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There are a number of different rotator cuff injuries that you can suffer, running from tendonitis to a full rotator cuff tear but the one thing that they have in common is that exercise will feature somewhere in the recovery programme. But what are the best shoulder exercises for a rotator cuff injury and when should you start exercising again.

The important thing to remember with a rotator cuff injury is that if you exercise too soon or at the wrong time you will almost invariably make it worse, so always err on the side of caution; if in doubt don't exercise. To understand why I say this you first need to understand the different injuries and problems that can beset your rotator cuff.

On a sliding scale from the least severe injury to the most severe, tendonitis of the shoulder is at the bottom end of the scale. This is simply a strained or pulled tendon which results in inflammation of the tendons. The inflammation causes pain or soreness in the shoulder. You need to rest your shoulder until the inflammation reduces; you can if you want help it along with ice packs and anti-inflammatory drugs but don't start exercising it until it has been pain free for a while.

If you exercise a shoulder that has tendonitis you may well end up with the next level of injury which is a shoulder impingement. This is where the tendon has become so swollen that it is actually getting trapped or impinged. There is one tendon in your shoulder called the supraspinatus tendon which actually runs through a channel of bone underneath your collar bone. When it becomes inflamed it can start to rub against the bone which causes a sharp pain especially when lifting your arm above shoulder height or reaching behind your back.

Again, refrain from exercise whilst you treat the inflammation. Most shoulder impingements will respond to rest, Ice and anti inflammatory drugs. In some extreme cases surgery is necessary to free up the impingement but always try the non-surgical route first. Once the inflammation has gone down you can start exe4rcising again.

If you ignore a shoulder impingement and try to work through the pain you will quickly start to damage the tendon by wearing it against the bone, the pain will get worse and your movement will become more and more restricted. Don't do it! Rotator cuff tears vary from partial tears to complete tears and you really don't want either if you can avoid it. Lots more rest, lots more ice and lots of anti-inflammatory drugs will help to reduce inflammation and let the tear heal. In severe cases surgery is an option. Only once the tear has healed, or been repaired should you start any form of exercise.

The exercise must be low weight, low resistance exercise. Do not start pushing weights. Do not make any movement that hurts as this is usually a sign of further damage being done. Steer clear of the gym. Try exercises that focus on the strength of the whole shoulder such as pilates or yoga. Shoulder injuries and in particular rotator cuff injuries are often brought about by aging and the changes in posture that come with it. By exercising the whole shoulder you get the balance back into your shoulder muscles helping you to not only heal but also to prevent future injuries.