Capacity: The aim of phase 3 is to increase the strength and endurance of the rotator cuff and upper limb throughout the full range of the shoulder.
Treatment
As required.
Taping
K-Tape can continue to be used if you have it available.
Foam rolling
This exercise massages the thoracic or upper area of the spine.
This is an excellent exercise for improving range of motion and helping to relieve upper back pain.
Teaching point:
- With hands behind the head, gently roll up and down from the lower ribs to the shoulders
Stretching
Can be done daily.
Pectorals
Teaching point:
- Place your arm so that it is slightly above horizontal, with your palm against the wall
- Turn your body away from the wall, keeping your hand firmly against the wall
- This will stretch your pec to the side nearest the wall
- Hold this position for 45 seconds
- Repeat on the opposite side
- 2 times a day
Posterior capsule
Teaching point:
- Bring your arm up to shoulder level and gently pull it across your body
- Use your other hand to pull the arm in until a stretch is felt in the shoulder
- Hold the stretch for 45 seconds
- 2 times a day
Trapezius stretch
Teaching point:
- Sit on a seat or bench in an upright position
- Use your hand to hold onto the side of the seat or bench which will stabilise the shoulder
- Move your ear to your shoulder
- 2 sets for 45 seconds
Neck rotation & flexion
Teaching point:
- Start in a good seated posture
- Turn the head to the left and to the right, as far as you feel comfortable
- Tilt the head to the left and right
- Hold for 1-2 seconds
- 2 sets for 45 seconds
- At least once a day
Active Range of Motion
Can be done daily.
Wall Mobility
Teaching points:
3 sets for 10 seconds for each exercise.
1) Shoulder Flexion
- Keeping your thumbs forward, Raise your arms as high as you can trying to touch your thumbs to the wall
- Maintain a good posture
2) Shoulder Abduction
- Keeping your thumbs slightly turned out, keep your arms at about 45 deg
- Bring your hands up above your head as if you were going to clap
3) Shoulder External Rotation
- Push your arms outwards (as if you are opening your hands and pulling them apart from each other)
- Maintain a good posture throughout
4) Internal Rotation
- Hands tucked in (not gripped)
- Bring your thumbs up as close to your shoulder blades as you can
5) Shoulder Extension
- With your hands flat, bring your arms back as far as you can go
- Keep your palms down
Strengthening
Can be done daily.
Shoulder flexion with resistance band
Teaching point:
- Stand on the band holding the other end in the hand of your injured shoulder
- Keeping the elbow straight, pull your hand straight up in front of you to about shoulder height
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase, you can then progress to light weights (cables and dumbbells).
Shoulder extension with band
Teaching point:
- Holds both ends of a band at hip height
- Keep the elbows straight and palms facing inwards
- Starting just in front of the body, pull the arms backwards, keeping the elbows straight and squeezing the shoulder blades together and down
- 3 sets for 8 reps
Note: Start with a light resistance band and gradually increase, you can then progress to light weights (cables and dumbbells).
Shoulder internal rotation
Teaching point:
- Start with your elbow out to the side • Keeping it next to your body, move your arm inwards towards your stomach using the band as resistance
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase, you can then progress to light weights (cables and dumbbells).
Shoulder external rotation
Teaching point:
- Take your arm out to the side as far away from you as you can
- They then slowly return to the starting position and repeat
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase, you can then progress to light weights (cables and dumbbells).
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
- 3 sets for 8 reps
Note: Start with a light resistance band and gradually increase, you can then progress to light weights (cables and dumbbells).
Shoulder abduction
Teaching point:
- Stand on one end of the band and hold the other end
- Keeping the elbow straight, pull your arm out to the side so that the hand ends up level with your shoulder
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase, you can then progress to light weights (cables and dumbbells).
Shoulder elevation
Teaching point:
- Stand tall, holding a weight you feel comfortable with
- Lift your shoulders straight up, then lower them back down
- 3 sets of 8 reps
Note: you can progress to a heavier weight
Bicep curls
Teaching point:
- Raise the barbell to your shoulders, keeping your arms close to your body
- Lower the barbell slowly, until your arms are fully extended
3 sets of 8 reps
Note: You can also use a dumbbell using one arm at a time.
Tricep extensions
Teaching point:
- Attach a band to a sturdy object above your head
- Extend your elbows, making sure to lock your arms at the bottom
- Control it on the way back up
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase.
Bent over row
Teaching point:
- Put your knee on the bench, with your arm fully extended pull the dumbbell up towards your chest
- Squeezing your shoulder blades at the top
- 3 sets of 12 to 15 reps
Upright row
Teaching point:
- Stand on a resistance band and pull both hands up towards your chin
- Keep your back straight and hold for a second at the top
- Slowly relax on your way down
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase.
Pull to face
Teaching point:
- Attach a band to a sturdy object at face level
- Keep your arms in towards your chin
- Control it on the way back
- 3 sets of 8 reps
Note: Start with a light resistance band and gradually increase.
Chest press
This exercise can be done at home on the floor or on the bench at the gym.
Teaching point:
- Push the weights above your chest as far as you feel comfortable
- 3 sets of 8 reps
Mid to inner range pectoral fly (keep reduced range)
Teaching point:
- Hold a dumbbell in each hand and start with your arms out to the side, just below shoulder height
- Keep a small bend in the elbows as you bring your arms forward so that your hands meet in front of your chest
- Slowly return to the starting position
- 3 sets of 8 reps
Note: gradually progress to heavier weights.
Functional
Can be done daily.
Running mechanics (Wall drills)
Teaching point:
- Go into a high knee while leaning into the wall
- Take the hip up to 90 degrees and pull your toes up towards the ceiling
- Once you feel more comfortable, pick up the speed and do sets of 3
- 2 sets of 5 on each side
Single leg drop jump
Teaching point:
- Start on the step, then hop off
- Hold on the landing for a couple of seconds and repeat
- 2 sets of 5 reps on each side
Note: You can make this more difficult by increasing the height of the box which is more challenging.
Running
Can be done daily.
Start jogging
Start jogging at a gentle pace. Progressively increase your speed and distance.
Move on to phase 4?
Check if you are ready to move on:
Exit criteria
- Pain-free through the full range
- Pain-free resisted shoulder exercises
- No apprehension with combined shoulder abduction and external rotation
- No pain during running Strength 80 – 90% uninjured side