Shoulder rehabilitation: 5 recommended exercises

"Physiotherapy is beneficial for almost all conditions involving the shoulder, whether following a conservative treatment route or in preparation for surgery," explains Dr. Beretta.

In recent years, literature has shown that there is no specific protocol for individual conditions, but that the shoulder and surrounding muscles should be treated as a whole. The approach must therefore be personalized, taking into account the patient's individual needs and the type of dysfunction present.

Regardless of the specific condition, physiotherapy aims to improve shoulder function through mobility exercises, strengthening, and manual techniques. Treatments are adapted to address common symptoms such as pain, stiffness, and muscle weakness, with the goal of restoring normal joint function and improving the patient’s quality of life.

There are various shoulder conditions that often require physiotherapy, including:

• Shoulder impingement syndrome: Although the term “impingement” is now considered outdated in literature, it is still commonly used and refers to the condition where the rotator cuff tendons are compressed during arm movements, causing pain and limited motion.
• Rotator cuff injuries: Tears or inflammation of the rotator cuff tendons, a group of muscles and tendons that stabilize the shoulder.
• Adhesive capsulitis (frozen shoulder): A condition characterized by stiffness and shoulder pain due to inflammation of the joint capsule.
• Shoulder instability: A problem where the shoulder joint is too mobile or dislocates easily, often due to injury or overuse.
• Bursitis: Inflammation of the subacromial bursa, a small fluid-filled sac that helps reduce friction between shoulder structures.
• Biceps tendonitis: Inflammation of the long head of the biceps tendon, which can cause pain in the front of the shoulder.
• Osteoarthritis: Wear and tear of the joint cartilage that can cause pain and limited motion.
• Fractures: Breaks in the shoulder bones, such as the humerus, scapula, or clavicle, requiring rehabilitation after bone healing.

Physiotherapy for these conditions aims to reduce pain, improve shoulder mobility and strength, and prevent further injury.

"In this regard," Dr. Saluzzo adds, "a typical exercise routine that can be easily repeated at home and helps maintain a healthy shoulder may include five simple exercises that cover a wide range of conditions. These should be performed pain-free, in sessions of about 20 minutes, three times a week:

• External shoulder rotation exercise,
• Shoulder elevation exercise,
• Supine abduction exercise,
• Scapula stabilization exercise,
• Elevation with internal rotation exercise."

External Shoulder Rotation Exercise

Preparation:

• Stand up straight.
• Place a mini resistance band around the upper arm, just above the elbow. The stabilizing arm is straight along the body.
• Hold the band with the other hand. The working arm should be at a 90-degree angle, with the elbow close to the torso.
• Keep your gaze forward.

Execution:

• Move the arm laterally outward (external rotation).
• Slowly return to the starting position.
• Repeat the exercise 10-15 times per side, for 2-3 sets. Keep the shoulders relaxed and avoid lifting them.

Shoulder Elevation Exercise

Preparation:

• Lie on your back with legs extended and arms at your sides.

Execution:

• Slowly lift the arm to its maximum elevation, then return to the starting position.
• Repeat the exercise 10-15 times per side, for 2-3 sets. Perform slow movements without pain.

Supine Abduction Exercise

Preparation:

• Lie on your back with legs extended and arms at your sides.

Execution:

• Move the arm laterally, sliding along the ground until you reach shoulder height.
• Repeat the exercise 10-15 times per side, for 2-3 sets. Tip: sliding the arm helps reduce resistance.

Scapula Stabilization Exercise

Preparation:

• Stand with your back against a wall, arms extended outward at a 45-degree angle, and elbows bent.
• Press your elbows against the wall, using a pillow or towel for cushioning.

Execution:

• Push your elbows against the wall, bringing your chest forward.
• Hold the position for at least 6 seconds, up to a maximum of 20 seconds.
• Repeat the exercise 10 times, holding for 6 to 20 seconds.

Elevation with Internal Rotation Exercise

Preparation:

• Stand holding a resistance band or weight in your hand, with the arm extended, abducted, and the thumb pointing down.

Execution:

• Raise the arm, staying about 10 cm below shoulder height.
• Slowly return to the starting position.
• Repeat the exercise 10-15 times per side, for 2-3 sets.