Saturday, June 25, 2011

Exercises for the shoulder

Recently, an executive from Microsoft was seen in our clinic that "was working through pain to make the shoulder pain better". I was impressed by the motivation towards the wrong approach!

Often times patients request a set of exercises to rehab their shoulder. The physical therapy program depends on the preferences of the orthopaedic surgeon and the surgery the patient had. I have seen many patients having problems with their physical therapy either because the therapist is "trying something different that works better" or because the exercise is intense and makes the shoulder more painful. The cornerstone of physical therapy for the shoulder is the "comfortable" exercise. When the exercises cause pain then it is unlikely that the shoulder will recover. The physical therapy should cause discomfort and tolerable pain but it should not cause inflammation from increased intensity. The slow and frequent exercises are key to a successful recovery. For your information the following link is provided that explains the correct set of exercises for the most frequent shoulder pathologic conditions.
http://orthoinfo.aaos.org/topic.cfm?topic=A00067

Shoulder Surgery Exercise Guide
Regular exercises to restore your normal shoulder motion and flexibility and a gradual return to everyday work and recreational activities are important for your full recovery.
Your orthopaedic surgeon and physical therapist may recommend that you exercise from 10 to 15 minutes 2 or 3 times a day during your early recovery period. They may suggest some of the following exercises.
This guide can help you better understand your exercise and activity program.
Pendulum, Circular

Pendulum, Circular
Bend forward 90 degrees at the waist, using a table for support. Rock body in a circular pattern to move arm clockwise 10 times, then counterclockwise 10 times.
Do 3 sessions a day.
Shoulder Flexion (Assistive)
Clasp hands together and lift arms above head. Can be done lying down (drawing A) or sitting (drawing B). Keep elbows as straight as possible.
Repeat 10 to 20 times.
Do 3 sessions a day.
Shoulder Flexion (Assistive)
Supported Shoulder Rotation
Keep elbow in place and shoulder blades down and together. Slide forearm back and forth.
Repeat 10 times.
Do 3 sessions a day.
Supported Shoulder Rotation
Walk Up Exercise (Active)
With elbow straight, use fingers to " crawl " up wall or door frame as far as possible. Hold 10 seconds. Repeat 3 times.
Do 3 sessions a day.
Walk Up Exercise (Active)
Shoulder Internal Rotation (Active)
Bring hand behind back and across to opposite side.
Repeat 10 times.
Do 3 sessions a day.
Shoulder Internal Rotation (Active)
Shoulder Flexion (Active)
Raise arm to point to ceiling, keeping elbows straight. Hold 10 seconds.
Repeat 3 times.
Do 3 sessions a day.
Shoulder Flexion (Active)
Shoulder Abduction (Active)
Raise arm out to side, elbow straight and palm downward. Do not shrug shoulder or tilt trunk. Hold 10 seconds.
Repeat 3 times.
Do 3 sessions a day.
Shoulder Abduction (Active)
Shoulder Extension (Isometric)
Stand with your back against the wall and your arms straight at your sides. Keeping your elbows straight, push your arms back into the wall. Hold for 5 seconds, and then relax.
Repeat 10 times.
Shoulder Extension (Isometric)
Shoulder External Rotation (Isometric)
Stand with the involved side of your body against a wall. Bend your elbow 90 degrees. Push your arm into the wall. Hold for 5 seconds, and then relax.
Repeat 10 times.
Shoulder External Rotation (Isometric)
Shoulder Internal Rotation (Isometric)
Stand at a corner of a wall or in a door frame. Place the involved arm against the wall around the corner, bending your elbow 90 degrees. Push your arm into the wall. Hold for 5 seconds, and then relax.
Repeat 10 times.
Shoulder Internal Rotation (Isometric)
Shoulder Internal Rotation
Keep elbow bent at 90 degrees. Holding light weight, raise hand toward stomach. Slowly return.
Repeat 10 times.
Do 3 sessions a day.
Shoulder Internal Rotation
Shoulder External Rotation
Keep elbow bent at 90 degrees at side. Holding light weight, raise hand away from stomach. Slowly return.
Repeat 10 times.
Do 3 sessions a day.
Shoulder External Rotation
Shoulder Adduction (Isometric)
Press upper arm against a small pillow alongside your body. Hold 5 seconds.
Repeat 10 times.
Do 3 sessions a day.
Shoulder Adduction (Isometric)
Shoulder Abduction (Isometric)
Resist upward motion to the side, push arm against back of chair. Hold 5 seconds.
Repeat 10 times.
Do 3 sessions a day.
Shoulder Abduction (Isometric)