Have you ever felt a dull ache or sharp pain in or around the shoulder? While at the gym, did you experience the pain after a heavy set of military or bench press or lateral raises? If yes, this pain may be a sign that you have damaged one or a series of muscles known collectively as the rotator cuff. Considered one of the most common shoulder injuries, rotator cuff damage is most common in men older than 40, but also affects people who participate in activities that require repeated over head arm movements, including swimming, baseball or weightlifting. This often painful malady can seriously impact quality of life, and has the potential to derail functions of daily living. Assuredly, it will deter you from moving forward with your fitness goals. Have no fear, though. Paying careful attention to form, avoiding or modifying certain exercises and strengthening often neglected parts of the shoulder and back can help you avoid a rotator cuff injury for pain-free living.

Without going into significant detail, it is helpful to understand the structure of the shoulder and why it’s so prone to injury so you can make informed decisions when determining which exercises to include and which to avoid in your routine. The shoulder is the most mobile joint of the body which allows for all kinds of movements in varied ranges of motion; a great asset considering the many assorted daily human functions. But such mobility comes at a cost as the muscles that surround and protect the integrity of the joint (supraspinatus, infraspinatus, teres minor and subscapularis) are very small, which limits their ability to move heavy objects and increases the potential for injury. These muscles also seek to keep the upper arm bone from dislocating from the shoulder, a big job for such little workers.

According to the University of Michigan Health Systems, “A rotator cuff injury is a strain or tear in the group of tendons and muscles that hold your shoulder joint together and help move your shoulder.” Such strains or tears most commonly are the result of overuse of the area musculature and tend to occur when the arm is repeatedly used over head. Potential causes involve using the arm to break a fall; lifting a heavy object; sports, including swimming, tennis, baseball and football; manual labor such as painting, raking leaves and housework (no, you can’t use this as an excuse to avoid those chores!); and other similar activities. Whether acute or chronic, rotator cuff injuries present themselves through either dull or sharp pains in the shoulder, area weakness and tenderness, and loss of shoulder movement. Those who have experienced a rotator cuff injury know full well the ramifications and tremendous pain involved.

Prevention really is the best medicine. Prevention allows you to live a full, quality life without painful obstructions. A few augmentations to your exercise routine will better arm you against injury.

One surefire way to tell whether you are prone to injury is to examine your posture. If you have shoulders that round forward, you’re making your rotator cuff muscles work overtime. These muscles are now out of alignment and must maneuver outside natural range of motion, which places excess strain on the tendons that keep the muscle attached to the bone. For example, one of the more common rotator cuff injuries involves the supraspinatus, a muscle that attaches to the shoulder blade and the front of the upper arm. When the shoulders round forward, this muscle can actually become compressed between the top of the arm bone and the bony process of the shoulder, limiting its range of motion and increasing friction for greater damage and lots of pain. Enough consistent friction and the soft tissue will develop microtears increasing its vulnerability toward strain. You might liken it to a rubber band. Poke holes through it and eventually the material will give out.

Rounded shoulders often result from spending excess hours in front of the computer, driving or other similar activity that causes a person to hunch forward. Over time, the muscles of the mid and upper back become weak, and the chest and frontal shoulder muscles shorten. One way to counteract this problem is to make every effort to get away from the computer and stretch the chest and shoulders on a regular basis. Consistent stretching will help release tightened tissues which will lessen the pull on the shoulders. While sitting, attempt to maintain optimal posture by pulling your shoulder blades together and dropping the shoulders away from the ears. Massaging the chest and shoulder muscles can be a great (though sometimes painful) way to fast-track your body to better alignment. When exercising, be ever vigilant about shoulder position and quality of movement.

A colleague of mine used to say, “For every chest exercise, perform two back exercises.” It is sound advice, particularly for office workers or those who drive on a regular basis. Since most of us already have tight, dominant chest and shoulder muscles, it is important to integrate balance into the workout and make sure you spend enough time on the back and rear shoulders. Different variations of rows, reverse flyes and other similar exercises are essential to strengthen the weaker back muscles.

Unless you have perfect posture (which you probably don’t), in order to avoid shoulder damage, you should consider some exercises off limits. One of the most popular, yet potentially dangerous, exercises is the lateral raise. As I said before, the smaller shoulder muscles are not made to lift heavy objects. Coupled with rounded shoulders, you’ve got a recipe for disaster. If you refuse to eliminate this exercise from your routine, you can modify the exercise by decreasing the weight and rotating the palms forward instead of inward toward the body. Another exercise to get rid of is the behind the neck pulldown. This exercise wreaks havoc on the shoulder muscles. Instead, pull the bar down toward your chest. When performing the overhead or military press, keep the arms and weights just slightly forward of the body for a more neutral position.

Avoiding rotator cuff injuries is essential to remaining active, and proper form and strength training are paramount to a healthy shoulder. Be sure to adequately warm up the shoulder muscles prior to lifting heavy loads or before heading out on the field for a game of flag football. Be kind to your shoulders and they will remain strong and capable.