Shoulder rehabilitation protocols

Shoulder and Arm Exercises

Shoulder Wallwalk

The exercise can help you achieve better use of your shoulder by improving its range of motion.

To Start: Find an open wall or door jam.

Facing the wall slowly walk your fingers up the wall. You walk up as far as you can while maintaining the space between your shoulder and your ear. This may decrease how much range of motion you achieve initially but it will your mechanics correct and decrease the chance of developing compensations.

Once you have the reached your maximal height, hold for 3-5 seconds and then slowly walk your fingers back down. Repeat this for 10 repetitions.

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Help keep your muscle tone and awake after having shoulder surgery. Isometrics ask muscles to fire but without moving the joint.

Start: Standing near a doorway or wall with your elbow bent.

External Rotation (ER): Stand with the back of your wrist against the wall. Keep your wrist neutral as you apply a force externally as if your palm was going away from you. Start with 20% force and slowly work up to 80%. Hold for 5-10 seconds for 10 repetitions.

Internal Rotation (IR): Stand on the other side of the wall with your palm facing the wall. Apply a sub-maximal force without eliciting pain.Start with 20% force and slowly work up to 80%. Hold for 5-10 seconds for 10 repetitions.

Abduction: Stand with your elbow against the wall. Apply force through the elbow.Start with 20% force and slowly work up to 80%. Hold for 5-10 seconds for 10 repetitions.

Adduction: Step away from the wall and place a towel between your arm and your thorax (ribcage). Apply a force as if you are squeezing your side. Start with 20% force and slowly work up to 80%. Hold for 5-10 seconds for 10 repetitions.

Flexion: Face the wall and apply force into the wall through your wrist keeping your wrist in neutral. Start with 20% force and slowly work up to 80%. Hold for 5-10 seconds for 10 repetitions.

Extension: Face away from the wall and apply force through the elbow. Start with 20% force and slowly work up to 80%. Hold for 5-10 seconds for 10 repetitions.

This is important stretch that helps improve your posture, your shoulder mechanics, and even help with neck pain.

Start: Stand next to a doorway. Lift your arm to 90 degrees so your palm is on the frame. You can place your arm lower if there is shoulder pain. You should feel a gentle pull on the chest wall. Now twist your body to the outside to increase your stretch. This should be pain-free. Hold for 30 seconds.

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This advanced exercise is perfect for any throwing athlete. It is a plyometric exercise which means your muscles will exert a maximal effort in a short period of time and is specific to the shoulder.

Equipment: small weighted ball of 3-5 lbs.

Start: Facing the wall, in a throwing position with your feet separated. Always engage your core.

You want to throw the ball into the wall with the intention of getting a rhythm going. You can start with a slow rhythm and gradually increase your pace. Practice for 30 seconds and slowly build to 60 seconds. Start with two hands and switch to single hand as tolerated.

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This exercise targets the four muscles of the rotator cuff. It is very important to have both strength and stabilization of the rotator cuff muscles to avoid injuries such as impingement and/or rotator cuff tears.

Equipment: theraband or resistance band, and a towel rolled up

Start: Place the rolled towel at your elbow and grab the theraband with both hands.

External Rotation: With the towel rolled at your side, keep your shoulder blade down and your wrist neutral. Slowly pull the theraband away from the opposite arm. Avoid pain.

Internal Rotation: Anchor the theraband onto an object or in the door jam. With the towel rolled and placed at your side, pull the theraband towards your abdomen. Make sure the band is at the height of your forearm with your elbow is bent to 90 degrees.

For both exercises practice for 2-3 sets of 10-15 repetitions.

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These exercises work the shoulder in three major planes of the shoulder. It is important to keep the elbow straight and shoulder blade down and back.

Equipment: theraband or a resistance band

Start: You are going to step on one end of the theraband.

Flexion: With your thumb pointing up and shoulder blade down and back, lift your straight arm up in front to 90 degrees.

Abduction: Again, the thumb will lead and lift your straight arm out to the side to 90 
degrees.

Scaption: You will bring your arm up at a diagonal (in between flexion and abduction) with your thumbs up.

Perform each exercise for 2-3 sets of 10-15 repetitions.

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This is an advanced shoulder exercise that may not be appropriate for all. Please consult your physical therapist prior to trying this exercise. It requires great core strength, stability and shoulder stability.

Start: Position yourself near a wall.

Place your feet on the wall and slowly walk your feet to get your body to be closer to the wall. The demands on your shoulder increase as you get closer. Once at the wall, perform shoulder shrugs. Return to standing slowly.

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A great exercise t
This exercise is great to build up to a full push up. It allows you to build strength while focusing on your mechanics without infliction of pain.

Start: Position yourself near a wall. The closer your feet are to the wall, the easier the exercise.

Place your hands directly inline with your shoulders. Keep your elbows in and perform a push up. This will isolate your triceps. You can isolate into your pectoralis muscles buy widening your hands and let your elbows fall out.

You can progress by lowering your body to a countertop, then to the floor but your knees down.

Perform 3x10.

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This is exercise is a progression of the wall push up and requires more scapular stability. It is a great way to a challenge to your daily routine. 
Equipment: a ball of your choice

Start: Place the ball on the wall at chest level and make a diamond shape with your hands.

Push up: Keeping your shoulders in a protracted position (shoulder blades away from your spine) perform a push up on the ball. The ball will add increase work as you try to stabilize.

Circles: Keeping your hands on the ball, perform small circles along the wall. You will have to shift your center of gravity. Work Clockwise and counterclockwise. A progression of this exercise is to perform this with only one arm. Be sure to keep the elbow straight.

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A challenging exercise that focuses on shoulder and scapular stabilization. It works all of the muscles of the shoulder girdle and can be very fatiguing.

You can perform this exercise on a ball or on the floor with your knees bent.

You will start with a light weight in your extended arm. Perform small circles in one direction for 30 seconds, then circles in the other direction for 30 seconds. 
Next, protract your arm (reaching up so your shoulder blade is off the floor/ball) and perform little circles in 30 second-bouts clockwise and counterclockwise. 
You want to make sure the motion is slow and controlled.

For more information, visit: www.stoneclinic.com/rehab

Excellent stretch to prevent and deal with neck pain.

These muscles tend to carry stress and need to be stretched on a regular basis.

The muscles that originate on the shoulder blade are the foundation muscles for the entire upper extremity. One of the scapular muscles is the serratus anterior muscle which is an important muscle to keep strong in order to maintain a healthy, stable shoulder.

This exercise focuses on scapular stabilization, allowing for the necessary strength to safely perform many upper extremity activities such as racquet sports, throwing, and push ups. Check out the fitness and rehabilitation programs at The Stone Clinic in San Francisco, an internationally recognized destination orthopedic and sports medicine clinic. http://www.stoneclinic.com/rehabilitation-protocols

Don't have wimpy triceps! Build up the back of your arms as much as you strengthen your biceps!

Take your shoulder strengthening out of the straight planes, and incorporate diagonal patterns to simulate functional real-life movements.

Old fashion with modern application. We all lift and place objects overhead. This trains for that activity and helps diminish the back injuries that result from weak muscles.

Everyone sitting at a screen all day or driving a car needs these exercises. Really helps avoid the forward slump of old age.

It's not named the rotator cuff for nothing...do this rotational exercise to strengthen the muscles that rotate your shoulder. While kind of boring, they're extremely effective.

A great exercise for spine mobility and stretch.

You will start on your stomach, hands at your shoulders, elbows at your side. Press up lifting your sternum and torso while keeping your pelvis on the floor. Hold for 15 seconds. You should not feel any low back pain. If you do, do not extend up as high.

Persons experiencing lumbar-disc issues will often get prescribed "McKenzie back extensions" which is similar; however, you do perform repeated press ups versus holding the stretch. Plus consult with your physical therapist to see if this is appropriate for you.

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Challenge your push up and add a row. This is a great progression of your standard push up that will add more demands on your core musculature and shoulders.

You need two dumbbells of your choice.

Start in the push up position with hands holding the dumbbell weights. Perform a regular push up, weight shift to one side and perform a row. Make sure you alternate sides and keep your hips level.

To make this harder, perform a push-up windmill. You will perform a push up and as you row turn your hips so you are in a side plank position. Make sure you alternate sides.

Repeat 2-3 sets of 10-15 repetitions.