Exercises for shoulder pain: how to begin and what to do [2022]

Continuing on in our shoulder series we look at our top exercises to help you recover from shoulder pain related to the cuff and its associated soft tissue structures.

Exercise and physiotherapy is an effective solution to rotator cuff tears and shoulder pain.

First the a bit of background about the effect of exercises and shoulder pain . The good news and most important bit of information I can give you is the solution to your shoulder may not be as drastic as needing surgery or injections and may be as simple as this 4 part process:

  1. Settle the pain down.
  2. Identify the cause of your shoulder pain.
  3. An effective and progressed exercise program to strengthen the weak movements.
  4. Stay consistent and be persistent with your rehab.

Shoulder pain diagnoses:

If you have shoulder pain and have had a scan its not uncommon to find you have been given the diagnosis of one of the following conditions:

  • Rotator cuff tears
  • Bursitis
  • Calcification

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Exercises for Rotator cuff tear, bursitis and calcifications.

These disorders generally fall into the WEAK and PAINFUL category. This results in the shoulder having the following issues:

  • Poor or altered movements that irritate the structures around the cuff including the bursa or tendon.
  • Lack of strength endurance in the cuff that affects the ability to perform repetitive movements or tolerate repetitive work.

So the best approach to take, and the one that has shown results equal or better than surgery in some cases, is a progressive exercise program that:

  1. Improves the quality of movement of the shoulder (make it a smooth operator so to speak).
  2. Increase the strength of not only the rotator cuff but also the muscles at the shoulder blade, elbow and grip.
  3. Strengthen up the specific movement patterns that you struggle with.

Strengthening  for the rotator cuff related shoulder pain.

That’s where a progressive exercise program that gets it moving smoothly and then builds up its strength and endurance comes into play.

This is the long-haul part and in reality your exercises in the first 12 weeks will need to be progressed in 3-4 weekly intervals as you improve.

After that you should be progressively strengthening it for 4-8 months from onset to get a long lasting successful shoulder

How to settle down the acutely painful shoulder

Often shoulders that are newly aggravated have constant pain and can be very uncomfortable to move. In this very early stage shoulder we need to settle the symptoms down and get the shoulder back to its happy place.

How do we achieve this?

  1. Offload the shoulder: use a rolled up towel and wedge it  in your armpit. This splints the shoulder and can be very useful to help settle it down.
  2. Isometric exercises: simple resisted exercises with no movement at the shoulder can help in the early stages. It may be that they have a “pain killing” type effect and importantly they keep the muscles firing in the presence of pain.
  3. Ice and Analgesia: in the early stages to settle the shoulder is a great and very simple strategy tp adopt.
  4. Pendular exercises: letting the arm hang down in a relaxed state and then slowly swinging it in circles. This gentle rhythmical type exercise can help with pain relief and keep the shoulder mobile.

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General rules to follow for shoulder rehabilitation:

  • The exercises should not aggravate your symptoms so its best to pick a range of motion you find is comfortably difficult without being painful.
  • Usually below shoulder height is a more comfortable place to exercise in . Especially in the early stages of recovery.
  • As symptoms settle and you get stronger you can work above shoulder height and eventually overhead.
  • In the early stages pick 1 or 2 exercises and as you improve you can add ,more challenging versions.
  • Start slow, low volume and small loads in the early stages and progress to higher volumes and bigger loads as you progress.
  • Try 2 – 5 sets x 8-15 reps done in a slow and controlled fashion.

 How to strengthen the cuff and scapular muscles.

Here we demonstrate a series of exercises using elastic tubing to increase the strength of the scapular and rotator cuff muscles.

Rotator cuff and scapular resistance band exercises:

 

Rotator cuff and shoulder weight exercises:

Late early to Mid stage exercise examples.

 

Mid to late stage exercises

 

In summary there is a lot you can do for rotator cuff related shoulder pain. It does take time but with a consistent approach you can get yourself back on track without the need for surgery.

If you have issues with shoulder pain or need a shoulder rehab program please contact us here

Cheers

Dave

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