Pilates guide
Exercise is the first treatment for most rotator cuff problems, including what's often called impingement and many worn tears, and the exercise that helps gets gradually harder: turning the arm out and in against a band or a light weight, shoulder-blade work, and weight on the arms built up in steps. Pilates can carry all of that, but on its own it has barely been tested: one small trial found it helped, and a 2026 trial found that adding unloaded Pilates moves to physiotherapy made no difference. So this guide shows how to make Pilates progressive for your cuff.
It covers which moves load the shoulder on the mat and the reformer and how to change them, the 5 out of 10 pain rule, building weight on your hands, tears from wear and from an injury, Pilates after a repair, what the surgery trials found, and our 20-minute step-by-step class. If your arm suddenly became weak after a fall or a lift, your shoulder looks out of place, or you have chest pain, go straight to the warning signs.
The 2025 US physiotherapy guideline puts an active exercise programme first for rotator cuff tendinopathy, and the UK's 2025 care pathway says most symptoms settle within 3 months. That covers what's often called impingement, and many worn tears too.
Across 7 trials (468 people), exercise that progressed and added resistance improved pain and function by about 15 points out of 100 more than nothing or placebo. Exercise that didn't progress was no better (4 points, which could be chance). The trial with the clearest result raised the load every other week.
In 33 people, 10 clinical Pilates sessions over 2 weeks eased pain more than conventional exercise. In a 2026 trial of 60 people with rotator cuff tendinopathy, adding unloaded Pilates moves to physiotherapy didn't help more than physiotherapy alone. Two more trials are registered and haven't reported. So Pilates helps as a way to do progressive cuff and shoulder-blade work, not as a treatment of its own.
In the trial with the clearest result, pain up to 5 out of 10 was allowed during exercise if it settled by the next session. 69% did well against 24% with general exercise, and 20% went on to choose surgery against 63%; at a year, 24% against 63%.
In a lab study of push-ups, the hands took about 49% of body weight from the knees, 64% on the floor and 41% with the hands raised on a high box. Those are push-up figures, a rough guide rather than measurements of Pilates moves, but they make a ladder: the wall, a worktop, your knees, then the floor.
Typical plans keep the arm protected for the first several weeks (a sling for 5 to 6 in one trial), start lifting the arm yourself from about 6 weeks and strengthening from about 12. Starting rehabilitation early didn't raise re-tears across 20 trials. Weight through the operated arm waits until your team allows it.
The supraspinatus, infraspinatus, teres minor and subscapularis wrap their tendons round the ball of the shoulder: they turn the arm out and in, help lift it, and keep the ball centred in its socket. Rotator cuff related shoulder pain covers tendon pain (often called impingement or subacromial pain), partial tears and small tears. The UK pathway calls it "a self-limiting condition" and says "most symptoms respond within three months". Our rotator cuff muscle guide has the anatomy.
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Many tears found on scans come from wear and are managed with exercise first; in one trial, partial tears did as well as intact tendons with specific exercise. Without surgery, small to medium tears may grow over 5 to 10 years, US surgeons' 2025 guideline says, and in a Norwegian trial unrepaired tears grew from about 16 to 32 mm over 15 years. A tear after a fall or a jerking lift, with sudden weakness, is different and needs a specialist soon. Our rotator cuff tear guide has the scan studies.
These are lab studies in people without shoulder pain. None measured a Pilates move in someone with a cuff problem, so what they mean for Pilates is our reading.
On the mat: the knee hover, planks, the leg pulls, the side bend and the push-up. On the reformer, the elephant, long stretch, up stretch and knee stretches put your hands on the footbar. In 23 adults on force plates, peak force through the hands was about 64% of body mass in a floor push-up, 49% from the knees, and 41% to 55% with the hands raised on a box. Less weight goes through the hands at the top of a push-up than at the bottom, and in 21 men, taking more weight onto the arms in plank variations raised the work of the shoulder and shoulder-blade muscles, including one of the cuff muscles. Take these push-up figures as a rough guide: no study has measured cuff load in a Pilates position.
The roll-up, swimming and the teaser reach overhead; rocking and the leg pull back take the arms behind you. On the reformer, the rowing series, backstroke and arm circles take loaded arms overhead and back. These are the moves to leave until the shoulder copes with lighter work (our suggestion).
In 22 healthy men doing reformer arm work, the shoulder muscles worked harder with each heavier spring (about 2, 3 and 5.5 kg of starting tension), and in the overhead version the authors wrote that heavy springs "may lead to abnormal compensation". In 26 men, the arm's angle changed which part of the trapezius, the big muscle across the top of the shoulder blade, worked most. Springs set the load, like weights, so start light.
The roll-over, jack knife, control balance and boomerang put weight on the shoulders and neck. Their own cautions keep them out with a shoulder or neck problem.
In 10 people, lying on your side and turning the forearm up drew the most activity from two cuff muscles (the infraspinatus and teres minor, at 62% and 67% of their maximum) of seven rotation exercises. A review says the thumbs-up "full can" raise works the supraspinatus about as much as the thumbs-down "empty can", with less risk of a pinch. In 26 trained men, pressing the floor away at the top of a push-up (the push-up plus) worked the serratus anterior, the muscle that holds the shoulder blade to the ribs.
In 33 people with shoulder pain (no diagnosis given), 10 clinical Pilates sessions over 2 weeks eased pain and disability more than conventional exercise, with no follow-up. In a 2026 trial of 60 adults aged 40 to 60 with rotator cuff tendinopathy, adding unloaded Pilates moves (5 to 10 repetitions, with no rule for making them harder) to physiotherapy didn't improve pain or arm function more than physiotherapy alone over 8 weeks. Its groups of 15 were allocated by coin flip, it was registered about 6 months after recruitment began, and its journal isn't indexed in PubMed, the main medical database.
Two more Pilates trials in the shoulder are registered and haven't reported, and no Pilates trial has studied tears or recovery after a repair. A 2026 review of exercise in middle-aged and older adults included only the first trial for Pilates, and misreported its size and length.
Across 7 trials (468 people), progressive, resisted exercise improved a combined pain and function score by 15 points out of 100 (somewhere between 9 and 21) against nothing or placebo; exercise that didn't progress or add resistance gave 4 points, which could be chance. The certainty is low.
In the Holmgren trial, 102 people on a surgical waiting list did 2 cuff exercises and 3 shoulder-blade exercises, 3 sets of 15 twice a day for 8 weeks, then once a day to 12 weeks, with the load raised every other week. 20% chose surgery, against 63% with general exercise, and still 24% against 63% at a year. Everyone had a steroid injection first, and the comparison group's exercise was weak. Whether higher doses work better is uncertain.
In 708 adults in 20 NHS trusts, up to 6 physiotherapy sessions over 16 weeks did no better over a year than one advice session with a home programme done 5 days a week, and no serious harms were reported. A smaller trial found one self-managed loaded exercise comparable to usual physiotherapy, though 30% of its data were missing.
A Cochrane review of 60 trials, mostly at high risk of bias, found one type of exercise or manual therapy was rarely better than another. The 2025 US guideline says motor control programmes, the closest match to how Pilates teaches control of the shoulder blade, "could be better" than standard ones, at low certainty.
Shaving bone from the roof of the shoulder (subacromial decompression) did no better than placebo surgery in 313 people, or at 10 years in another trial of 210, and a Cochrane review of 8 trials (1,062 people) rates that finding high certainty.
The 2025 US physiotherapy guideline puts an active exercise programme first, which "may include motor control and/or resistance training exercises of various load", and finds supervised programmes no better than home ones. The British Elbow and Shoulder Society's 2025 pathway adds painkillers, advice and early physiotherapy, considers one steroid injection at 6 to 8 weeks and refers at 12 weeks, and says the most effective physiotherapy "remains uncertain". US surgeons' 2025 guideline finds that physical therapy and surgery both improve small to medium full-thickness tears. The US physiotherapy guideline doesn't mention Pilates.
During shoulder strengthening, pain up to about 5 out of 10 is acceptable, and a little is expected. By your next session it should be back to where it was before. If it isn't, use a lighter band or weight or a smaller range next time, not nothing.
It comes from the Holmgren trial, which set each person's load this way and raised it every other week while pain stayed within the limit. In Pilates, apply it to the band work, the arm springs and each step of weight on your arms.
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Stop and get checked if you get a sharp pain with a sudden loss of strength: a small tear can get bigger.
Sharp pain, a feeling that the shoulder is slipping or a clunk, pins and needles or numbness spreading down the arm, or pain that's worse the next morning and doesn't settle by your next session (our suggestion, from NHS inform's pain guide and the reformer case report). Tell your teacher about shoulder pain, a past dislocation, surgery or breast cancer treatment before class.
Stop an exercise, or shrink its range, if you get the feeling the shoulder is about to slip out (editorial).
The order is our suggestion, as on our Pilates for shoulder pain guide, from the push-up force study (a rough guide, measured in push-ups rather than Pilates moves), the plank study and the moves' own pages. The wall push-up and push-up plus doses are from our Pilates for shoulder pain class and guide; the incline push-up and knee plank doses are editorial, as our yoga for wrists guide gives them; the knee push-up dose and the week or two at each step are editorial; the knee hover dose is the move page's dose.
See the movement on the 3D figure: Wall push-up
Our editorial order, from the Holmgren trial, the GRASP trial's home programme and the UK pathway. The 0.5 to 1 kg steps and the timings are editorial.
Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
That is the site's shoulder line. Leave Pilates for that arm until it has been seen (our suggestion).
In a Cochrane review of 9 trials (1,007 people, mostly small worn tears of the supraspinatus, average ages 56 to 68), repair gave about 0.87 points out of 10 less pain at a year than treatment without surgery, at moderate certainty, and a little more function, at low certainty. In people over 55 with small tears that didn't follow an injury, physiotherapy did as well as repair at about 6 years. US surgeons' 2025 guideline finds both physical therapy and surgery improve small to medium tears.
In a Norwegian trial of 103 people with tears up to 3 cm, repair was 11.8 points better on a 100-point shoulder score at 15 years, and 15 of the 51 people given physiotherapy later had surgery. Unrepaired tears grew from about 16 to 32 mm. So ask a shoulder specialist whether yours should be repaired.
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Strength getting worse, or the shoulder not clearly better by 12 weeks of exercise: ask for a specialist opinion.
That is our rotator cuff tear guide's line. Pilates can carry the exercise in those 12 weeks if the arm work gets harder over time.
Hospitals differ on the sling, the limits and when each exercise starts, and the size of your tear matters. Our rotator cuff repair guide sets out the usual NHS hospital stages; this section only says where Pilates fits.
The US shoulder therapists' consensus: about 2 weeks with the arm kept still, protected movement with help to 6 weeks, then lifting the arm yourself, and progressive strengthening from about 12 weeks. In the Norwegian trial: a sling for 5 to 6 weeks, active movement from 6 weeks and strengthening after 12. Our repair guide's typical precautions include: "No pushing up from a chair, bed or bath with that arm: until 12 weeks in one plan, with care for 3 months in another."
Across 20 trials, starting rehabilitation early didn't raise re-tears and gave a little more movement in the first months. In trials of 124 and 206 people, early movement helped range for a while without harming healing, and US surgeons' 2025 guideline rates early and delayed movement (up to 8 weeks) as similar. Early here means the movement your team prescribes, not Pilates.
Scans find the tendon has torn again in about 15% to 21% of repairs, more often with age and bigger tears. In a review, 88.5% of people returned to their activities, after about 6.6 months on average. No study has looked at a return to Pilates (or yoga) after a repair.
Our suggestion, from the repair guide's stages and precautions: until your team allows weight through the arm, Pilates means breathing, leg and trunk work with the operated arm resting at your side, and no lying on the operated side. Then the wall push-up, before any move on your hands.
No knee hover, planks, push-ups, leg pulls, side bend, elephant, long stretch or knee stretches on the repaired side until your team allows weight through the arm, and no reformer arm springs until they allow resisted work.
No pushing up from a chair, bed or bath with that arm: until 12 weeks in one plan, with care for 3 months in another.
Arm work in the straps (seated arm work, rowing, arms lying down, pulling straps and backstroke on the long box) works the cuff and shoulder blades against springs, and in healthy men muscle activity rose with each heavier spring. Start with the lightest arm spring, arms below shoulder height and in front of you, elbows near your sides for turning the arm out and in (our suggestion).
Footwork, leg springs, bridging, feet in straps and side-lying leg work keep your arms resting, so most of a reformer class can carry on. The hundred in the straps does load the shoulders, and the classical manual lists shoulder issues as a precaution for it.
The elephant, long stretch, up stretch and knee stretches put weight through your hands on the footbar. Treat them like planks, and bring them back at the same step (our suggestion).
Rowing, backstroke and arm circles take loaded arms overhead or behind you. Leave them until the cuff copes with lighter work and you've reached the last weight-bearing step (our suggestion).
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One reformer maker lists "Wrist, arm or shoulder problems" as a precaution for arm work and shoulder problems for kneeling abdominals, and doesn't recommend kneeling arm work facing the footbar, because balance, control and coordination "may be a challenge to maintain". Tell your teacher about the shoulder before class.
Gentle range first, pain-free. Lateral breathing, "5 to 8 breaths at the start of every session"; pendulum, "About 1 minute (10 small circles each way), 2 to 3 times a day"; table slide, "10 slow repetitions, 1 to 3 times a day"; stick-assisted turning out, "For a very irritable shoulder, 10 slow repetitions, pain-free, twice a day"; the open book, on your pain-free side, "8 to 10 slow openings each side, pausing 2 seconds at the end (our editorial starting point)" (the move page's dose for each).
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoPendulum exercise (Codman's pendulum)Beginner · A bench or box
3D demoTable slide (seated forward reach)Beginner · A bench or box
3D demoStick-assisted external rotation (lying)Beginner · Other / check instructions
3D demoSide-lying open bookBeginner · No equipmentThe core of the page, within the 5 out of 10 rule. External rotation with a band, 2 to 3 sets of 12 to 15 each arm, two or three times a week; side-lying external rotation with a tin of beans or a light weight, 2 sets of 8 to start (our Pilates for shoulder pain class), building to 2 to 3 sets of 12 to 15, lowering over about 3 seconds; internal rotation with a band, 2 rounds of 12 to 15 each arm; raises with your thumbs up (scaption), to shoulder height, 10 to 12, lowering over 3 seconds (our guide to strengthening your rotator cuff, for each). For the Holmgren trial's dose: 3 sets of 15, twice a day for 8 weeks, then once a day to 12 weeks, raising the load every other week.
Y-T-W raises, 5 of each shape, W and T first, adding the Y when lifting your arms overhead is comfortable (our Pilates for shoulder pain class), building to 5 to 8 of each letter for 2 rounds (our rotator cuff strength guide). The swan, "5 to 6 reps", kept small; swimming, "2 to 3 sets of 20 to 30 seconds", arms by your sides or bent while it's sore; band row, "3 sets of 10 to 15, stopping 2 to 3 reps short of failure, with 60 to 90 seconds' rest", elbows stopping at your sides at first (the move page's dose for each). Wall angels, 8 slow slides, only as high as is comfortable (our Pilates for shoulder pain class); band pull-aparts later, 2 or 3 sets of 12 to 15 (our rotator cuff strength guide).
Wall push-up, 2 sets of 8, and push-up plus at the wall, 8 to 10 (our Pilates for shoulder pain class); incline push-up, 2 to 3 sets of 8 to 12, and knee plank on the forearms, 3 holds of 10 to 20 seconds (editorial, as our yoga for wrists guide gives them); knee push-up, 2 sets of 6 to 8 (editorial). Last, the knee hover and the high plank, "3 holds of 15 to 30 seconds", and the Pilates push-up, "2 to 3 rounds of 3 push-ups" (the move page's dose for each).
3D demoWall push-upBeginner · A wall
3D demoScapular push-up (push-up plus)Beginner · No equipment
3D demoIncline push-upBeginner · A bench or box
3D demoKnee hover (Pilates tabletop hover)Beginner · No equipment
3D demoKnee plankBeginner · No equipment
3D demoKnee push-upBeginner · No equipment
3D demoStraight-arm plank (high plank)Intermediate · No equipment
3D demoPush-up (Pilates)Intermediate · No equipmentThe trunk and hips don't have to wait (our suggestion). The hundred, "50 beats to start, building to 100 (the classical count)", arms pumping low or resting; single-leg stretch, "6 to 10 each side", hands resting lightly on your shins; shoulder bridge, "3 to 5 kicks each leg", arms long by your sides; side kick, "8 to 10 each side", lying on your pain-free side with your head on your lower arm (the move page's dose for each).
Most of these are the moves' own cautions, word for word; the reformer changes are our suggestion.
The leg pull front: "Skip it with shoulder pain." The leg pull back: "Skip it if your wrists or the front of your shoulders hurt." The kneeling side kick: "Skip it with wrist or shoulder pain." Control balance: "It may not suit a shoulder or neck injury." The sleeper stretch: "Lying on the shoulder compresses it: stop for a pinch at the front of the shoulder, and skip it with a painful or unstable shoulder." Leave out the roll-over, jack knife, boomerang and upward plank too (our suggestion).
The side bend: "If your wrists or shoulders hurt, use the knee side plank or a forearm side plank instead." The push-up: "With shoulder pain, do the push-ups against a wall instead, and stop if the front of your shoulder pinches (our suggestion)." The double leg kick: "If the hand clasp hurts your shoulders, hold a towel between your hands." The roll-up: "If your shoulder is stiff or sore, reach your arms forward rather than overhead (our suggestion)." The mermaid: "If your shoulder is stiff or sore, reach only as high as is comfortable (our suggestion)." Rocking: "Holding your ankles pulls your shoulders back, so skip it if the front of your shoulder hurts (our suggestion)." The hip twist: "Mind your wrists and shoulders: with tight shoulders, bend the elbows and rest on the forearms."
Swimming: "With shoulder pain, keep your arms by your sides or bent and lift only your chest and legs (our suggestion)." The high plank: "With shoulder pain, try the forearm plank or rest your hands on a bench." The side kick: "If propping on the elbow hurts your shoulder, rest your head on your arm."
The lightest arm spring first; arms below shoulder height and in front of you; overhead and behind-the-back strap work later; the hands-on-the-footbar moves at the plank step; and no kneeling arm work facing the footbar (our suggestion, from the maker's precautions and the spring studies).
With hypermobility, the NHS advises not overextending your joints: keep your elbows soft rather than locked, use fists if your wrists bend back too far, and push the floor away rather than sinking into your shoulders.
That is the line on the hands-down Pilates moves' own pages.
Keep your arm in front of you, and leave the arm-out-and-turned-back position (some strap work, the doorway stretch) for later, as our Pilates for shoulder pain guide says. Stop or shrink any move that makes the shoulder feel about to slip.
In pregnancy, after the first trimester, keep time flat on your back to a few minutes: prop your upper body up, or use a side-lying or all-fours version.
That is the Pilates moves' shared caution.
Pain and stiffness in every direction, worst when turning the arm out, is more likely a frozen shoulder: our Pilates for frozen shoulder guide covers it. After breast cancer surgery, start with the exercises your team gives you; our Pilates for shoulder pain guide has a section on it.
Our 20-minute step-by-step class comes first: gentle range, then cuff and shoulder-blade strength, then weight on your arms. Add the band session on 2 or 3 other days, starting with the lightest band. The swimmers' class and the push-up progression are for when your shoulder copes with planks.
A 20-minute Pilates class for a sore shoulder: gentle range first, then shoulder-blade and rotator cuff strength, then light weight on the arms, in steps.
20 minBeginner15 movesA bench or box, Other / check instructionsA 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.
25 minBeginner12 movesA wall, A bandA 25-minute dryland Pilates class for swimmers: shoulder-blade control, trunk endurance, back extension, hips and rotation, built for loose shoulders.
25 minBeginner16 movesA wallWork up to full push-ups: wall, incline and knee push-ups, then the floor push-up and harder variations.
15 minBeginner8 movesA wall, A bench or boxA 20-minute yoga sequence for shoulder pain: gentle movement, standing poses with the arms low, shoulder strength, and weight on the arms built up from the wall.
20 minBeginner16 movesA bench or box, A wallThese are the same warning signs as our shoulder pain, rotator cuff tear and rotator cuff repair guides, word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Your surgical team's plan comes first. These are our rotator cuff repair guide's lines:
During shoulder strengthening, pain up to about 5 out of 10 is acceptable, and a little is expected. By your next session it should be back to where it was before. If it isn't, use a lighter band or weight or a smaller range next time, not nothing.
Stop and get checked if you get a sharp pain with a sudden loss of strength: a small tear can get bigger.
Sharp pain, a feeling that the shoulder is slipping or a clunk, pins and needles or numbness spreading down the arm, or pain that's worse the next morning and doesn't settle by your next session (our suggestion, from NHS inform's pain guide and the reformer case report). Tell your teacher about shoulder pain, a past dislocation, surgery or breast cancer treatment before class.
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Call 999 if:
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
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The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
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Exercise that gets harder within a pain limit has the evidence: in the Holmgren trial, 69% did well against 24%, and exercise that progressed beat nothing while exercise that didn't progress didn't. The US guideline's first treatment is an active exercise programme.
No exercise repairs a tendon, and no Pilates trial has studied tears. Exercise works for many people with small, worn tears, but tears up to 3 cm did better repaired over 15 years in one trial.
In the 2026 trial, adding unloaded Pilates moves to physiotherapy didn't help more than physiotherapy alone, though the trial was small and had weaknesses. What helped in the trials was exercise that progressed and added resistance.
The load can be stepped up: in push-ups, about 41% of body mass went through the hands with them raised high, 49% from the knees and 64% on the floor. The wall, a worktop, your knees, then the floor is how our shoulder guides bring it back.
Many worn tears are managed with exercise first, and surgery added little for them at a year. A tear after an injury with sudden weakness is different: see the warning signs.
Subacromial decompression did no better than placebo surgery, and the result held at 10 years.
In a lab study, shoulder muscle activity rose with each heavier spring, and the authors warned that heavy springs overhead may bring compensation. Start light.
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It can be, if the arm work gets gradually harder. Exercise is the first treatment for most rotator cuff problems, and the exercise that helped in trials progressed and added resistance. Pilates itself has only two tiny trials, one positive and one showing no added benefit from unloaded moves.
Usually, yes, with changes: arms low at first, light springs, weight on your arms built up in steps, and pain kept to about 5 out of 10, settling by your next session. Get help first if your arm suddenly became weak after a fall or a lift, or your shoulder looks out of shape.
While it hurts: the leg pull front and back, the kneeling side kick, control balance, the roll-over and jack knife, upward plank and the sleeper stretch. Do the side bend as a knee side plank and push-ups at a wall. On the reformer, leave heavy arm springs, overhead strap work and kneeling arm work facing the footbar for later.
Turning the arm out and in with the elbow at your side (lying on your side with a light weight, or with a band), Y-T-W raises and a small swan face down, and band rows. Then weight on your arms in steps: the wall, the knee hover, knee planks and push-ups.
It can be, starting with the lightest arm spring: in lab studies, shoulder muscles worked harder with each heavier spring, and very heavy springs brought compensation. Footwork, bridging and side-lying leg work don't load the shoulder. The elephant, long stretch and knee stretches put weight on your hands, so treat them like planks.
No exercise repairs a tendon, and no Pilates trial has studied tears. For small, worn tears, exercise works for many people and surgery added little at a year. Tears up to 3 cm did better repaired over 15 years in one trial, so ask a shoulder specialist whether yours should be.
Yes, when your surgical team says so; its plan comes first. Typical plans protect the arm for the first several weeks and start strengthening around 12 weeks. Until the team allows weight through the arm, Pilates means breathing, leg and trunk work with the arm resting, and no planks or hands-down moves.
Up to about 5 out of 10 during the exercise, back to where it was by your next session. If it isn't, use a lighter band or a smaller range next time, not nothing. Stop and get checked for a sharp pain with a sudden loss of strength.
In 708 NHS patients, one advice session with a home programme did as well as up to 6 physiotherapy sessions. See a physiotherapist if it isn't improving after 2 weeks of looking after it yourself; the UK pathway asks for a referral if it isn't better by 12 weeks. In many areas you can refer yourself.
Moves that put your weight on your hands, or load the arm overhead or behind you, can irritate a cuff that isn't ready, and so can heavy reformer springs. Start light and build up. Pain that is still worse by your next session means go back a step.
Probably not: shaving bone off the roof of the shoulder did no better than placebo surgery, still at 10 years. Most rotator cuff pain settles within 3 months with exercise.
Call 999 for shoulder or arm pain with chest pain that feels tight or spreads to your arms, neck or jaw, and go to A&E if, after a fall, your shoulder looks out of place. Get help the same day for sudden weakness lifting the arm after an injury. See a GP or physiotherapist if it isn't better after 2 weeks of looking after it yourself.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
