Rehab Protocols for Shoulder Injury

Examples include impingement syndrome, rotator-cuff injury, frozen shoulder, etc.

Improve flexibility. You can accomplish this by stretching the chest (pectorals), mid-back (lats), upper neck (trapezius), and posterior shoulder. One of the most common stretches for the shoulder is the anterior shoulder stretch (placing an arm against a door and twisting your body away). Avoid this! It loosens the front shoulder capsule and leads to instability. Always stretch the back of the shoulders instead by crossing your arm across the front of your body to the other side.

Build endurance. Build up movements in pain-free ranges of motion. Wall crawls and lifting exercises using very low weights and high repetitions are good options. Always ensure you get adequate rest between each set.

Increase strength. Begin with isometric exercises, avoiding full effort but increasing repetitions. Whenever we strengthen the shoulder muscles such as the rotator cuff, always avoid using greater than 5 lbs of weight.

The rotator cuff is a small muscle and more weight does not mean better outcomes.

Improve proprioception/balance. This is one of the most overlooked parts of shoulder rehab. You can start with push-ups against the wall, progressing to push-ups on a ball against the wall, to push-ups on the floor, to push-ups on unstable surfaces such as a rocker board, vibration platform or gym ball.

Functional exercises. Gradually build up to throwing, lifting, and reaching activities with no pain. Continue with strengthening exercises while increasing functional exercises.