The shoulder complex is made up of a series of bones, muscles, ligaments and tendons. The muscles of the shoulder complex provide much stability for the shoulder through its normal range of motion, and include the prime mover and prime stabilizer of the shoulder. Also included is the rotator cuff, which is made up of tendons from four muscles: the suprapinatus, infraspinatus, teres minor, and subscapularis.

The shoulder complex and rotator cuff is widely used in sports that require an overhead throwing motion such as baseball and swimming; and, during activities of daily living such as lifting and rising from a seated position, or during activities included within some occupations that may require constant and repetitive overhead motions. Because of its common use, injury of the shoulder complex can result in significant disability.

Injury to the shoulder complex can include rotator cuff tendonitis, bursitis, or rotator cuff tears, among others. Common causes of rotator cuff injury are usually grouped into two main categories: repetitive use injury (chronic overhead activity, degeneration due to aging, etc) or, less commonly, traumatic injury (falling on an outstretched hand, etc).
Symptoms of rotator cuff injury can include the following: decreased range of motion, loss of strength, point tenderness, and anterior-lateral shoulder pain that may radiate down the lateral arm.

Depending on the severity and mechanism of injury, treatment may require surgery; however, conservative treatment with a physical therapist or athletic trainer is quite effective, and therefore highly recommended and widely used. Conservative treatment for rotator cuff injuries falls into three main steps.

First, the main primary goals of treatment are to reduce inflammation, initiate tissue recovery and control pain. These goals can be reached through different means such s heat treatment, electrical stimulation, ultrasound, and soft tissue mobilization; combination; of which can decrease pain and joint stiffness, increase blood flow and circulation and stimulate repair of soft tissue in the injured area.

Second, stretching and isometric strengthening exercises are used to prepare the shoulder to re-strengthen and initiate recovery of normal functioning. Gentle stretching exercises can improve range of motion by increasing flexibility of muscles and tendons of the injured complex. While improving range of motion, isometric strengthening exercises are done because they
provide an increase in muscular strength and contraction without having to move through a painful range of motion. After stretching and greater flexibility have allowed for a greater pain- free range of motion and muscle strength has started to improve, treatment continues to the third step.

During the third step of treatment, therapeutic exercise is used for aerobic and strength conditioning to recondition the body and restore normal body function. These workouts can be completed using exercise machines, the upper body ergometer, and theraband exercises. This step is also extremely important in prevention of further injury through an increase in strength and physical fitness as less fit individuals are more susceptible to injury or re-injury.