Core strength connected to a healthy shoulder

Rotator Cuff Injury: Is Core Stability the Missing Link to Recovery?

Nico Varela in Health & Wellness August 2025 • 4 min read.

"New research explores the connection between core strength and shoulder health, offering insights for better rehabilitation after rotator cuff repair."

The shoulder joint relies on a complex network of muscles working together to allow a wide range of motion. When neuromuscular control and stability are compromised through injury, shoulder function suffers. A key element in this control is the rotator cuff (RC), a group of muscles that stabilize the shoulder joint.

Rotator cuff (RC) pathologies, including tears, are surprisingly common, affecting a significant portion of the population over 50. While surgery is often necessary to repair these tears, success isn't guaranteed. Re-tears occur in a substantial percentage of cases, highlighting the need to look beyond just the shoulder itself for effective rehabilitation strategies.

While core stability has gained attention for its role in athletic performance and lower extremity injury prevention, its impact on shoulder health has been largely unexplored. This article delves into a recent study investigating the relationship between core stability and upper extremity function in individuals who have undergone rotator cuff repair. The findings suggest that a strong core might be more critical to shoulder recovery than previously thought.

Core Stability: Why It Matters for Shoulder Rehabilitation

Core strength connected to a healthy shoulder

Core stability goes beyond just having strong abs. It refers to the ability to control the muscles of the trunk and pelvis to create a stable base for movement. This stability is crucial not only for protecting the spine, but also for optimizing strength and endurance in the limbs.

Think of your core as the foundation of a house. A weak foundation compromises the stability of the entire structure. Similarly, a weak core can disrupt the efficient transfer of energy to the shoulders, potentially hindering recovery after a rotator cuff repair. A strong core can help:

Minimize stress on the shoulder joint.
Improve strength and endurance of shoulder muscles.
Enhance energy transfer during movements.
Reduce the risk of compensatory movements that can lead to re-injury.

The study compared two groups: patients who had undergone rotator cuff repair (RC repair group) and a control group of healthy individuals. Core endurance was assessed using tests like the Flexor Endurance test, Prone Bridge, and Supine Bridge. Upper extremity function was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, Short Form-36 (SF-36) and the Close Kinetic Chain Upper Extremity Stability (CKCUES) test. The results revealed that the control group demonstrated significantly better core endurance and upper extremity function compared to the RC repair group.

The Takeaway: A Holistic Approach to Shoulder Recovery

These findings emphasize the importance of considering the neuromuscular system as a whole when addressing shoulder injuries. While traditional rehabilitation programs often focus solely on the shoulder, incorporating core stabilization exercises may lead to more effective and lasting results.

If you're recovering from rotator cuff repair, talk to your physical therapist about incorporating core strengthening exercises into your rehabilitation program. These exercises can help improve your overall stability, reduce stress on your shoulder joint, and optimize your recovery.

Future research should investigate the specific types of core exercises that are most beneficial for shoulder rehabilitation, as well as the long-term impact of core stability on preventing re-tears and maintaining shoulder function. By addressing core stability, rehabilitation programs can provide more holistic and effective care and improve patient outcomes for RC repair surgery.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3233/bmr-170962, Alternate LINK

Title: Is There A Relation Between Rotator Cuff Injury And Core Stability?

Subject: Rehabilitation

Journal: Journal of Back and Musculoskeletal Rehabilitation

Publisher: IOS Press

Authors: Ali Çağdaş Yörükoğlu, Raziye Şavkın, Nihal Büker, Khaled Yahya Abdullah Alsayani

Published: 2019-05-05

Everything You Need To Know

What role does the rotator cuff play in shoulder function, and how can injuries affect it?

The shoulder joint depends on coordinated muscle action for movement. When neuromuscular control and stability are affected by an injury like a rotator cuff tear, shoulder function is compromised. The rotator cuff, a group of muscles, stabilizes the shoulder. Core stability provides a base for the shoulder to function optimally. Improving core endurance can minimize stress on the shoulder joint, improve strength, enhance energy transfer, and reduce re-injury risks.

What does core stability really mean, and why is it so important for recovering from a rotator cuff injury?

Core stability is the ability to control trunk and pelvis muscles, creating a stable base for movement. It's not just about strong abs. A weak core disrupts energy transfer to the shoulders, hindering recovery after rotator cuff repair. Strengthening the core through specific exercises may lead to better and lasting results by improving the function of the entire neuromuscular system.

How was core stability and upper extremity function evaluated in the study involving rotator cuff repair patients?

The study compared individuals post-rotator cuff repair (RC repair group) with a control group. Core endurance was assessed using tests like the Flexor Endurance test, Prone Bridge, and Supine Bridge. Upper extremity function was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, Short Form-36 (SF-36) and the Close Kinetic Chain Upper Extremity Stability (CKCUES) test. The control group showed better core endurance and upper extremity function.

If I've had a rotator cuff repair, why should I focus on core exercises instead of just shoulder exercises?

Individuals who have undergone rotator cuff repair often focus on shoulder-specific exercises, but incorporating core stabilization exercises into rehabilitation programs is essential. Core exercises can improve outcomes by enhancing the function of the entire neuromuscular system, leading to more effective and lasting results in shoulder recovery. Focusing solely on the shoulder might not address underlying core weaknesses that contribute to re-injury.

Why is it important to consider the role of core strength when dealing with rotator cuff injuries and rehabilitation?

Rotator cuff pathologies, like tears, are common, especially in those over 50, frequently requiring surgery. However, re-tears are common, indicating that focusing only on the shoulder isn't enough. Core stability plays a role in shoulder health that warrants further exploration. A strong core is essential for athletic performance, injury prevention, and overall shoulder health, and it is crucial for optimizing rehabilitation outcomes after rotator cuff repair.