Rotator cuff-related pain (RCRP) is the most common upper body injury I see in triathletes.

RCRP is a large category for any type of shoulder pain that results from the rotator cuff.

Here's my rehab framework for managing your shoulder pain and get you back training asap:

Before we get into the framework it's important that we know what we're talking about.

The rotator cuff is the supporting muscle group for the shoulder and there are 4 muscles that make up the group

These tendons + the biceps tendon are usually the source of injuries in the triathletes and swimmers I work with.

The most common injury is a tendinopathy.

There can be other injuries but they are treated much the same.

So what's the process?

1. Calm everything down asap 

The first step in any process is to calm things down.

If you are having some shoulder pain then we know something there is ticked off and we need to let it settle back down.

Our first goal is to unload the area enough to get some rest (but not so much that you stop completely).

This usually means backing off swimming and strength training (if those are irritating the shoulder).

It's better to take a short pause now than a hard stop later.

Sometimes movements can also help calm things down.

2 of my starting points:

• ISO banded holds

• Gentle full range of motion

If none of this is helping then ice, heat and soft tissue massage might further help calm things down.

2. Increase ROM and shoulder control

Once you can do a few things with the shoulder we need to make sure you have full range of motion (ROM) AND good control of your motions.

We can do this with a few simple movements:

• full OH press

• scaption raises

• hangs

• supine swimmers

• T-spine rotations

The goal is to get everything in the shoulder region moving pain-free.

(I will usually start some of this step while we are doing the initial loading of the muscles with ISOs or banded exercises).

3. Increase shoulder strength

Once you have full ROM and things are feeling pretty good it's time to build some strength in the rotator cuff.

There are 2 big ways to build strength in the rotator cuff:

• isolated shoulder motions

• compound movements

I like a combo of both.

Isolated work focuses specifically on the rotator cuff muscles to ensure that you can control your shoulder motions through the full ROM.

Many athletes seem to lack control of the upper portion of their movements.

I regularly see people with a strong OH press and bench press.

But are unable to do a full shoulder rotation with a small DB.

Once you have good control we can progress to a Tri Strong upper body plan which you can maintain for the long run.

4. Return to sport

The final phase of your shoulder rehab is building back into sport.

In a perfect world you will have been training as much as possible.

Pausing anything that is completely irritating.

For triathletes usually we need to build back into the swim.

Here are 5 phases I like to walk athletes through:

• 4 x 50 m (repeat 3-4 times)

• 4 x 100 m (repeat 3-4 times)

• 4 x 150 m (repeat 3-4 times)

• 4 x 200 m (repeat 3-4 times)

• 4 x 250 m ((repeat 3-4 times))

This allows you the chance to test out the shoulder in the water and see how it feels.

I will encourage athletes to repeat each phase 2-3 times over a week, depending on how they are feeling in the water.

Slowly increase the total time that you are swimming.

Once you can handle a full set of these a regular workout should be no issues.