General instructions
Equipment. Depending on which exercise(s) your therapist and doctor give you, you may need weights or a wooden bar. Use disc weights (donut weights-the kind with a hole in the center) or small dumbbell weights for these exercises. You will need 1/2 pound increments ranging from 1/2 pound to 6 pounds. This equipment can be purchased from many sporting goods stores. Dowel rods can be cut to your specifications at any lumber yard.
Wear your brace or sleeve if your doctor has prescribed one while doing the exercises.
Determine the maximum amount of weight your unaffected arm can lift in each exercise by performing each with the most weight you can handle. If the exercise seems easy, do it again with more weight. Record this maximum weight for each exercise that the unaffected arm can lift. This is the goal you work toward with the injured arm.
Exercise the weaker arm once a day, every day. Perform the exercises slowly, at a rate of one repetition per second.
Start exercising the weaker arm with a weight that will allow you to barely complete the prescribed number of repetitions because of fatigue. If the exercise seems easy, add more weight next time. If the exercise is too difficult, decrease the amount of weight next time. Over time, as the exercises become easier, increase the amount of weight by 1/2 pound. Do not add more repetitions, but continue to increase weights as you get stronger.
These exercises are designed to be performed pain free. if you experience pain while doing them, decrease the height of the lift and/or the amount of weight you are lifting. The generalized muscle soreness you will feel is normal and should not be confused with joint pain. As you progress with the exercises, the soreness will diminish.
When the weaker arm can lift the same weight as the stronger arm, continue the exercise with both arms to strengthen both of them to their maximal potential. When you have reached this level, perform the exercises every third day.
The Exercises
Exercise 1: Shoulder Extension
Lie on your stomach with your hands by your hips. Place a dumbbell or disc weight in the hand of the injured arm. Lower this arm down off the side of the table so that the hand is near the floor directly below the shoulder. Keeping your elbow straight, slowly lift that arm backward toward the ceiling with the palm facing up. Try to keep the front of your shoulder on the table as you raise your arm. Your hand should come up about 2 to 4 inches above the level of the table. Then, slowly lower your arm back to the starting position and repeat this exercise for 2 sets of 10 repetitions. You may rest for 30 seconds between sets. DO NOT CAUSE PAIN.
Exercise 2: Shoulder Flexion
Sit in a straight back chair and hold a weight in the hand of the arm to be exercised. Keeping the elbow straight, slowly lift that hand up in front of the body until it reaches a 90 degree angle directly in front of the shoulder. DO NOT CAUSE PAIN. Slowly lower the arm down to the starting position. This exercise should be performed a total of 20 times. A 30 second rest can be taken after the first 10 repetitions. DO NOT CAUSE PAIN.
Exercise 3: Shoulder Hyperflexion
Lie on your stomach with your arms out in front of you. Place a dumbbell or disc weight in the hand of your injured arm and slowly raise that arm toward the ceiling approximately 4 inches. Keeping your elbow straight, slowly lower your arm back to its starting position on the table. Repeat this exercise 10 times. Rest 30 seconds and repeat 10 more times for a total of 20 repetitions. DO NOT CAUSE PAIN.
Exercise 4: Shoulder Abduction
Stand in front of a mirror. Place a dumbbell or disc weight in each hand. Your arms should be by at your sides with your palms facing in toward your legs. Rotate your palms outward as you slowly raise your arms out to the side of your body 90 degrees. DO NOT CAUSE PAIN. At the top of the lift, rotate your hands back down toward the floor and slowly lower the arms down to your starting position. This exercise should be performed ten times followed by a 30 second rest and a second set of 10 repetitions for a total of 20 lifts. DO NOT CAUSE PAIN.
Exercise 5: Diagonal Shoulder Pattern
Stand in front of a mirror. Place a dumbbell in the hand of the arm to be exercised. Then place that hand in front of the hip of your opposite leg. The palm should be facing in toward the leg. Slowly lift the weight up and away from you diagonally across your body. As you are moving in this pattern, you should allow your hand to rotate so that the thumb is pointing out over your shoulder at the top of the lift. Lower the arm back slowly to the starting position, again rotating the hand to the starting position as you go. Do this exercise 10 times. DO NOT CAUSE PAIN.
Exercise 6: Rhomboid Strengthening
Lie on your Stomach with the hand of your injured arm in the small of your back at your belt level. Your palm should be facing the ceiling with the back of your hand on your spine. Place a small dumbbell or disc weight in that hand and lift it slowly up toward the ceiling. The elbow stays bent and the palm push up away from the belt approximately 2 to 4 inches. Slowly lower your hand back down to your belt and repeat this exercise 10 times. DO NOT CAUSE PAIN.
Exercise 7: Shoulder External Rotation
Prone variation
Lie on your stomach close to the edge of a firm table. Your elbow should be at a 90 degree angle to your shoulder, the upper arm resting on the table, …the forearm and hand hanging over the edge of the table. The hand is directly below the elbow. (it may be a good idea to place a pillow between the table and upper arm for comfort.) Holding a weight in that hand, keep the elbow bent and at the level of the shoulder. It acts as a pivot point to the hand. Lift your hand up toward your head by rotating the shoulder. Slowly reverse this rotation by lowering the hand back down to the starting position. This exercise should be done ten times in a row followed by a 30 second rest and another set of ten repetitions for a total of 20 repetitions. DO NOT CAUSE PAIN.
Side Lying Variation
Lie on your side opposite the arm you will be exercising. Allow the elbow of the exercising arm to rest on your waist. The hand of that arm should be holding a weight and resting on the floor in front of your belly-button. Lift the weight up until it is parallel to the floor. The elbow stays bent and in contact with your waist, serving as the pivot point of the movement. Slowly lower the weight back down to the floor. DO NOT CAUSE PAIN.
Exercise 8: Shoulder Internal Rotation
Lie on your stomach on a table or firm surface. Your shoulder should be at a 90 degree angle, the upper arm resting on the table, and the elbow and forearm hanging over the edge of the table at a 90 degree angle. (it is a good idea to place a pillow between the table and upper arm for comfort.) Holding a weight in the hand of the exercising arm and keeping that elbow bent to a 90 degree angle, slowly bring the hand up to the rear to the level of your hip. Then slowly bring the arm back to the starting position. This exercise should be done ten times in a row followed by a 30 second rest and another set of ten repetitions for a total of 20 repetitions. DO NOT CAUSE PAIN.
Exercise 9: Wall Push-ups
Stand facing a bare wall approximately 1 foot away from it. Reach both arms out in front of you to touch the wall. Let your palms rest firmly on the wall. Your elbows should be straight. Move forward or backward in order to feel comfortable with this reach. Slowly bend both of your elbows so your nose comes very close to the wall. Then slowly straighten your elbows back to the starting position. Do this exercise 10 times. When you find this easy, try the same thing but with one arm at a time. DO NOT CAUSE PAIN.
Exercise 10: Supraspinatus Strengthener
Sit in a straight back chair and place , small weight in the hand of the arm to be exercised . This hand should be rotated so that its thumb points to the floor. The elbow should be straight. Keeping this arm at an angle halfway between the front of your body and the side of your body, lift that weighted arm up to the height of your shoulder. Slowly lower the arm back to the starting position. DO NOT CAUSE PAIN.
Exercise 11: T-Exercise
Sit tall in a straight back chair. Place a disc weight in the hand of the arm to be exercised. Holding the weight with your fingertips directly in front of your shoulder, have the back of the hand face the shoulder. The elbow should be out to the side of the body at shoulder height. Slowly push the weight out in front of your chest, straightening the elbow. Keeping the hand at shoulder height all the time, move the arm to your right and then to your left as if you are “crossing the letter t”. The hand should then return to center and in to the starting position of the exercise. This exercise should be performed 10 times each day. DO NOT CAUSE PAIN.
Exercise 12: Bicep Strengthening
Sit on a chair and hold a dumbbell weight in the hand of the arm to be exercised. Rest the forearm of that arm on your thigh. Keeping the elbow steady as the pivot point of the exercise, slowly bend the elbow so that the weight comes up toward your face. Slowly lower the weight back down to the starting level. Repeat this exercise 20 times with a 30 second rest after ten repetitions. DO NOT CAUSE PAIN.
Exercise 13: Tricep Strengthening
Sit on a chair facing a mirror. Hold a dumbbell weight in the hand of your arm to be exercised. Raise that arm up to a position where the elbow is by your ear and your head is back by your shoulder bone. Keeping your elbow steady as the pivot point of the exercise, slowly straighten the elbow. Then, lower the weight back down to the shoulder by bending the elbow. Do this exercise 10 times. Rest 30 seconds and repeat again 10 more times for a total of 20 repetitions. DO NOT CAUSE PAIN.
Exercise 14: Pulley Exercise
Buy or construct a pulley system and hang off a door or wall mounted hook. Stand facing the pulley system grasping an end with each hand. Keep the shoulders level to each other at all times. With your strong arm, pull your hand down so that the weak arm is stretched up toward the top of the pulley. Slowly reverse the action so the weak arm pulls the strong arm up to the stretched position. Repeat this 10 times on each side. DO NOT CAUSE PAIN.
Exercise 15: Rubber Band Exercise
Place a wide office rubber band around the tips of all five fingers. Spread the fingers apart from each other as far as you can. Slowly release the tension of the rubber band, returning your hand to its starting position. You should do this at least 50 times a day. Very eventually, work up to 200 finger extensions per day. DO NOT CAUSE PAIN.
Exercise 16: Theraband Series
Using the large rubber strip given to you by your therapist, tie the ends of the strip in a knot to form a large circular band. Then try the following exercises:
A. Stand in front of a secured door and place one end of the rubber band around the doorknob. Hold the other end of the rubber band in your hand. Keeping your elbow flexed at a 90 degree angle, pull your arm back away from the door against the resistance of the band. Release the tension of the band slowly as you return to the starting position. Repeat this exercise 20 times. DO NOT CAUSE PAIN. DO NOT HOLD YOUR BREATH.
B. Stand with your side next to a secured door. Place one end of the rubberband around a doorknob. Hold the other end of the band in your hand. Push the band forward until you encounter resistance from the band. Slowly release the tension until your arm is in the starting position. This exercise should be repeated 20 times. DO NOT CAUSE PAIN. DO NOT HOLD BREATH.
C. Keeping your elbows by your sides, bent to a 90 degree angle, place the rubber around your hands in front of your body. Try to pull your hands away from each other thereby placing resistance on the band. Slowly release the tension on the band, allowing your hands to resume their starting position. DO NOT CAUSE PAIN. DO NOT HOLD BREATH.
D. Stand with your right side by a securely closed door. You should be approximately 18″ away from the door. Place one end of the rubber band around the door knob and hold the other end in your hand. Keeping your elbow by your side, pull the band toward your stomach. Slowly release the band, allowing your arm to return to the starting position. The elbow must stay on the waist at all times. DO NOT CAUSE PAIN. DO NOT HOLD YOUR BREATH.
Exercise 17: Rhomboid/Posterior Deltoid Lift
1. Lying on your stomach on a narrow table, drop both arms straight down off the table toward the floor. Grasp a dumbbell weight in each hand and lift them up directly to your sides without bending your elbows. Slowly lower the weights down to your starting position. Repeat for a total of 25 repetitions.
2. Repeat the above exercise 25 more times, but this time bend your elbows as you raise your arms to your sides. DO NOT CAUSE PAIN.
