How to Protect Your Shoulder: Exercises to Skip With a Supraspinatus Tear

A supraspinatus tear is a common injury, particularly among athletes and individuals who engage in repetitive overhead activities. The supraspinatus muscle is one of the four muscles that make up the rotator cuff, which is essential for shoulder stability and movement. This muscle plays a crucial role in lifting the arm and stabilizing the shoulder joint. A tear in the supraspinatus can lead to significant pain, weakness, and reduced range of motion. Proper management of this injury is vital to prevent further damage and promote healing. This article will focus on exercises that should be avoided if you have a supraspinatus tear, the reasons why they should be avoided, and safer alternatives to help you recover effectively.

Understanding the Supraspinatus Muscle and Its Role

The supraspinatus muscle is located at the top of the shoulder blade and is responsible for abducting the arm, which means lifting it away from the body. It is one of the most commonly injured muscles in the rotator cuff, especially in individuals who perform repetitive overhead activities such as throwing, swimming, or lifting weights. A tear in this muscle can occur due to acute trauma, such as a fall, or more commonly, due to chronic overuse and wear and tear over time.

Symptoms of a supraspinatus tear include shoulder pain, especially when lifting the arm, weakness, and difficulty performing everyday activities such as reaching or lifting objects. Early diagnosis and appropriate treatment are crucial for preventing long-term damage and loss of function.

Exercises to Avoid With a Supraspinatus Tear

1. Overhead Shoulder Press
   • Why to Avoid: The overhead shoulder press is a common exercise in strength training routines, but it places significant stress on the rotator cuff, particularly the supraspinatus muscle. Lifting weights above the head can exacerbate a tear by increasing the strain on the injured muscle, potentially leading to further tearing and inflammation.
   • Alternative: Instead of overhead presses, consider lateral raises with light weights or resistance bands to work the deltoid muscles without compromising the supraspinatus.
2. Behind-the-Neck Presses
   • Why to Avoid: Behind-the-neck presses, whether with a barbell or dumbbells, are notorious for putting the shoulder joint in an unnatural position, increasing the risk of impingement and further injury to the supraspinatus. This exercise can exacerbate pain and lead to more significant tears.
   • Alternative: Opt for front shoulder raises or external rotation exercises to strengthen the shoulder muscles while minimizing the risk to the supraspinatus.
3. Upright Rows
   • Why to Avoid: Upright rows involve lifting a barbell or dumbbells to the chin while keeping the elbows high. This movement can cause the supraspinatus to become pinched between the upper arm bone and the acromion (a bony part of the shoulder blade), leading to impingement and worsening of a tear.
   • Alternative: Shrugs and scapular retraction exercises are safer options that focus on the trapezius and rhomboid muscles without risking further injury to the rotator cuff.
4. Dips
   • Why to Avoid: Dips are a compound exercise that primarily targets the triceps but also engage the shoulders and chest. The position of the shoulders during dips can place excessive strain on the rotator cuff, especially the supraspinatus, increasing the risk of aggravating a tear.
   • Alternative: Triceps pushdowns with a resistance band or cable machine can effectively target the triceps without placing undue stress on the shoulder.
5. Lat Pulldowns Behind the Neck
   • Why to Avoid: Similar to behind-the-neck presses, lat pulldowns behind the neck force the shoulders into an awkward and vulnerable position. This can lead to impingement and worsen a supraspinatus tear. The forward pull of the exercise can also stretch the injured muscle excessively.
   • Alternative: Perform lat pulldowns in front of the body with a wide grip, or consider using a resistance band for pull-aparts to work the back muscles safely.
6. Plyometric Exercises
   • Why to Avoid: Plyometric exercises, such as box jumps, clapping push-ups, or medicine ball throws, involve explosive movements that can put sudden and intense stress on the shoulder joint. These high-impact activities can easily exacerbate a supraspinatus tear by causing further trauma to the already weakened muscle.
   • Alternative: Focus on controlled, low-impact exercises such as stationary cycling or walking, which can help maintain cardiovascular fitness without compromising shoulder health.
7. Heavy Lifting
   • Why to Avoid: Heavy lifting, especially when it involves the upper body, can strain the shoulder muscles, including the supraspinatus. Whether lifting heavy objects at work, performing deadlifts, or engaging in heavy resistance training, the excessive load can worsen the tear and prolong recovery.
   • Alternative: Engage in light resistance exercises with proper form, and prioritize rehabilitation exercises that strengthen the shoulder stabilizers, such as scapular retractions and wall slides.
8. CrossFit-Style Workouts
   • Why to Avoid: CrossFit workouts often include high-intensity, high-repetition movements that can be demanding on the shoulders. Exercises like kipping pull-ups, snatches, and overhead presses are common in CrossFit and can easily lead to overuse or exacerbate a supraspinatus tear.
   • Alternative: If you enjoy CrossFit, modify your routine by focusing on lower-body exercises, core work, and non-impact cardiovascular activities. Consult with a physical therapist for specific modifications.
9. Swimming (Certain Strokes)
   • Why to Avoid: While swimming is generally a low-impact exercise, certain strokes, such as freestyle and butterfly, involve repetitive overhead motions that can strain the supraspinatus. The constant overhead arm movement can aggravate a tear, especially if the stroke mechanics are not perfect.
   • Alternative: If you want to swim, consider using a kickboard to work on your lower body, or opt for backstroke, which places less strain on the shoulder.
10. Tennis and Other Overhead Sports
    • Why to Avoid: Sports that require repetitive overhead motions, such as tennis, badminton, or volleyball, can be particularly harmful to a torn supraspinatus. The quick, forceful movements required in these sports can lead to further tearing and increased pain.
    • Alternative: Consider switching to sports that do not require overhead movements, such as cycling, running, or lower-impact activities like walking or yoga.

The Importance of Proper Rehabilitation

Recovering from a supraspinatus tear requires a carefully structured rehabilitation program that includes strengthening and stretching exercises designed to restore shoulder function without risking further injury. It's crucial to work with a physical therapist who can guide you through exercises that are safe and effective for your specific condition.

1. Rotator Cuff Strengthening
   • Exercise Examples: Internal and external rotations with resistance bands, isometric shoulder exercises.
   • Purpose: These exercises help to strengthen the surrounding muscles of the rotator cuff, providing better stability and support for the shoulder joint.
2. Scapular Stabilization
   • Exercise Examples: Scapular retractions, wall slides, and seated rows with light resistance.
   • Purpose: Strengthening the scapular muscles improves shoulder mechanics and reduces the risk of further injury to the supraspinatus.
3. Range of Motion Exercises
   • Exercise Examples: Pendulum swings, passive arm stretches, and assisted shoulder flexion.
   • Purpose: These exercises help maintain or improve the shoulder's range of motion without placing excessive strain on the injured muscle.
4. Postural Training
   • Exercise Examples: Thoracic extensions, seated rows, and shoulder blade squeezes.
   • Purpose: Proper posture is essential in reducing shoulder impingement and alleviating stress on the rotator cuff.

When to Resume Normal Activity

The timeline for returning to normal activities after a supraspinatus tear varies depending on the severity of the tear and the individual's adherence to rehabilitation. Generally, mild tears may heal within a few weeks to months with conservative treatment, while more severe tears may require surgical intervention and a longer recovery period.

Before resuming normal activities, it's essential to have clearance from your healthcare provider. They will assess your shoulder's strength, range of motion, and stability to determine if it's safe to return to your previous level of activity. Returning to activities too soon can lead to re-injury and prolonged recovery.

Conclusion

A supraspinatus tear is a serious injury that requires careful management to avoid further damage and promote healing. Avoiding specific exercises that strain the shoulder and focusing on a structured rehabilitation program are key components of a successful recovery. By making informed choices about your exercise routine and working closely with a healthcare professional, you can regain shoulder strength and function while minimizing the risk of re-injury.