Mobility, strengthening and functional or sports specific exercises should form part of a dislocated shoulder rehabilitation program.
On this page:
- Mobility exercises
- Strengthening exercises
- Functional exercises
The following guidelines are for information purposes only. We recommend seeking professional advice before beginning rehabilitation. It is very important to avoid any movement that combines moving the arm upwards, out to the side and rotated back (lateral rotation and abduction) as this is the position a dislocated shoulder is most vulnerable.
- Gently swing the arm forwards, backwards and sideways whilst leaning forwards.
- Gradually increase the range of motion
- All exercises should be pain free
- Aim to reach 90 degrees of motion in any direction
Assisted exercises (play video)
Once the shoulder has started to heal, your therapist may start you doing active assisted exercises. This involves you using your good arm to assist the injured arm through the range of movement. Some good examples of this include:
- Holding onto a broomstick with both hands shoulder width apart
- Using the good arm, push the injured arm out to the side, and back towards the body.
- This should be performed in both directions, taking the injured arm across the body and away from the body (adduction/abduction)
- Lying on your back or seated in a chair, grip the hand of your injured side with the good side
- Slowly and gently bring the arms up and towards your head, and if you feel comfortable, over the head If at any time you feel like the shoulder is going to pop out, stop and return to the resting position
- Using the broomstick, this time keep your elbows into your side
- Allow the stick to move to the left and right in front of you, rotating the shoulder joint
These involve using your muscles against gravity and work towards gaining full use of the shoulder and should cover all the movements at the shoulder joint.
- Flexion - Lift the arm in front of you & above the head
- Extension - Move the arm out behind out
- Abduction - Take the arm away from the body to the side and up above the head Adduction - Move the arm across the body Internal
- Rotation - Keep the elbow bent by your side, turn the forearm in so that your wrist touches your stomach
- External Rotation - Keep the elbow bent by your side, turn the forearm outwards so that your hand points away from you
A strengthening program for an anterior dislocated shoulder can begin as soon as pain allows. It is important for the athlete to avoid any movements which abduct and laterally rotate the shoulder in the early stages as this is the position the shoulder is most likely to dislocate again. Initially static exercises involving no movement should be done and progressed gradually.
Isometric shoulder exercises (Play video)
Isometric means without movement, also known as static contractions. These are exercises where the muscles are being worked without moving the joint, and are often quite useful if the joint itself is still healing.
Isometric extension - Standing with your back against a wall, with your arms by your side. While keeping your elbows and wrists straight, push back into the wall and hold for 5 seconds. Work to increase this to 10 seconds. Repeat this 5 times.
To do the same for isometric flexion face the wall and use it as resistance in the same way as for extension exercises.
Isometric adduction - With a small pillow or a rolled up newspaper between your injured arm and your torso, squeeze inwards and try to hold it in position. Start with a small item and gradually move to larger sizes to work through a larger range of movement. Hold for 5 seconds (work to increase to 10). Repeat this 5 times (work to increase to 10).
Isometric Abduction - Stand side-on to a wall, with the arm to be worked next to it. Place the back of the wrist against the wall and push outwards as if trying to raise the arm to the side. Hold for 5 seconds (work to increase to 10). Repeat this 5 times (work to increase to 10).
External Rotation - Stand facing a door frame. Keep the elbow bent to 90 degrees and place the back of the hand against the frame. Push against the it. Hold for 5 seconds (work to increase to 10) and repeat 5 times (work to increase to 10).
Internal Rotation - Stand facing a door frame. Bend the elbow to 90 degrees, and place the palm of the hand on the side of the door frame and push against it. Hold for 5 seconds (work to increase to 10) and repeat 5 times (work to increase to 10).
Rotator cuff exercises (play video)
Internal rotation - This is the most important exercise as it strengthens the muscles which help prevent an anterior shoulder dislocation. Three of the five muscles which medially or internally rotate the shoulder are the pectoralis major, subscapularis and latissimus dorsi. In the early stages it is important to keep the shoulder joint in the inner range of motion. This means working from the position where the hand is out in front so it works across the body. Taking the shoulder into the outer range of motion puts it at risk of dislocation.
External rotation - works the muscle which externally rotate the shoulder. It can be done with a resistance band or a dumbell. This exercise should be avoided in the very early stages. When the shoulder has healed enough to begin external rotation exercises it is important to remain within the internal range of movement until told otherwise by your therapist.
Externally rotating the shoulder before it is ready puts it at risk of dislocation. Wrap the resistance band around something stable and hold the other end standing so that the band crosses the body. Keeping the elbow bent to 90 degrees and the upper arm by the side, rotate the shoulder to pull the band away from the body.
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.
Stand on the band holding the other end in the hand of your injured arm. Keeping the elbow straight, pull your hand straight up in front of you to about shoulder height. Once the athlete is comfortable with the exercises above, the resistance band can be replaced with weights to progress the strengthening exercises described above.
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.
Stand on the center of the band and hold the ends in either hand. Start with the elbows bent and hands at shoulder height. From there, straighten your arms and push up above your head. Slowly return to the starting position and repeat. Many of these exercises can also be performed with free weights as your strength progresses.
Functional exercises are those which reproduce every day movements or sports specific movements. They are more advanced rehab exercises to bridge the gap between injury and returning to full sports specific training.
Below we demonstrate some examples of functional exercises for a dislocated shoulder. It is important to check with your doctor or trainer before attempting these exercises.
Wobble board exercises (Play video)
- To improve the joint awareness you can use a wobble board or cushion, just as you would if you were rehabilitating an ankle injury.
- Start on all fours, knees on the floor and hands on the wobble board.
- Aim to hold the board still for 1 minute.
- Progress to performing circles with the board.
- Try performing mini push-ups, still maintaining the central position.
- Progress further by balancing with your hands on the board, legs straight and toes on the floor (like the full push-up position).
Re-bound exercises (Play video)
- Stand facing a wall
- Throw a light ball at chest height with both hands against the wall and catch it again.
- Progress by using a heavier ball
- Progress further by using one hand only
- Progress again by moving further back and throwing higher.
One handed rebound (Play video)
- Rebound exercises using one hand can also be done. This is especially useful for people who compete in throwing or racket sports.
- This is a very late stage strengthening exercise for shoulder dislocation and should not be done until given the go ahead until your trainer has approved.
- The shoulder is most vulnerable to dislocation in this position if it is not strong enough