Exercises

Shoulder Exercises

The most common cause of shoulder pain is Impingement Syndrome. Often called bursitis, cuffitis, or "Thrower's Shoulder", it is common to all overhead activities, such as tennis, racquetball, baseball, and swimming.

It is caused by excessive rubbing of the Rotator Cuff muscles on the undersurface of the shoulder bone during overhead activities. This rubbing causes inflammation (swelling and redness), which results in pain about the shoulder whenever the arm is placed in an overhead position.

One of the causes of Impingement Syndrome is muscle strength imbalance between the forward throwing muscles and the "recovery" muscles, which take the arm into an overhead position. These "recovery" muscles are also known as the Rotator Cuff muscles and are often weaker in strength than the forward throwing muscles.

Exercises to strengthen the Rotator Cuff muscles will help, over the long term, to prevent Impingement Syndrome and, therefore, shoulder pain.

Begin by bending forward at the waist, supporting yourself with the uninvolved arm. Take a light weight (1-2 pounds) and do 15 lifts directly to the side with the elbow straight. Repeat this exercise set 4 times (Figure 1)




		Figure 1

Repeat these sets of exercises (4 sets of 15 lifts) with the arm positioned 45 degrees behind your original position (Figure 2) and again at 45 degrees in front of your original position (Figure 3).

You should use enough weight so that these exercises "feel" difficult. You should add weight as your muscles increase in strength.

As you do these exercises, you should feel the muscles around the shoulder blade getting a workout. These "shoulder blade muscles" are the Rotator Cuff muscles.

Remember that these exercises are meant to be helpful over the long term and will not produce an immediate cure. If you are active in overhead sports, you should be doing these exercises on a regular basis.


		Figure 2



	Figure 3

Rehabilitation After Shoulder Surgery

Rehabilitation of the shoulder should begin the first several days after surgery. Phase I includes Passive Range of Motion of your shoulder, and lasts for the first 3-4 weeks after surgery. During this time, movement of the shoulder should be done by a partner (friend, parent, spouse, physical therapist, or athletic trainer). This avoids stiffness of the shoulder while protecting the shoulder muscles.


1. With your shoulders square to your assistant, he/she lifts the elbow forward as far as can be tolerated and holds this position for a count of 10. (Figure 1).




		Figure 1

	2. With your assistant to your side, he/she lifts the elbow to the side as far as can be tolerated and holds this position for a count of 10. (Figure 2).


	Figure 2

		3. With your assistant facing you, and the involved elbow held at the side, the hand and wrist are moved outwards as far as can be tolerated and held for a count of 10. (Figure 3).


		Figure 3

	4. Finally, with the arm either in or out of the sling, lean forward and let your shoulder and arm dangle. Make small circles with your elbow and/or fingers. Make progressively bigger and bigger circles. Perform these exercises 2-3 times per day. After the first month, Phase II will include further physical therapy to work on more range of motion and strengthening of your shoulder.

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