If shoulder pain is throwing off your game, it’s likely that one muscle of your rotator cuff is to blame. Here I’ll give you 6 supraspinatus exercises that will help rehab your shoulder and improve your form.
A shoulder injury can really throw you off – and not only by messing with your aim.
It can make it difficult to even lift that arm up, much less throw an effective pitch, pass or punch.
And there’s nothing more deflating than preparing to take a swing or shoot the ball and feeling your arm crumble weakly as you try to lift it up…
If you’ve been feeling weak and in pain, especially when trying to reach overhead, let’s figure out what is likely going on, and then how to help you heal and rebuild your strength.
Rotator Cuff Functions
Your rotator cuff is a group of four muscles – supraspinatus, infraspinatus, subscapularis and teres minor – which all connect your scapula to your humerus.
Any of these muscles can be involved in a rotator cuff tear, but the supraspinatus is the most commonly injured .
This muscle runs along the top of your scapula (above the spine of the scapula, hence the name “supra”spinatus) and connects to the top of your humerus.
Like the name implies, the rotator cuff muscles including the supraspinatus work to rotate your arm. However, they also do more than that.
They play a huge role in controlling the humeral head during shoulder flexion and abduction.
This helps to keep your humerus centred in the joint, ensuring smooth movement and also preventing shoulder impingement.
Individually, the supraspinatus also plays a key role in shoulder abduction, providing most of the torque on initiation of shoulder abduction from neutral and a quarter of the torque necessary to abduct the shoulder.
But again, its primary function is to help stabilize the humeral head to maintain proper alignment during movement. 
In normal movement, your scapulae rotate upwards, tilt posteriorly and rotate externally when your humerus is elevated .
If these movements don’t happen (say due to muscle weakness or an injury) the risk for further injuries and tears increases – especially when your arm is elevated.
What’s Behind Shoulder Injuries?
Sometimes, the cause of a supraspinatus or rotator cuff injury is clear and sudden. These cases typically involve trauma, like falling on your arm when it was outstretched, or a failed max bench press.
But most cases are more of a gradual, subtle injury. These tears occur over time, thanks to a tendon being worn down by repetitive motions or poor posture.
Where do you feel pain coming from the supraspinatus?
Supraspinatus pain is classically felt on the upper and outer aspect of the arm, towards the front. If you are feeling pain more on the top of the shoulder, it could be pain from the AC joint or the neck.
Sometimes in younger people there is a primary instability issue, with the shoulder partially losing its alignment and this mechanically overloads a part of the rotator cuff tendon.
A lack of blood flow that can come with aging, smoking and genetics can also contribute to this kind of tear.
Because of these reasons, people over 40 and people who use overhead shoulder motions repeatedly – like tennis players and people who lift weights – are at a greater risk for rotator cuff tears , especially if they don’t address movement and postural dysfunctions before they cause injury
And if the supraspinatus is failing to properly perform its role in maintaining humeral alignment, as may happen if the muscle is weak, you could be at a greater risk for a rotator cuff tear, and at greater risk for shoulder impingement .
Steps to Rehab an Injured Shoulder:
If your shoulder’s been feeling weak or painful when you reach up, or maybe if you just know you’re at risk for a supraspinatus injury thanks to repetitive overhead motions, it’s time to start the rehab process and build up a healthy joint.
And this process starts with getting a diagnosis for your tear from a doctor.
Get Extent of Tear Diagnosed
This is an important step in making sure you heal properly, so don’t skip it.
However, there’s news that will reassure you.
First, in around 80% of people with rotator cuff tears, no surgery is required and other methods are sufficient for easing the pain and reinstating proper function .
Also, studies have shown that self-managed exercise programs are just as effective as traditional therapy for healing issues in the rotator cuff tendons .
So don’t think that going to the doctor is committing yourself to going under the knife or to months of therapy – it’s not.
It is however, still entirely necessary, because it’s not quite possible to tell on your own what grade of rotator cuff tear you have.
Most partial thickness rotator cuff tears fall into one of three grades, based on their severity.
In Grade 1, the tear is only about 3 millimeters deep.
In Grade 2, it’s deeper (between 3 to 6 mm), but still less than half the thickness of the tendon . In Grade 3 tears, the tear is over 6mm, or more than half the thickness of the tendon.
If you have mild pain and weakness, it’s likely you have a Grade 1 injury. More severe pain or major trouble moving your shoulder points to a more severe tear .
Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. The classic full thickness rotator cuff tendon tear involves the supraspinatus and then progresses to involve the long head of biceps, followed by the infraspinatus and subscapularis.
You may be surprised to hear that even if you suffer from a full thickness tear it does not mean you are doomed for surgery. There are a number of factors to take into consideration, age, activity level, demands placed upon the shoulder, general health, overall tear size and condition of the muscle associated with the tendon tear. If a tendon tear is neglected it can progress in size over time. The muscle that is associated with the torn tendon becomes fibrotic as it is no longer stimulated. The key is to monitor the size of the tear with regular ultrasound or MRI investigations to determine what is happening with the structure of the rotator cuff tendon.
Because more severe tears require a more careful monitoring and recovery process, it’s important you go get a firm diagnosis.
Test Yourself for Supraspinatus Tear
There are some tests, however, that you can perform yourself to see if your supraspinatus is involved – the Zero Degree Abduction Test and the Drop Arm Sign.
Zero Degree Abduction Test
For this test, simply stand with your arms by your side. Have someone resist you (or use a wall) as you try to abduct your arm on the painful side.
Turning your thumb towards the floor will activate the supraspinatus muscle preferentially and accentuate your pain response.
If lifting your arm away from you in this way causes pain, your injury is likely a supraspinatus issue. .
Drop Arm Sign
You can also test for the Drop Arm Sign. You can do this on your own by passively lifting the affected arm with your opposite arm, then lowering it slowly.
If your supraspinatus is injured, your deltoid muscle will likely go through a jerky contraction to try to control the movement on its own .
This will result in pain, a hunched shoulder and an arm that quickly drops before reaching the waist.
6 Supraspinatus Exercises for Shoulder Rehab
These supraspinatus exercises, which are separated into 3 levels, are ideal for building back up the strength in your shoulder and in your supraspinatus.
That’s because each level utilizes both closed chain and open chain exercises to get the best of both worlds.
Plus, each level progresses in range of motion, stabilization requirement and/or load, in order to build strength and intensity intelligently and safely.
And the types of approaches I’ve provided here are backed by research, so you don’t just have to take my word for it.
Studies have shown that PNF, or proprioceptive neuromuscular facilitation, techniques helped subjects with supraspinatus tears increase blood flow and regain function in their shoulder .
And research has shown that risk of a shoulder impingement is greater with internal rotation of the arm, than with external rotation , so these exercises focus on externally rotating the shoulder and gently activating the supraspinatus.
These first techniques are remedial supraspinatus exercises that to be done until there is 0 pain doing them. They’ll help encourage circulation and healing.
The first move also utilizes PNF techniques to help reprogram your nervous system for better posture maintenance.
The Lasso – 3-5 sets x 30-45 sec
4 Point or Front Support – 3 sets x 30-45 sec
The key is to re-establish a foundation for movement, read more here. If you are not successful with the above exercises, I would try two other techniques the active sleeper stretch and thoracic spine mobilization. If you are not sailing along easily at this point with your exercise progressions, then you may have more pronounced movement dysfunction and would benefit by the shoulder control course.
The moves at this level are slightly progressed in terms of load and stability challenge. They’ll start to gently build supraspinatus strength.
Side Lying External Rotation
Front Support on Medicine Ball
These exercises further increase the challenge by introducing both a greater range of motion and bigger load, while still utilizing PNF techniques. Now we’re really cooking.
Medicine Ball Pushup
Give these supraspinatus exercises a try, and be patient while doing them. Your goal at first is just to increase blood flow and provide gentle movement.
Don’t move on too quickly – your efforts to speed up the healing process could only serve to set you back and slow the entire thing down, so CHILL!
Move through the exercises, advancing when you feel no pain and feel ready, and your shoulder (and supraspinatus) will come back better and stronger than ever.
Meaning, not only will your throw and lift probably get better, but you’ll also be at a reduced risk of future shoulder problems.
However, don’t forget that the shoulder is a complex SYSTEM and we have just targeted a small part of that system…
If you do want to make sure you address the entire system, check out my Scap Strength program.
This article was reviewed and updated on November 20, 2020 by our Chief Medical Officer, Dr. Erin Boynton, MD, FRCS to include new research and information on latest surgical developments. Read more about Dr. B here.