The American Academy of Orthopedic Surgeons divides shoulder problems into two categories based on causation. Cases that are caused by the shoulder joint moving or being forced out of the normal position are referred to as instability related. Those resulting from the rubbing of the shoulder muscle against the top of the shoulder blade are related to impingement. The exercises used during shoulder rehabilitation are designed to address the factors that led to the injury.
Assessment of Injury
Before a strengthening program is prescribed, a specialist will assess the type of injury to decide the treatment. During the assessment you will be asked to describe how the injury happened, you should be as detailed as possible. You will be asked to describe the shoulder pain in terms of location, severity, frequency and what activities aggravate the injury. This will be followed by an physical assessment where the shoulder will be observed and range of motion will be determined.
Types of Injuries
Shoulder dislocation, separations, or tears of the rotator cuff are typically the result of a stretching or tearing of the muscles, tendons or ligaments of the shoulder and are referred to as instability related issues. Diseases of the rotator cuff including tendinitis and bursitis as well as arthritis and frozen shoulder are all impingement related issues and the result of a rubbing and irritation of the bone surfaces, muscles, tendons and ligaments or the shoulder.
Basic Strengthening Exercises
During a shoulder rehabilitation program you will perform exercises that aid in strengthening the muscles, tendons and ligaments of the shoulder, helping to stabilize the joint as well as take pressure off of surfaces. Basic exercises such as shoulder blade squeezes, where you bring the shoulder blades together, and shoulder shrugs, where a single shoulder is lifted, should be held for five seconds and repeated 10 times up to three times a day.
Intermediate Strengthening Exercises
As you progress through a rehab program, intermediate exercises such as internal and external rotations vs. a resistance band will be used. In an internal rotation you will stand with your arm bent to a 90 degree angle while holding a resistance band, rotating the shoulder in towards the body. The external rotation involves the same arm position, however the action is reversed and you will be pulling the band away from the body.
Advanced Strengthening Exercises
More advanced program participants may perform internal or external rotations at a 90 degree angle verse a resistance band. Both of these exercises are performed standing up with the back straight and the arm you are exercising bent at a 90 degree angle. Internal rotations require the user to rotate the shoulder backwards while holding a resistance band that is anchored in a lower position in front of you. External rotations require the user to rotate the shoulder forward while holding a resistance band that is anchored to a higher point behind you. Intermediate and advanced exercises should be performed in 3 sets of 15 to 20 repetition. If you are not able to perform an exercise with perfect form then lessen the resistance by moving closer to the point where the band is anchored or changing to a lighter band.
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