Nose Creek Physical Therapist Modified Gym Strengthening Program for Shoulder Rehabilitation |
| Physical Therapy Exercises - Day 1: (Back, Shoulders, Triceps.) |
| 1) Back: |
| a) Lat. Pull (chin up grip position with hands placed narrowly apart and palms facing you) | | b) Seated Row (with elbows at side) | | c) Reverse Pec Dec / Reverse Flys |
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| 2) Shoulders: “Advanced Stage 3 dumbbell exercises” |
| a) Shoulder Flexion- (standing position): Raise Arms to 80 degrees elevation in the scapular plane i.e. - 30 degrees forward from the lateral position. To protect Rotator Cuff make sure to raise arms up with the thumbs pointing up, and go down slowly with the thumbs pointing down. | | b) Rotator Cuff (side lying position) | | c) Pitching eccentric/negative (side lying position) | | d) Superman shoulder blade retraction dynamic movements in the “T, Y, I” positions. (On stomach) |
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| 3.) Triceps: |
a) Seated machine resisted elbow extension or kickbacks. | b) Pulleys in the standing position |
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| Physical Therapy Exercises – Day 2 (Legs, Chest, Biceps) |
CAUTION- Do not do excessive weight with chest and biceps exercises. Physiotherapists warn that this contributes to Anterior Shoulder pain. |
| 1) Legs: |
a) Squats or Leg Press or Lunges (1 of 3) | b) Legs curls (hamstrings) | c) Leg extensions (quadriceps- only do the top 45 degrees of movement | d) Calf raises (2 legs then progress to 1 leg) |
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| 2) Chest: |
a) Narrow grip bench with dumbbells in line with shoulders. | b) Pec Dec/Chest Flys (do not lose sight of elbows) |
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| 3) Biceps: |
a) Machine/Preacher bench (maintain good upright posture do not slump) | b) Dumbbells in standing |
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| Physiotherapy Guideline |
Do 30 minutes of cardiovascular exercises with each gym workout. | Remember to stretch shoulder muscles after workouts. | Do 3 sets of 10 repetitions for regular exercises, but progress shoulder exercises to 3 sets of 20 repetitions before advancing up in weight. | Only raise the weight up once per week. | Alternate between different muscle groups as you do your workout. | Ask your Physical Therapist about safe maximum weight to progress to in the long term. |
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| Physiotherapist Exercise Suggestions: |
Do 2 exercises for the posterior muscles for every 1 for the anterior muscles. | Do not lose sight of your elbows. | Do ER drills. | Do isolated adduction and abduction scapular platform exercises. | Do eccentric drills for the scapula and posterior RC. | Be careful with exercises that emphasize the power muscles groups (axiohumeral muscles). | Do not do exercises that compromise the anterior capsule. | | Avoid positions of impingement. |
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Exercise Position Continuum- The athlete must understand the progression from a position of low demand and maximum control (modified neutral) to a position of maximum demand requiring near perfect co-ordination and timing (90/90). |
| Physiotherapy Exercise Regulations: |
You must identify and treat the problem. | The quality of the movement is the most important factor when doing shoulder exercises. Do not be concerned with load and repetitions. | Stop when you can not execute the exercise perfectly. | The patient should feel in control at all times while doing the exercise. | General shoulder exercises stand a good chance of compounding the problem. |
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| Nose Creek Physical Therapy Scapular Retractor Strengthening Exercises |
a) In sitting or standing against a wall (6 times/day) | Arms relaxed at side, pull your shoulder blades “Down and In” towards your spine. Hold 10 seconds, then relax for 10 seconds. Repeat 10 times. |  | b) On stomach (Prone) | Raise straight arms off floor until horizontally in line with trunk, palms face the floor. Pull shoulder Blades "Down and IN". Hold for 10 seconds, then relax for 10 seconds. Repeat 10 times. |  |
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2) Shoulder Girdle Stretches |
a) Standing Shoulder Flexion against a wall/post | Standing against wall/post raise your straight arms as high as possible until you feel a stretch. Palms face the ceiling, then the wall above you. Hold at end range for 10 seconds, then slowly lower arms, Repeat 10 times. | b) Doorway. (chest) | Arms on doorway at elbow height. Place one foot through the doorway lean chest and hips through doorway until you feel a stretch. Hold for 30 seconds, repeat twice. |  |
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| Elastic Resistance |
a) Flexion Repeat 30 times. |
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b) Extension Repeat 30 times. |
Hook elastic over doorknob. Pull back, keeping your elbow straight. Hold for 2 seconds. Slowly return to the starting position. |
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c) External Rotation Repeat 30 times |
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d) Internal Rotation Repeat 30 times. |
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Stand with your involved side next to a closed door, elastic attached to the doorknob. With your elbow bent and by your side, pull out to the side. Hold for 2 secs. Relax. Progress to rotation movements in varying amounts of shoulder flexion. |
Stand with your involved side next to a door. Attach one end of the elastic to doorknob. With your palm facing towards you and elbow at your side, stretch the elastic across your body. Pull your fist to your belly. Slowly return to the starting position. |
