Rotator Cuff Injuries & Pilates: What You Need to Know

Ever had shoulder pain that won’t shift, especially when reaching, lifting, or even lying on your side? It could be a rotator cuff injury—and if that sounds technical, don’t worry, I’m here to break it down and, more importantly, show you how Pilates can help.

What is a Rotator Cuff Injury?

Your rotator cuff is a group of four muscles and tendons that keep your shoulder stable and allow smooth movement. These muscles work hard every time you lift your arm, reach behind you, or rotate your shoulder—so when they’re injured, you really feel it!

What Causes a Rotator Cuff Injury?

Rotator cuff injuries can be sudden (acute) or develop over time (chronic). Here’s what typically causes them:

Repetitive Overhead Movements – If you’re constantly reaching overhead (think painting, decorating, swimming, or tennis), your rotator cuff takes a lot of strain.

Lifting Heavy Objects with Poor Form – That awkwardly lifted shopping bag or suitcase can lead to a strain.

Age-Related Wear & Tear – As we get older, our muscles naturally weaken and become more prone to injury.

Poor Posture – Forward-rounded shoulders (hello, hours spent at a desk or scrolling on a phone) place extra stress on the rotator cuff.

Sudden Trauma – Falls, knocks, or even reaching too far too fast can cause an injury.

Signs You Might Have a Rotator Cuff Injury

• Shoulder pain, especially when lifting your arm or lying on the affected side.

• Weakness in the arm—struggling to lift, hold, or rotate objects.

• Limited range of motion—difficulty reaching behind your back or overhead.

• Clicking or popping sounds when moving your shoulder.

If any of this sounds familiar, don’t ignore it—moving the right way is key to recovery.

Pilates for Rotator Cuff Recovery

Pilates can be brilliant for recovering from a rotator cuff injury. The key is gentle, controlled movement to restore mobility, strengthen supporting muscles, and improve posture.

Best Pilates Exercises for Rotator Cuff Injuries

1. Shoulder Blade Squeeze (Scapular Retraction)

• Sit or stand tall, gently squeeze your shoulder blades together.

• Hold for 5 seconds, then release.

• This activates postural muscles and supports the shoulders.

2. Wall Slides (Scapular Mobility)

• Stand against a wall with arms in a “goalpost” shape.

• Slowly slide your arms up and down, keeping contact with the wall.

• Helps restore movement and posture without strain.

3. External Rotation with Light Resistance

• Hold a light resistance band, elbows bent at 90 degrees.

• Keep elbows tucked into your sides and slowly rotate the forearms outward.

• Strengthens the rotator cuff without overloading it.

4. Arm Openings (Thoracic Mobility)

• Lie on your side with knees bent, arms extended forward.

• Open your top arm, rotating through your upper body while keeping hips still.

• Improves shoulder mobility and spinal rotation—great for posture.

5. Modified Pilates Swimming

• Lie on your stomach with arms by your side (not extended forward).

• Gently lift and lower opposite arm and leg without strain.

• Strengthens the shoulders, back, and core without pressure on the injury.

6. Isometric Shoulder Hold

• Stand with elbows bent at 90 degrees, pressing hands lightly against a wall or resistance band.

• Hold for 10 seconds, then release.

• Builds endurance in the rotator cuff muscles without irritating them.

What NOT to Do: Pilates Exercises to Avoid

While movement is essential for recovery, some exercises can worsen the injury. Avoid:

• Overhead weightlifting – No shoulder presses or lat pulldowns.

• Planks & weight-bearing arm exercises – Full planks, push-ups, or side planks put too much strain on the joint.

• Fast or jerky arm movements – No rapid arm circles or pulses.

• Heavy resistance band exercises – Start light to avoid overstressing the area.

• Deep internal rotation movements – Avoid pulling the arm forcefully across the body.

Final Tips for Rotator Cuff Recovery

• Start with mobility before progressing to strength.

• Listen to your body—if it hurts, modify or stop.

• Strengthen the supporting muscles (your core, scapula stabilisers, and back) to help your shoulder.

• Use light resistance and focus on control, not intensity.

If you’re dealing with a rotator cuff injury or shoulder pain, Pilates can help—but doing the right exercises in the right way is key.

Want to know more about how Pilates can support your recovery? Get in touch for details on our classes!