It is essential an accurate diagnosis is made before beginning any shoulder rehabilitation.
Shoulder rehabilitation exercises usually begin in the early stages with mobility exercises, and progress to isometric or static shoulder exercises before dynamic, then functional or sports specific exercises.
On this page:
- Rehabilitation for specific shoulder injuries
- Isometric shoulder exercises
- Shoulder mobility exercises
- Shoulder stability exercises
- Dynamic shoulder exercises
- Functional & proprioception shoulder exercises
Shoulder rehabilitation for specific injuries
Select from the options below for specific shoulder injury rehabilitation exercises:
Isometric shoulder exercises
Isometric or static shoulder exercises are performed using an immovable object, such as a wall or possibly a partner to provide resistance. The joint does not move at all but the muscles will contract. They are used in the earlier stages of shoulder rehabilitation where joint movement may be painful.
These should be performed in flexion, extension, abduction, internal and external rotation, as long as there is no pain.
- Isometric shoulder flexion – The arm is moved slightly in front of the body, with the fist touching a wall in front. The athlete tries to list the arm upwards against the resistance of the wall. Hold for 5-10 seconds.
- Isometric extension – The athlete stands with their back to a wall and the arm just behind them. They try to push the arm back against the wall. Hold for 5-10 seconds.
- Isometric abduction – The athlete stands side-on to a wall and tries to push the arm out to the side against the wall. Hold for 5-10 seconds.
- Internal (medial) rotation – The arm is bent at the elbow and the wrist pushed against the wall as if trying to rotate around to the stomach. Hold for 5-10 seconds.
- External (lateral) rotation – The arm is bent at the elbow and the wrist pushed back against the wall as if trying to rotate outwards. Hold for 5-10 seconds.
Bouhler exercises are excellent for the shoulder blade muscles and the mid-back, particularly the Rhomboids and lower part of the trapezius muscle. Static muscular contractions using the wall as resistance. Ensure the abdominals are tightened and the back is flat against the wall.
- Exercise 1 – Patient pushes the thumbs to the wall, hold for 5 seconds, relax and repeat.
- Exercise 2 – The patient pushes the backs of the hands into the wall. Hold for 5 seconds, rest and repeat.
- Exercise 3 – The arms are positioned at a 45-degree angle from horizontal and then pushed back into the wall. Ensure the elbows are straight and shoulder blades retracted (pulled together).
This exercise can be progressed by performing the same movements in a prone lying position (on the front)
Shoulder mobility exercises
Shoulder mobility exercises are usually done in the early stages of rehabilitation as and when pain allows. This obviously depends on how bad your injury is and what stage of rehabilitation you are at. The aim is to increase the pain-free range of movement at the shoulder.
Pendulum exercises are the most basic and should be done as soon as pain allows. Later use of a pole or wand can help increase the range of movement further. The athlete stands as shown with the bodyweight resting on the uninjured shoulder. Keeping the injured shoulder relaxed, bodyweight is shifted between the feet to initiate a back and forwards motion. Standing with the feet level and at shoulder width, transferring the weight from right to left can be used to increase side to side movement.
Pole Mobility Exercises
Wand exercises use a long pole such as a broomstick to move the injured arm. The other arm powers the movement and the injured arm is kept relaxed as it is moved throughout its range of motion. Use the pole or stick to navigate the injured arm to avoid excess stress. Follow the movements shown in the videos; flexion, lateral rotation, medial rotation, abduction, and horizontal flexion/extension.
To stretch the top of the shoulder a rolled up towel can be placed between the bent elbow and the body. The other hand pulls the elbow inwards. The aim is to increase superior capsule mobility and shoulder extension. A rolled up towel is placed between the arm and the side of the body. With the elbow bent, the athlete pulls the elbow towards the body using the other hand.
Shoulder stability exercises
Stability exercises for the shoulder are an important part of the rehabilitation process. In particular, scapular stabilization (shoulder blade) is important for producing the normal movement patterns required in the shoulder joint to return to full fitness and prevent future injury.
Wobble board exercises for shoulder stability
A wobble balance board is often used as part of ankle rehabilitation. But this handy piece of kit can also be used to strengthen the scapular muscles and core stabilizers.
The athlete starts with the hands on the wobble board shoulder width apart. For the more basic version of this exercise, the athlete supports themselves on their knees, this can be progressed through to the toes. Whilst maintaining balance the athlete performs circular movements on the board.
Swiss ball exercises
This is a plyometric exercise which challenges shoulder stability and the muscles of the upper extremity due to the shoulder having to provide stability.
The athlete positions themselves on the ball at the hips and places the hands on the wobble board. The athlete attempts to maintain balance whilst moving the arms. This can be progressed by positioning the ball lower down the body.
Horizontal Abduction In Prone
The horizontal abduction exercise strengthens the teres minor and the infraspinatus muscles along with the posterior deltoid and the scapular stabilizers. The athlete lies with the arm over the edge of the table. The arm with the weight is lifted up into a horizontal extension.
Read more on shoulder stability exercises.
Dynamic shoulder exercises involve movement and make up a large part of a shoulder rehab program. The can usually begin as soon as pain allows, although check with your therapist or trainer which are suitable for your specific injury. Working the medial or internal rotation muscles is important after shoulder injuries, especially dislocations and impingement syndromes. Exercises include medial and lateral rotation, chest press, and others using resistance bands or dumbbell weights.
Functional shoulder exercises bridge the gap between basic shoulder rehabilitation and more sports specific exercises. They make use of medicine balls for catching and throwing with more explosive or ‘plyometric’ type exercises. Proprioception is the bodies positional awareness and is often damaged from injury resulting in a loss of coordination and shoulder stability.