Re-Load: The aim of phase 2 is to continue to protect the area and improve the condition of the muscles
Treatment
To be done daily.
Cold therapy
Apply ice/cold therapy for 10 minutes every 2 hours initially.
Reduce frequency as your symptoms improve.
Massage
If available, see a therapist for a deep tissue massage around the upper arm, upper traps, neck, pectorals and upper back.
Taping
Use K-Tape if available.
Active assisted range of motion
To be done daily.
Pendulum
Pendulum mobility exercises are good for very early-stage shoulder mobility.
Teaching point:
1)
- In a bent-over position keeping the arm relaxed gently swing it forwards and backwards as far as it feels comfortable
- 3 sets of 10-12 swings on each side
2)
- In a bent-over position take your arm out to the side as far as feels comfortable
- 3 sets of 10-12 swings on each side
3)
- In a bent-over position draw a big circle with your arm, making the circle as big as you can
- Keep your arm relaxed
- 3 sets of 10-12 swings on each side
Note: All exercises should be pain-free, so if it hurts then stop and be patient.
Flexion with gym ball
Teaching point:
- Lift the ball over your head, using your good arm to assist the injured arm
- Apply a little pressure to the ball
- Lift the ball over your head as far as you feel comfortable
- Give your shoulder a little stretch as you lift the ball
- 3 sets of 10 reps each
Abduction with gym ball
Teaching point:
- Use your good arm to assist the injured arm as you lift the ball to one side
- Swing around to the opposite side
- 3 sets of 10 each
Supine internal and external rotation
Teaching point:
- Lie on your back, and bring your elbow up creating a 90-degree bend
- Slowly rotate the shoulder back and forth, keeping a 90-degree bend in the elbow
- 3 sets of 10 reps each
Strengthening
To be done 2 to 4 times a week.
Shoulder flexion
Teaching point:
- Stand with your back against the wall, maintaining a good posture
- Keeping your thumbs forward, bring your arms up over your head as far as you can (touching your thumbs against the wall)
- Keep your back against the wall, lower your arms back down to your sides
- 5 sets of 15 seconds on each side
Shoulder extension
Teaching point:
- Holds both ends of a band at hip height, with the elbows straight and palms facing inwards
- Starting just in front of the body, pull the arms backwards
- Keep the elbows straight and squeeze the shoulder blades together and down
- Mid-range
- 5 sets of 15 seconds on each side
Shoulder internal rotation
Teaching point:
- Start with the band attached to a fixed point on your side
- Hold another end of the band in one hand, with the elbow bent and the upper arm by your side
- Keep the elbow by your side, and move your hand towards your stomach as far as is comfortable
- Slowly return to the starting position
- Mid-range
- 5 sets of 15 seconds each
Shoulder external rotation
Teaching point:
- Wrap the resistance band around something stable
- Hold the other end standing so that the band crosses the body
- Keep the elbow bent to 90 degrees and the upper arm by the side
- Rotate the shoulder to pull the band away from the body
- Mid-range
- 5 sets of 15 seconds on each side
Shoulder adduction
Teaching point:
- Wrap the band around something secure
- Hold the other end and stand with your injured side closest to the attachment
- Keeping the elbow straight, pull your hand across your body as far as is comfortable
- Mid-range
- 5 sets for 15 seconds on each side
Shoulder abduction
Teaching point:
- Stand with your back against the wall, maintaining a good posture
- With your thumbs slightly turned out, bring your hands up over your head as if you are about to clap
- Keep your back against the wall, lower your arms back down to your sides
- 5 sets of 15 seconds on each side
Proprioception
To be done 2 to 4 times a week.
4 point kneeling over ball
Teaching point:
Exercise 1 – Supine over a Swiss ball
- On your hands and knees, lean over the Swiss ball with your belly resting on the ball
- Gently transfer your weight onto your affected arm keeping your elbows straight
- 4 sets for 30 seconds
Note: This exercise is to get your shoulder used to taking a little weight and to get your shoulder muscles working.
Exercise 2 – Shoulder taps
- Touch the shoulder with your hand and come back down.
- Then do the opposite side
- Keep the buttocks and core nice and tight
- 4 sets for 30 seconds
Note: The further you come out from the ball, the harder it will be.
Exercise 3 – Mini press-up
- In a push-up position, control your core as you slowly lower through to a full push-up
- Keep the buttocks and core nice and tight
- 4 sets for 30 seconds
Note: The closer your body is to the ball, the easier you will find the exercise. The further away it will become more challenging.
Cardiovascular
Up to 5 times a week.
Stationary cycle
Stationary cycle 20 mins.
Every other day at a minimum – up to x 5 per week.
Move on to phase 3?
Check if you are ready to move on:
Exit criteria
- Pain-free to touch over the head of the humerus
- Pain-free active-assisted range of movement exercises
- Pain-free isometric rotator cuff exercises
- Pain-free proprioception exercises below 900