper extremities,
  • Still listening to and repeating the awful, anatomically incorrect cue of “Shoulders Back and Down” when we have our arms overhead
  • General limitations to intelligent progression of bodyweight movement (to break that down a bit: I mean, if you go to the gym, you build your way up to lifting higher weights. In yoga asana, plank and down dog hold our body weight from day one)

Rotator cuff injuries in the general population are also incredibly common, but in the general population they are more often from deconditioning and disuse of the upper body. Yogis use our upper bodies all the time! Why do we still get shoulder and rotator cuff boo-boos?

Frankly, it’s because what we do on the mat rarely offers the chance for specific strengthening of our RTCs. So I’ve created a short video for you with two ways to easily incorporate RTC strengthening on the mat (scroll all the way to the bottom).

What exactly is the Rotator Cuff?

“Rotator cuff” is short-hand for 4 small muscles that form a claw-like grasp on the head of the upper arm bone, the humerus.

Here’s a visual that works for me: the rotator cuff clasps onto the humeral head a bit like this claw around the orb (claw = rotator cuff):

Dragon Claw with Orb from Bogrim at Deviant Art https://www.deviantart.com/bogrim/art/Dragon-Orb-200311255

Now that you have that magic-inspired image, enjoy these images of the actual muscles of the rotator cuff:

1. Infraspinatus:

sneaks up from the back lower half of the shoulderblade

Infraspinatus

2. Teres Minor.

Not going to search for a separate photo for this tiny guy, but you can see it just below and to the outside of infraspinatus in the image above.

3. Supraspinatus.

This one sits on top of the shoulder and is partly responsible for the action that you see in the following GIF (the motion of abduction).

Supraspinatus

4. Subscapularis

Subscap is trickier to visualize. It is on the side of the shoulderblade facing the ribcage, opposite infraspinatus. You’ll best see where it is in the GIF below:

Subscapularis

The important points:

Your rotator cuff muscles are each fairly small. They are stabilizers. Not power lifters. This cuff is a little trickier to access and benefits from resisted rotational moves that we rarely practice on the mat.

What to do

Watch and learn two strengthening moves for your rotator cuff that also happen to be easy to incorporate into your yoga. All you need is a block (or two).

I hope you enjoyed this video (and perhaps learned from this post). Do you have your own go-to RTC moves on the mat? Have you had a RTC injury from yoga? I hope you’ll share your thoughts and ideas in the comments below.

14 Comments on “Two Tips for Rotator Cuff Strengthening in Yoga

Patricia Navin
October 31, 2018 at 3:53 pm

I like these ideas a lot. In the classes I teach I have been using an arm flow of arms up, to cactus, down to what I call offering pose which is the shape you show initially seated and holding the two blocks. I had an (undiagnosed by a PT) pinching at the front of one of my shoulders and using this flow really helped relieve it. Can’t wait to use these new moves from you with my students!!

Reply
DrFoster
October 31, 2018 at 10:54 pm

Hi Patricia, I’m glad you liked these!

Reply
Linde
November 12, 2018 at 2:09 pm

Hi Ariele,
I’ve been struggling with a rotator cuff injury for the past couple of months because (after having done many classes over the years) I’ve started an at home yoga practice. I’ve now realised that the downward dog cues taught to me weren’t right for me (“shoulders away from the ears”) and it caused me to sort of “hammock” through the shoulders in my downward dog. I’ve been seeing a physio who does yoga herself and she has corrected my down dog, but it’s frustrating that there are so many yoga teacher out there who don’t correct your poses and I want to encourage anyone starting out with yoga to do a proper introductory course and not just go to single classes. To be fair, I did do an introductory course and I feel like it gave me the right building blocks for my yoga practice that followed. Unfortunately I either lost the right posture in my down dog or I’ve done it wrong from the beginning. I don’t know.
Anyway, I’ve become very interested in proper yoga alignment and yoga anatomy, so that’s how I found your page and youtube channel. Looking forward to following your classes.

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DrFoster
November 12, 2018 at 3:17 pm

Hi Linde, I’m sorry you experienced this injury. I think the issue is actually deeper than yoga teachers who don’t correct your posture. Many yoga teachers simply don’t know that “shoulders away from the ears” does not make sense anatomically. They hear a yoga teacher before them say it, so they repeat it. I’m definitely on a mission to move us out of those kinds of automated repeating of cues, and into deeper inquiry and critical thinking. That’s the foundation of my online anatomy mentorship. Thank you so much for seeking out my teachings and following here.

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mehva roffman
December 4, 2018 at 11:22 am

i have a very long standing rotator cuff/frozen shoulder injury, have done pt and still do chiropractor, the second exercises hurts to do it on that side, a lot of things hurt it some and i work a little into the pain but not too much. used to have hyper mobile shoulders and injured both sides in dance and yoga, one healed one didn’t also have scoliosis adding to the issue. i dont want surgery. much of my body is hyper mobile other than extremely short achilles and calf bones

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DrFoster
December 4, 2018 at 11:38 am

the second of these exercises is quite challenging. Keep working on getting your strength back – and I recommend you use the guidance of a physical therapist 🙂

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Jill Abel
November 22, 2019 at 12:28 pm

Had surgery. Extremely painful, no good result. Trying acupuncture again. Yoga? Good luck

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DrFoster
November 22, 2019 at 8:44 pm

I’m sorry you had a failed surgery for your rotator cuff. I hope you are also working with a skillful physical therapist/physiotherapist who really listens to you and re-evaluates at every visit. For those who need RTC surgery, they need surgery. If you want to strengthen your rotator cuff preventatively, you can do it within the context of almost any movement practice, including yoga as demoed.

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Alexandra
April 30, 2020 at 4:31 pm

This is great advice, can’t wait to listen to the rest of your videos. I’m wondering, if you do have a mild rotator cuff injury (I get a twinge when i lift my arms out to the sides, but not a massive pain), should you stop doing yoga? Or keep doing it and avoid certain poses? Thanks so much. As a scientist, I’m always interested in the biological science behind my yoga!

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DrFoster
May 1, 2020 at 11:28 pm

Hi Alexandra, There’s no real answer to your question, because this injury can vary significantly person-to-person and of course yoga asana has a huge amount of variability. To be extremely general, I would avoid weight bearing overhead poses like downward facing dog until you feel more healed. And, more importantly, I would see a physical therapist that can help figure out what contributed to the injury in the first place and specifically what positions to avoid along the path of healing. I do telehealth physical therapy sessions if that might be helpful to you: https://wellilo.janeapp.com

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Neelam Sakhrani
November 3, 2020 at 6:57 am

Hi
I am yoga practitioner
I have mild pain in my upper arm doc says it’s rotator cuff tear ,can you tell me what postures I should avoid during this phase n how to strengthen it, should I practice vinyasa or not

Reply
Dr. Ariele Foster
November 3, 2020 at 2:19 pm

Hi Neelam, I am not able to give you individualized physical therapy advice, but feel free to book a telehealth appointment with me at https://wellilo.janeapp.com – otherwise I recommend seeing a local physio who has yoga understanding and experience

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Niky
July 12, 2023 at 9:20 pm

What asanas are recommended for supraspinatus tendonitis. Don’t want to worsen it

Reply
Dr. Ariele Foster
July 25, 2023 at 3:58 pm

hello! Excuse the long delay in responding. This is definitely more of a complex question than I suspect you mean to ask. As a physical therapist, all of these questions come up: is it formally diagnosed? Why did supraspinatus tear? Are there any co-issues like neck pain, carpal tunnel, bone spurs or genetic shape? I’d want to do muscle testing and overall upper extremity functional testing before giving a truly appropriate answer to this question….but let me suggest something a little less “peek into my brain” and more helpful hahhaha… Set up a few sessions with a physical therapist so that you can learn if there are POSITIONS to avoid. (Excuse my all caps, i am not yelling, just emphasizing). When you learn the positions that irritate your unique shoulder (rotator cuff injuries are alway connected to the rest of the body that may have contributed to the injury in the first place), you can start to notice those as they come up in asana, other movement / fitness or everyday activities. Then you can avoid them as your symptoms are still high. When your symptoms / discomfort reduce you can gradually build up tolerance to those activities again. So, I hope that helps. If you’d like to work with me — I do video analysis and telehealth in addition to in person sessions — you can book at https://wellilo.janeapp.com — all my best, Ariele

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