Fix These Hidden Issues to Instantly Improve Rotator Cuff Pain

By Grant Frost · Physiotherapist • Last clinically reviewed: 04 March 2026

Your Wellness Nerd

Good day and welcome back to the channel. So in today's video, I want to show you a series of exercises that you can do to immediately improve how your rotator cuff tear feels and functions.

Because clinically as a physiotherapist, one of the most missed perspectives that I think a lot of people don't realize in regards to a rotator cuff tear is that in most instances, it's best to think of that tear as a consequence of something else. And for most people, that something else is a lack of range of motion somewhere else.

So, we're going to go through a couple of very important mobility exercises and a slightly different strength exercise that I love to give to my rotator cuff pain patients to hopefully improve how the shoulder complex as a whole functions and ultimately how your rotator cuff tear feels and functions as well. And if you're a member of the channel, there'll be an extended version of this video where we go a little bit deeper into some variations of these exercises as well. So, let's get into it.

1. The Hidden Cause of Rotator Cuff Tears

Before we get to these important exercises, I just want to flesh out this idea that your rotator cuff pain may be a consequence of something else. Yes, you may have an obvious tear in your supraspinatus, your subscapularis, your infraspinatus. We need to understand that that has to be there for a reason.

Yes, you may have had an acute incident where you fell and landed on your shoulder and something gave or tore or broke in that moment. But for the majority of people, these sorts of things just occur. They seem to happen out of nowhere. You wake up one day and your shoulder starts to hurt and you get a scan and it shows that there's something that isn't perfect in that shoulder.

And importantly, we need to look at the moment that your shoulder pain began, not as the start of something new, but as the last straw. It's the moment that something in your shoulder didn't tolerate how your shoulder is loaded up, how it's moving, how it's held, how it's positioned, and it may have been dealing with something relatively abnormal for long enough that it just reached its threshold of coping. And the onset of your pain is technically the moment that it's no longer tolerating those things.

So, if we're ever trying to have a conversation about what you need to do to permanently fix your rotator cuff pain or tearing or dysfunction, we absolutely need things that make your pain feel better. But if we don't also look at it through the lens of why is that actually there, then we could be missing some of the very simple, manageable, and controllable things that we'll go through today that also need to change to give it the best environment to go away and stay away forever.

2. Upper Back Mobility

But because we want to be results-based, before we do each one of these exercises, I would urge you to do a movement or an activity that alerts you as to how your shoulder pain feels today. Then as you do each one of these exercises, immediately recheck that exact same movement again to see if anything has genuinely changed. So that being said, let's start to work on your upper back mobility and see what influence that's having on your shoulder pain.

So when trying to improve your upper back mobility, I've always found that one of the best ways to do that is with a lacrosse ball or a tennis ball. And then once you've got your ball either lying down on the ground, sitting or standing up against a wall, take that ball and as always start at the bump just below the base of your neck.

We can put the ball in there right in the middle. Let it roll straight off to the side. We're going to be on the spinal joints when we're right next to the bump. We just want you to lie down on top of the ball and then just relax on top of that. All we're looking to do here is we're looking to find an area that feels a little bit stiff, tight, or restricted. We want to leave the ball here. Let it press into those joints. Spend 30 seconds, 60 seconds, however long you feel you need to so that you feel like this starts to give a little bit. And once you've done that, we can just move it down a little bit to the next spot that feels restricted. Keep repeating that process, working all the way down to the bottom of that shoulder blade.

We obviously want to compare to both sides because one side will feel stiffer, tighter, and more restricted. There's every chance that the side that you're having shoulder pain on is the side that your upper back also feels the most stiff and restricted. But just double check where you feel is the most stiff, tight, and restricted and be there the most. Remember, we're right up against the bumps in the middle. We're not on the bumps.

If we then come out a little bit wider, almost halfway between the inside of that shoulder blade and those bumps down the middle, we're going to be able to influence the rib joints as those ribs attach into the spine. These joints can get just as stiff, tight, and restricted. So, we just want to look for anything inside that shoulder blade that feels restricted enough that it could be a handbrake to your normal shoulder function.

And once you've systematically worked all the way down, then out a little bit to where the ribs are, then all the way back up again, what we want you to do is then immediately sit back up again and reassess the exact same movements that you used before to see if anything has genuinely changed. Because clinically, a genuine handbrake of restriction and tightness in the upper back can essentially challenge how your shoulder blade moves. So when you're doing things, your body may have to work around that or more importantly, it may rob you of your ability to express full normal range of motion. And it's not until we take that handbrake off, feed some normal slack back into the system, you then get access to that normal shoulder range once again.

And remember, if you have a rotator cuff tendon tear, and we're thinking that that is a consequence of something. That consequence can be restrictions in your upper back. You may find that doing that on its own may immediately improve how your shoulder feels and functions straight away. But give it a go and let me know in the comments down below how you felt that went.

3. Shoulder Internal Rotation

Because once you've done that, the next thing we want to work on is your ability to internally rotate your shoulder. So exercise number two is going to go after some of the tightness that we tend to occur at the back of that shoulder, which when we assess you often manifests in a lack of shoulder internal rotation. And as I mentioned, missing shoulder internal rotation is huge and it's often missed because we don't specifically test for it in a lot of instances.

So for you, what you can do is if you sit back up against a wall with your elbows out, you should in theory be able to get somewhere close to touching the wall that you're on before you feel your shoulder lifts off. So a really simple way to try and improve that is to do the very simple across the body stretch.

Once again, we always need to pay attention to how your shoulder feels doing this. But if you can have your elbow straight up in a good position, with your other hand, just reach across and gently pull that arm across your body, looking for some sense of tightness through the back side of that shoulder. We don't want anything to feel like it's jamming up at the front. So, we want to again try and gently pull that across. Make sure your thumbs up.

Once you've found a decent stretch, we want to push this arm back into this hand to make that tightness work for 5 to 10 seconds. The idea is that if you tense up that tight spot, it creates a reflex in your brain that when you stop tensing, that tissue will physically release a little bit, which means that you may immediately be able to go that little bit further into the stretch than you could before you find the next version of that tightness. So, we keep repeating that process. Find where it's tight, tense it up, hold it for 5 to 10 seconds, and then relax. It'll give a little bit. You should be able to go a little bit further.

If you feel you can get all the way around here, you may then be able to gently turn your thumb down a little bit more to create more internal rotation and then eventually get to the same position again. This requires a lot of internal rotation range of motion. If you do this and it jams you up the front, keep your thumb up. Keep yourself out of a little bit more of that internal rotation. Focus on getting to those tight spots.

Then what you should feel again coming back to the same test again, you should immediately feel like it's a little bit easier to improve that shoulder internal rotation before your shoulder wants to lift off. But more importantly, when you go back to doing the movements that you did beforehand, we're looking for it to feel immediately better in some way. So taking off a potential hidden handbrake at the back of your shoulder alongside a potential handbrake in your upper back can be really powerful ways to improve how much range of motion your shoulder has and how you load up that tendon over time.

4. Shoulder Strength

And then once you've started to feed some slack back into the system and hopefully loading up those tendons better, the next exercise we want to touch on is just a really powerful global shoulder muscle strength exercise that'll hopefully get everything working together really well.

So with this general shoulder strength exercise, I'm going to do this on my hands and knees just because it's convenient. But for you specifically, I would ask that you do this with your feet on the ground with your hands on a bench or a table just so you can regulate how much tension goes through that shoulder.

But how this strength exercise works is for me being on my hands and knees. So we want your shoulder blades back which may feel like your chest is sinking through your shoulders. Want to squeeze those shoulder blades together. The other thing that we want to do here is we want to create a lot of external rotation through the system. As you gently rotate your elbows around so that the point of your elbow is almost facing backwards, the crease is facing forwards. Creating that rotation will engage your rotator cuff as a whole. So, we just need to make sure that that rotational movement doesn't feel too painful, too tender to do. It needs to feel safe and comfortable.

By loading up your hands, putting weight through your hands consistently. We're not only asking all the muscles in your shoulder to work, we're also asking a lot of the muscles in your shoulder blade to work as well. We're trying to get everything to function as a whole as opposed to just doing the isolated rotator cuff strength exercises. But for me, one of the best ways to strengthen your rotator cuff and your shoulder complex together is to get down and put some pressure through your hands in a good shoulder posture with that external rotation force going through. Just spend 30 seconds or a minute here just to make sure that you feel like you start to fatigue or shake a little bit.

If you feel like it's getting a little bit too easy, we can turn this into a push-up position so more force is going through there. We want you to feel like you're shaking a little bit and not losing or sort of dumping out of that good setup position. But a way to progress this really comfortably, we can get you to start doing a shoulder tap where we keep everything the same, trying to stabilize on that one side and tap your arm and then come back again, set up, tap the other side. This just challenges your ability to do this in real time. And if it's easy enough for you, you can spend 30 seconds or 60 seconds in this position, making this a single arm exercise, amplifying the amount of pressure and load that goes through that shoulder, making it harder and harder for yourself, provided that it doesn't irritate or annoy your symptoms.

If you've loaded yourself up really well, you can then also retest your movements to see if activating all those muscles together does improve how your shoulder pain feels.

5. Daily Shapes and Postures

As always, it wouldn't be a video about trying to solve something if we didn't find some way to bring this back to your basic daily shapes and postures. To be fair, posture probably isn't the right word. We're probably looking more so at positions and shapes. And more specifically, if you are someone who throughout your day realizes that some of the shapes and positions that you get into, whether you're at the desk, whether you're driving, whether you're standing in a kitchen doing something, whether you're like me, you're bent over a bed all day, we're looking for clues as to some of the constant shapes and positions you may get in a lot throughout the day that may ask your shoulders to drop and roll forwards.

The reason why these shapes are so important is that as soon as your arms drop and roll forwards, the line of gravity and the weight of that shoulder pulls on those tissues. The weight of your arm pulls on the back of the shoulder, which again can limit your internal rotation over time. And the whole weight of your shoulder complex is hanging off your neck and upper back. So again, if you find that freeing up your upper back, freeing up your internal rotation, strengthening all the muscles together improves your symptoms. If you don't then try and reclaim better up tall shoulders back positions more consistently, then you may be constantly asking those tissues just to retighten and rewaken without even realizing it.

So, we need to pair up these general exercises with a renewed sense of awareness of how you are in space, bringing everything closer to you or bringing yourself closer to what you're doing so that your shoulders and your elbows can be relatively close to your side and you don't feel like you're getting sort of rounded and bent over to do the things you need to do. I can't stress that enough. Everyone hates talking about posture. It's never anyone's fault. It's often just a consequence of what the modern world demands of us. But from the perspective of trying to broaden your perspective on this topic, everything has to happen for a reason. And if that tendon has become injured or damaged for whatever reason, taking a look at the really basic, boring things that you do with that shoulder every day can give you really strong insights into what you may need to change going forwards to get a different result.

Living With Persistent Pain?

If your pain has lasted longer than expected, feels disproportionate to injury, or hasn't responded to standard treatment, you may benefit from a broader approach. Learn more about our shoulder pain physiotherapy services in Port Macquarie.

Want personalised guidance?

If you'd like help making sense of your aches, pains, or ongoing symptoms, you can book with Grant either in Port Macquarie or via an online telehealth consultation.

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