Shoulder Reconditioning

ARE YOU FEELING ANY OF THE FOLLOWING?
Pain or tenderness in the front, side or back of the shoulder occurs when:

  • Throwing
  • Serving
  • Spiking
  • Hitting an overhead
  • Hitting a backhand/forehand stroke
  • Sleeping on your side
  • Raising your arm overhead
  • Beginning a game or workout

 

Overuse injuries to the rotator cuff muscles, that surround the shoulder blade, are common in racquet, throwing, hitting sports and swimming. These muscles are specifically involved in motions used in these sports and also in helping to hold the upper arm bone in the shoulder socket. Rotator cuff injuries often involve muscle strength and flexibility imbalances.

This condition is often bought by:

  • Increasing the speed and force of throwing or hitting motions too quickly when starting a new sport season
  • Repeatedly hitting or throwing at high speed and with high forces over a long period of time
  • Tight pectoral (chest), posterior shoulder joint capsule, and rotator cuff and lat (mid back) muscles
  • Weak rotator cuff muscles
  • Faulty throwing, hitting, and weightlifting technique

 

TO RELIEVE PAIN AND SPEED RECOVERY
Unless your shoulder pain is severe or you're unable to raise your arm, you can try the following:

  • Rest - from all activities that cause pain, especially throwing, and racquet sports and golf.
  • Ice 2-3 times per day. Place crushed ice in a plastic bag over the shoulder for 15 minutes.
  • Aspirin or Ibuprofen
    - To reduce pain - take according to the product's guidelines
    - To reduce inflammation - take 650 mg of aspirin or 400 mg of ibuprofen three times per day for 1-2 weeks.
  • Important - Stop taking if medication causes stomach upset or bloody stools. Contact your physician if you are currently taking other medications or if you have any questions

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RANGE OF MOTION
Pendulum Exercises
For each exercise below, hold on to a table or chair with your uninjured arm and bend forward (about 45°) at the waist. Let your injured arm dangle freely from your shoulder while using body (trunk) movements to move it. Do each exercise for three minutes, three times per day.

 

Arm Circles

  • Swing your arm clockwise, making small circles and gradually increasing to larger circles.
  • Next, make small to larger circles in a counter clockwise direction.

 

Forward/Backward

  • Swing your arm forward and backward at your side.
  • Start with small movements and slowing increase the size of your arm swing.

 

Side to Side

  • Swing your arm side to side in front of your body.
  • Start with small movements and slowly increase the size of your arm swing.

WALL WALKING
For the following exercises, start with your injured arm straight and your fingertips on a wall at waist-level.

Technique: Slowly walk your fingers up the wall to the point of a strong stretch, and then slowly walk back down to your starting position. You may need to step closer and farther away from the wall to keep your elbow straight.
Frequency: Do three sets of 10-20 repetitions, 2-3 times per day.

 

Forward

  • Stand facing the wall.
  • Walk your fingers up the wall in front of your body.

 

 

Side

  • Stand with your injured arm next to the wall.
  • Walk your fingers up the wall to the side.

 

STRETCH
The following exercises increase the flexibility of your shoulder muscles.

Technique: Unless otherwise instructed, stretch to a gentle (not painful) pull, and hold for 20 seconds without bouncing. Stretches can be performed all at once or spread throughout the day.

Frequency: Unless otherwise instructed, do 2-3 sets of 30 second counts, 2-3 times per day. Caution: Discontinue an exercise if it is painful.

 

Overhead (Lat) Stretch

  • Raise your arms overhead until you feel a stretch in your upper back and back of the shoulders.
  • Hold, without bouncing for 20 seconds.
  • Stop doing this exercise if it makes your shoulder pain worse.

 

Corner Stretch (chest)

  • Stand in a corner with your arms on the walls and one foot in front of the other.
  • Slowly bend the lead knee until you feel a stretch in the chest muscles, then hold.
  • Caution - Do not rest your entire body weight on your upper arms, this can overstretch the stabilizing structures of the shoulder.

 

Biceps Stretch

  • Holding a towel, reach overhead and let the towel fall behind your back.
  • With the other arm, grasp the bottom end of the towel, keeping your elbow straight and palm down.
  • Let your top arm gently pull your bottom arm and hand back and up until you feel a stretch.
  • Do not lean forward.

 

Shoulder Blade Stretch

  • Grasp the elbow of your injured arm and pull it across your body toward the opposite shoulder.
  • Hold when you feel a stretch in the back of your shoulder.

 

Shoulder Blade/ Upper Back

  • Bend over at the waist.
  • Raise one arm forward to shoulder level and bend the elbow.
  • With your opposite hand, grab the elbow and pull it across your chest while rotating your upper body in the same direction.
  • Hold when you feel a stretch in the back of the shoulder and between your shoulder blades.

 

Triceps Stretch

  • Grasp the elbow and pull it across your body toward the opposite shoulder.
  • Hold when you feel a stretch in the back of your shoulder.

 

Overhead Stretch
(mid back and back of shoulder)

  • Bend over at the waist and rest your arms on the table with your thumbs up.
  • Slowly drop your head and body down below your shoulders.
  • Hold when you feel a stretch behind your shoulders and mid back.

 

 

Priming the Pump
(back of shoulder)

  • Lie on your side with the upper arm straight forward from the shoulder and elbow bent 90°.
  • Grab your forearm with the opposite hand.
  • Slowly push the forearm down.
  • Hold 2-3 seconds when you feel a stretch in your shoulder, then relax.
  • Try 10-15 repetitions per day, especially after sports or workouts.

 

Wall Stretch

  • Stand with your feet and body facing away from the wall.
  • Place your arm on the wall behind you with your elbow slightly bent.
  • Slowly straighten your elbow until you feel a stretch in front of your shoulder and upper arm.
  • Hold for two seconds then relax.
  • Do 10-15 repetitions per day.

 

Neck Stretch

  • Sit tall while holding onto the chair with your hand.
  • Grab the top of your head with the opposite hand.
  • Slowly pull your head over to the side until you feel a gentle neck stretch.
  • Drop the free hand towards the floor and allow the shoulders to drop.

 

Armpit Stretch
(top of shoulder and upper back)

  • Sit tall while holding onto the chair with your hand.
  • Grab the top of your head with the opposite hand.
  • Slowly pull your head over to the side while rotating your head down.
  • Hold when you feel your neck and upper back stretch.

ISOMETRIC STRENGTHENING
In the following exercises contract/tighten your shoulder muscles without moving your arm.

Technique: Hold 3-5 counts at the end position.
Frequency: Do three sets of 15-20 repetitions, 2-3 times per day.

 

Forward

  • Face a wall with your arm straight.
  • Place the thumb-side of your hand against the wall.
  • Push your hand forward against the wall.

 

Backward

  • Stand with your back against a wall.
  • Keep your arm straight with the little finger-side of your hand against the wall.
  • Push backward against the wall.

 

Outside

  • Stand with your arm against the wall with your elbow straight.
  • With your arm slightly away from your body, push out against the wall with the back of your hand.

 

Inside

  • Stand with your arm straight at your side.
  • Keep your elbow straight and palm resting against your side.
  • Push inward against your leg.

 

Internal Rotation

  • Bend your elbow 90° and rest the forearm and palm on the stomach.
  • Keeping the elbow next to your side, push inward against the stomach with your forearm and palm.

 

External Rotation

  • Bend the elbow 90° and rest the forearm and hand on the stomach.
  • Grasp the forearm with the opposite hand.
  • Keeping the elbow next to your side, push the forearm outward against the opposite hand.

STRENGTHENING EXERCISES

Technique: Perform each exercise slowly, hold for 3-5 seconds at the end position.
Frequency: do 2-3 sets of 8-15 repetitions per day.
Tubing Progression: Increase resistance when you can finish all three sets of 15 repetitions without fatigue.
Weight Technique: Start with 1-2 pounds. When you are able to do three sets of 15 repetitions without fatigue, increase the weight by one pound. The goal is 5-7 pounds.
Caution: If any of these exercises are painful, try (1) decreasing the tightness of the tubing, (2) lifting less weight, or (3) doing the exercise through the pain-free range only. If these do not help, stop the exercise and go back to doing the isometric strengthening exercise(s). Try the tubing and weight exercise(s) again the 3-7 days.

 

Forward Fly

  • Hold a weight or tubing with your thumb up and arm at your side.
  • Keep your elbow straight and slowly raise your arm forward to shoulder level.
  • Hold, and then relax.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Side Fly

  • Straighten the elbow and rest your arm at the side.
  • Hold the weight or tubing with the palm facing forward and thumb pointing up.
  • Slowly raise your arm straight out to your side to shoulder level.
  • Hold, and then relax.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Empty Can

  • Hold a weight or tubing with your thumb down and arm at your side.
  • Keep your elbow straight and slowly raise your arm in a forward diagonal (at either 2 o'clock for the right arm or 10 o'clock for the left arm) from the body.
  • Stop at just below shoulder level and hold.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Open Can

  • Hold a weight or tubing with your thumb pointing up and your arm at your side.
  • Keep your elbow straight and slowly raise your arm in a forward diagonal (at either 2 o'clock for the right arm or 10 o'clock for the left arm) from the body.
  • Stop at just below shoulder level and hold.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Bent-Over Rowing

  • Bend forward at the waist with knees slightly bent.
  • Stand on the tubing or hold a weight with your arms dangling down toward the ground.
  • Keeping your back flat, slowly raise your arms up and out to the side, allowing the elbows to bend until they are even with your shoulder.
  • Hold, and then relax.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Internal Rotation with Weights

  • Lie on your injured side with your elbow bent 90°.
  • Rest your forearm on a table or the floor and hold a weight.
  • Keeping the elbow bent and next to your side, and slowly raise the forearm up to your stomach.
  • Hold, and then relax.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

External Rotation with Weights

  • Lie on your side with your elbow bent 90° and tucked into your side.
  • Holding the weight in your hand, start with the forearm on your stomach.
  • Keeping the elbow bent and next to your side, and slowly raise the forearm away from your stomach.
  • Hold, and then relax.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Internal Rotation Tubing

  • Tie tubing to the door and stand with your arm facing the door.
  • Bend the elbow 90° and tuck it into your side.
  • Starting with the forearm away from your body, slowly pull the tubing and forearm in to the stomach.
  • Hold, and then relax.

 

External Rotation Tubing

  • Tie Tubing to the door and stand with the opposite side facing the door.
  • Bend the elbow 90° and rest the forearm on your stomach.
  • Slowly pull the forearm away from your stomach and out to your side.

 

Shoulder Shrugs

  • Stand with your elbows straight and your arms resting at your sides.
  • Holding weights or tubing that you are standing on, slowly shrug your shoulders up.
  • Hold, and then slowly lower.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Bicep Curls

  • Tuck your elbow into your side.
  • Hold a weight or tubing with your palm up.
  • Slowly bend the elbow.
  • Hold, and the slowly relax.
  • Do not lean back or arch your back.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Triceps Kickback with Weights

  • Bend slightly at the waist while holding onto a bench or table.
  • Raise your elbow back to shoulder level, allowing the forearm to dangle down.
  • Slowly straighten your elbow, raising your forearm and weight backward.
  • Be sure not to move the shoulder.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Press Down with Tubing

  • Hold tubing in one hand.
  • Hold the other end of the tubing in the opposite hand with your elbow fully bent.
  • Slowly straighten your elbow, pulling the band down with the hand.
  • Hold, and the slowly relax.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Forward Fly with Weights (chest)

  • Lie on your back with the injured arm straight out to the side from your shoulder.
  • Hold a weight with your elbow slightly bent.
  • Slowly raise your arm up until it is straight forward from your chest.
  • Hold, and then slowly lower.

Weights:
Start with _____ lbs. The goal is _____ lbs.

 

Back Fly with Tubing

  • Tie tubing to the door and stand facing the door.
  • Keeping your arm straight, pull the tubing as far as possible past your hip.

 

Forward Fly with Tubing

  • Tie tubing to the door and stand with your injured shoulder facing a door.
  • Hold your arm straight out to the side at shoulder level.
  • Pull your arm straight forward.

 

Hitchhiker with Tubing

  • Tie the tubing to a door and stand with opposite side facing the door.
  • Raise your arm straight forward to shoulder-level.
  • Hold the tubing with your elbow straight.
  • Pull the tubing away from your body until your hand is straight out to the side from the shoulder.

 

Adduction

  • Tie tubing to the door and stand with the injured shoulder facing the door.
  • Keep your elbow straight.
  • Starting with the arm out to the side of your body, slowly pull your arm into your side until it crosses your belly button.

 

Shoulder Blade Squeeze

  • Lie on your stomach with your elbows out to the side and forearms handing toward the door. (1).
  • Squeeze your shoulder blades together (2).
  • Raise your lower arms up to parallel with your elbows. (3)
  • Hold, and then slowly return to the starting position.
  • Progression - Add 1-2 pound weights when this becomes easy.