Sunday, October 30, 2011

Strengthening the shoulder a bit at the time, focus on safety.

Most shoulder problems include an element of shoulder stiffness. Often this stiffness can be resolved with some simple, safe shoulder mobility exercises, and when it is resolved many of the symptoms disappear.

In addition, after shoulder injury or surgery, shoulder strengthening exercises may be helpful, but these should only be started after surgery with the specific instructions of the surgeon, respecting the special considerations of each shoulder in each individual patient. In strengthening the shoulder, we emphasize that the exercises should not cause discomfort and that they should be easy enough that twenty repetitions can be comfortably performed. The goal is to make the integrated movements of the shoulder stronger without causing injury.

We usually start with the 'supine press' series.






Here we start with two hands together holding a washcloth (A). The cloth is pressed slowly up to the ceiling by both hands. When this gets easier, the hands are held further apart during the press up (B). As the strength improves, a small (1 lb) weight is pressed up with one hand alone (C). Then the angle of inclination is increased by sitting up on a pillow or wedge while the small weight is pressed upwards (D). By sitting up at progressively higher angles, the arm becomes able to elevate while sitting upright or standing (E).

Shoulder shrugs can be helpful in regaining the strength of the shoulder blade muscles.




The shoulder press up also builds shoulder blade muscles.






In special circumstances, it may be indicated to work on internal and external strengthening exercises using isometrics, rubber tubing, or weights.

Internal rotation:





External rotation:





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