These exercises can be used in the rehabilitation of shoulder impingement syndromes. They include mobility and then strengthening exercises.
It is important that full mobility is maintained or regained in the shoulder joint for rehabilitation to be successful. In addition, the athlete must also have correct biomechanical function of the shoulder joint. This is easily lost if the athlete has suffered an injury of the shoulder for any length of time. In particular the shoulder blade (scapular) and upper arm bone (humerus) should move together. In the injured athlete this 'rhythm' is often lost.
Mobility and stretching
Stretches can be done on a daily basis assuming there is no pain. Stretching must be done regularly and continued throughout the rehabilitation process. Below are some important stretches would should be performed in order to encourage full range of motion and improved posture.
Place one forearm arm against a fixed point such as a doorframe or corner of a wall.
Gently lean forwards and turn away from it to stretch the chest muscles.
Again, hold the position for 20 to 30 seconds and repeat 3 times. The athlete should feel a gentle stretch in the front of the shoulder but not pain.
Place the hand on the lower back and use the other hand to pull the elbow forwards.
Keep your hand on your lower back.
You should feel a gentle stretch at the back of the shoulder.
Hold for 20 to 30 seconds and repeat 5 times assuming there is no pain. If it is painful then discontinue.
Anterior shoulder stretch
Grasp something above you such as a doorframe (or something similar if not tall enough).
Move forwards leaving the arm behind to stretch the front of the shoulder and chest muscles.
Hold the position for 20 to 30 seconds and repeat 3 times.
The athlete should feel a gentle stretch in the front of the shoulder but not pain.
Posterior shoulder stretch
Place one arm across the front and pull it in tight with the other.
The athlete should feel a gentle stretch at the back of the shoulder.
Again, hold the position for 20 to 30 seconds and repeat 3 times. The athlete should feel a gentle stretch in the back of the shoulder but not pain.
Stretching should be done as soon as pain will allow and maintained throughout the rehabilitation process and beyond. Little and often is generally better than a big effort for a few days and then forgetting it as soon as the athlete feels the injury has settled down.
The strengthening exercises below are aimed at strengthening the rotator cuff muscles which are involved in stabilising the shoulder joint. There is also an emphasis on the upper back muscles such as the Rhomboids and Serratus Anterior which improve posture.
Always make sure any strengthening exercises are pain-free. If there is any pain, stop immediately.
External rotation lying
The athlete lies on their side with the arm to be worked on top.
The upper arm should be resting on your side and the elbow bent so that the hand points towards the floor.
Rotate the shoulder so that the hand moves up, towards the ceiling as far as possible.
It is also important in all shoulder rehabilitation to strengthen the muscles of the shoulder girdle in order to maintain correct shoulder biomechanics. The shoulder girdle consists of the shoulder blade (scapular) and the collar bone (clavicle). The following exercises are designed to strengthen the shoulder girdle.
The athlete aims to pull the shoulder back, whilst keeping the arm straight and the head still.
The only thing to move when doing this exercise should be the shoulder.
Aim to build up gradually (without a weight at first) from 3 sets of 10 repetitions to 3 sets of 30.
Once 3 sets of 30 are reached with no adverse affects, then the weight can increase.
Scapula squeeze exercises
These exercises are designed to develop control over the shoulder blades by squeezing them back and holding them.