How to Build Pectoral Muscles With a Torn Rotator Cuff

Shoulder pain can significantly interfere with your exercise activities. However, you can still safely perform an upper body workout with a shoulder injury.

Get clearance from your doctor or exercise under the supervision of a physical therapist if you have a rotator cuff tear — the wrong type of exercise can land you in the operating room having your rotator cuff tendons sewn back together.

Read more: How to Recover From a Rotator Cuff Injury — Plus 4 Exercises to Help

Your shoulder is the most mobile joint in the body. However, this also makes it more prone to injury. Performing chest exercises with a shoulder injury, such as a rotator cuff tear, can lead to more problems if you aren't careful.

The rotator cuff is a group of four muscles — supraspinatus, infraspinatus, teres minor and subscapularis — that help move and stabilize your shoulder joint. The tendons of these muscles can fray over time due to overuse and poor posture causing them to rub against bone. This can eventually lead to a complete tear. Less commonly, the rotator cuff can tear with trauma, such as a fall.

Rotator cuff tears are frequently treated with physical therapy. People who are very active might require surgery for their injury, followed by physical therapy. Do not attempt chest exercises with a shoulder injury until your pain has subsided and you have regained both a full range of motion, and enough strength to complete everyday tasks.

Read more: The 3 Best Exercises for Your Chest

Before you try to choose shoulder-friendly chest exercises, you must first master proper exercise posture. According to an April 2016 article published by International Journal of Sports Physical Therapy, an important part of recovery from rotator cuff injury is learning to maintain proper shoulder posture, particularly during overhead movements.

The rotator cuff tendons lie on top of your upper arm bone, under a bony roof that is formed by part of your shoulder blade. When you sit in a slouched position, which many people do, you further decrease the amount of space between these bones. This causes impingement, or pinching of the tendons — especially when your arms are raised above shoulder height.

Reaching your arms up and out to the side also pinches your rotator cuff tendons. This position, called abduction, is also used during many chest strengthening exercises, such as bench pressing, supine flyes, pec deck and dumbbell chest presses.

However, this doesn't mean chest day has to be put on hold if you have a rotator cuff injury. Just add some shoulder-friendly chest exercises to your routine. Begin with 10 repetitions of each exercise, working up to three sets in a row.

Move 1: Close Grip Push-Ups

Push-ups can still be performed as part of an upper body workout with a shoulder injury. Perform close-grip push-ups, as demonstrated by ExRx.net, with your elbows closer to your body to avoid the extreme shoulder abduction that occurs with regular push-up position. In addition to strengthening your pectoral muscles, the close grip push-up also puts more emphasis on your triceps.

1. Lie on your stomach on a firm surface.
2. Place your hands directly under your shoulders, or just inside your shoulders.
3. Press up into a plank position, supporting your weight on your palms and the balls of your feet.
4. Keeping your body straight from head to toe, bend your elbows and lower yourself toward the ground. If desired, touch your chest lightly on the ground.
5. Press back up to complete one repetition.

Move 2: Incline Bench Press

The commonly-performed wide-grip bench press should be avoided if you have shoulder pain, according to Massachusetts General Hospital's Sports Physical Therapy. Modify your bench press by using an incline bench at a 30-degree angle, instead of lying on a flat surface. This will reduce the amount of stress placed on your shoulder joints and rotator cuff.

1. Position yourself under the barbell rack. Grab the barbell with your hands shoulder-width apart.
2. Lift the barbell out of the rack.
3. Lower the bar until it is approximately one inch from your chest; then press back up.
4. Keep your elbows at a 45-degree angle from your sides throughout this exercise. Allowing your elbows to flare out will increase pressure on your shoulders.

Move 3: Chest Press Machine

Use a lever machine to perform a chest press with a torn rotator cuff, rather than a cable machine. Lever machines stabilize the weight for you, and limit your range of motion, helping to keep your shoulder in a safe position.

1. Adjust the height of the seat so that the horizontal handles are at chest height.
2. Press the foot lever to bring the handles in front of your body. If available, grasp the vertical handles to reduce shoulder abduction.
3. Press the weight out in front of you until your elbows fully straighten; then return to the starting position.

To further reduce stress on your shoulders during this exercise, minimize the distance that your elbows travel backward between repetitions.

Move 4: Pec Deck Machine

Performing supine pec flyes can increase pain with a rotator cuff injury. Not only are you fighting the pull of gravity, but your arms can easily drop below horizontal, putting your shoulders in a vulnerable position. Substitute the pec deck machine as a safer alternative.

1. Adjust the seat until the handles are chest-height.
2. If available, decrease the range of motion so that your arms are slightly in front of your body in the starting position.
3. Keeping your elbows slightly bent, pull the handles toward each other, across your chest.
4. Return to the starting position at a controlled speed.

Move 5: Dumbbell Floor Press

Try the dumbbell floor press as a free-weight option for chest exercises with a rotator cuff injury. Laying on your shoulder blades provides additional stabilization to your shoulder joints.

1. Lie on your back with your knees bent and feet on the ground. Hold one dumbbell in each hand.
2. Bend your elbows to 90 degrees.
3. Position your elbows at a 45-degree angle from your sides.
4. Press the weights up toward the ceiling, bringing them together over your chest.
5. Lower back down and lightly touch your elbows to the ground.