A personal injury can pop up at any time, drastically limiting one’s strength and/or mobility. While you may not need to move immediately into assisted living apartments, you should address your injury right away or you can run into chronic problems which are often difficult to resolve.
For serious shoulder injuries that need immediate attention, you should visit your nearest urgent care center to have them taken care of. Once the injury has been treated, however, the work is often not over. For injuries to a sensitive joint such as the shoulder, you will likely have to perform various shoulder rehabilitation exercises. Completing a prescribed regimen of shoulder rehabilitation exercises will help reduce your chances of reinjury.
If you have found that your shoulder injury is preventing you from enjoying activities you did previously, you should strongly consider seeking a consultation from a physical therapist. There are also a number of steps you can take from the comfort of your own home or local gym.
By completing these specific shoulder rehabilitation exercises under the guidance of a professional, you can aid in speeding up your rehabilitation and getting back to the activities you love — going out to play golf with some colleagues, go rock climbing and try to beat your best time, or go sailing on a sunny day.
The Anatomy of the Shoulder
The shoulder is one of the most commonly injured sites in the human body. The joint involves the complex interplay of a number of bones, tendons, and muscles, allowing it to articulate in many directions. While this lends the arms a great deal of mobility, it comes at a cost. This site tends to get injured quite easily, and issues with the shoulder can be a challenge to diagnose.
To understand how to diagnose and and repair the shoulder, we must begin with the composition of the joint itself. Let’s go through the bones, tendons, and muscles which comprise the shoulder.
The Bones of the Shoulder
- The Scapula
The scapula, known colloquially as the shoulder blade, is a flat, triangular bone which connects the humerus with the clavicle. A ridge divides thescapula into two sections, termed the infraspinous and supraspinous fossae. It forms the rear section of the shoulder girdle, a term which refers to the entire set of bones that connects our arms on each side of our body. The scapular ridge ends at a point called the acromion, which meets with the clavicle and forms the shoulder’s upper socket. - The Humerus
The humerus is the bone that forms our upper arm. At the top it meets the scapula, while at the bottom it connects to the radius and ulna which comprise our forearms. The part of the humerus that connects with the shoulder is called the “anatomical neck.” This section meets the shoulder in a part of the joint called the glenoid fossa. - The Clavicle / Collarbone
The collarbone is the only long bone in the human body which sits horizontally. The collarbone is actually two bones which sit on each side of the base of the neck. Fractures of the collarbone are common, and the signs of a fracture are clear — most people who have fractured their collarbone will experience tenderness, swelling, and difficulty moving the arm.
The group of muscles and tendons which attach these bones and allow the shoulder to move is called the rotator cuff. If any of these components are damaged — the muscles in the rotator cuff, the cartilage cushioning the bones, the glenoid socket that holds the head of the armbone, the capsule which is a sheet of fibers surrounding and stabilizing the shoulder joint, the synovium which lubricates the capsule and joint with synovial fluid, the acromion at the top of the joint — you’re going to run into issues with shoulder pain and mobility.
Here are some of the most common shoulder injuries which can plague anyone, whether they are a high-level athlete or they just celebrated their 70th birthday.
Common Shoulder Injuries
Shoulder Tendonitis
When the rotator cuff or the biceps tendon get inflamed, the resulting condition is referred to as shoulder tendonitis. This is a common injury for athletes which can result from tennis, baseball, lifting weights, and more. It is the repeated overhead movements of the arms associated with these activities which can cause shoulder tendonitis.
This inflammation can range from mild to severe; it may cause constant pain, or it might only hurt when doing certain motions and activities. If you’ve been experiencing any level of of pain or tenderness in the shoulder as well as some limits to your shoulder mobility, you may be dealing with shoulder tendonitis.
However, it is often helpful to get the opinion of a medical professional in order to be certain of your diagnosis. Common diagnostic tools for this condition involve a variety of imaging techniques, including ultrasound, x-ray, and MRI. Once it has been confirmed that you have shoulder tendonitis, your healthcare provider will put together a treatment plan.
Subacromial Bursitis
This condition results from a swollen and inflamed bursa — specifically, the bursa that lies between the acromion at the top of the shoulder blade and the rotator cuff muscle complex. We have many bursae throughout our body. These small sacs of fluid cushion joints, reducing the amount of friction that occurs between bones and the soft tissues they meet with.
Subacromial bursitis tends to be comorbid with rotator cuff tendonitis, as both can be caused by overuse of the shoulder. As the tissues get inflamed, space in the shoulder complex is reduced. This can cause the shoulder tendons to rub and even fray, resulting in discomfort and pain during a variety of activities.
Shoulder Impingement
Impingement of the shoulder refers to rubbing between the acromion the tendons and bursa. Impingement often leads to cases of tendinitis or bursitis.
Shoulder Dislocation / Instability
Those with hypermobility of their shoulder get this extra range of motion at a cost; it tends to be easier for them to accidentally dislocate their shoulder. A complete dislocation involves the ball of the humerus fully separating from the socket of the shoulder joint. Partial dislocations denote incomplete separation of the ball of the humerus from the shoulder socket.
Even once the ball of the upper arm bone has been returned to the socket, shoulder problems can persist. The muscles, tendons, and ligaments of the shoulder complex are often damaged in the dislocation process, resulting in continued pain and instability of the shoulder. Physical therapy may be necessary to prevent future full or partial dislocations.
Other conditions of the shoulder include arthritis and fractures to the shoulder bones. These conditions are less frequently addressed by physical therapy, so we don’t get into them today. Here are some shoulder exercises that can help relieve symptoms associated with the above shoulder conditions.
Exercises for Injuries of the Shoulder
The Crossover Arm Stretch
Those who have participated in organized sports will probably remember their coach making them do this stretch before practice. To do this stretch, use one arm to pull the other across the body, doing your best to keep it horizontal. Try to avoid tightening the shoulders or allowing the arm to droop as you perform the stretch.
When using this stretch as a shoulder rehabilitation exercise, you should hold it in this position for 30 seconds at a time four times on each side. Relax your shoulder for 30 seconds between each stretch, and repeat the process on the other arm. Do you best to avoid putting excess pressure on the elbow while performing the stretch.
Plank / Modified Plank With Alternating Hand Tap
When you’re trying to rehabilitate your shoulder, it’s particularly important to focus on strengthening and improving the stabilizing muscles of the joint complex. One way to accomplish this is by performing alternating hand touches while in a plank or modified plank position.
To start, try this shoulder rehabilitation exercise in a modified plank position. This means knees on the ground to greatly reduce the difficulty for the stabilizing muscles. In this position, alternate lifting one hand and touching it to the other in a slow, controlled manner. When this becomes too easy for you, switch to a full plank (knees off the ground and back straight) when doing this exercise.
Seated or Standing Row
While you may associate rows with bodybuilding programs, they make an excellent shoulder rehabilitation exercise as well. This exercise can be performed at the gym using a machine or at home using resistance bands. If you are performing this exercise at the gym for rehabilitation purposes, make sure to keep the weight stack on a relatively low setting.
Grasping the handle of the machine or resistance band, pull your elbow straight back and return it to the starting position in a slow, controlled motion. Make sure to avoid raising and tightening the shoulder and keep your arm near your side as you perform the exercise. To maximize muscle activation, focus on squeezing the shoulder blade during the concentric (the first part) of the motion.
Internal and External Isometric Shoulder Cuff Rotation
There are multiple ways in which you can perform internal and external rotator cuff exercises. If you have a machine or a resistance band, you should be pulling or pushing the weight or resistance toward or away from you on a horizontal plane of motion. This means keeping your elbow bent to 90 degrees throughout the motion.
To perform the internal rotation shoulder cuff exercise, you keep your elbow locked and pull the resistance band or weighted machine toward your body. To perform the external rotation shoulder cuff exercise, you keep your elbow locked and push the band or weighted machine away from your body. Zion Physical Therapy has a great video demonstrating what this shoulder rehabilitation exercise looks like when performed with a resistance band.
Scapular (Shoulder Blade) Squeeze
One way to help improve overall shoulder health is to regularly engage our upper back muscles and squeeze our shoulder blades together. Done properly, the space between the shoulder blades should be significantly reduced while engaging the back. It can be helpful to imagine using your shoulder blades to press an object placed on your upper spine.
It’s important to squeeze down and back, not up and back. The elbows can provide a helpful cue for completing this exercise properly. While you grow accustomed to completing the scapular squeeze with proper form, you can try bringing your elbows straight back as you squeeze. This will prevent you from squeezing the shoulder blades too high.
Shoulder Pendulum
This is a very gentle and simple shoulder rehabilitation exercise from OrthoInfo, perfect for those who are just starting out a shoulder rehabilitation routine. Try this exercise if your shoulder pain is triggered very easily, as it puts virtually zero stress on the joint. The shoulder pendulum also doesn’t require any equipment, meaning you can introduce thisshoulder rehabilitation exercise to your regimen today.
To perform this shoulder rehabilitation exercise, start by bracing yourself with one arm against a hard surface, such as a table or counter, and leaning forward. Make sure not to have a rounded back or locked knees as you lean. Begin by gently swinging your other arm forwards and backwards. After several repetitions, switch to a side to side motion. Lastly, swing your arm around in a circular motion, doing several repetitions clockwise and counterclockwise. Then switch arms and do the process again.
In Conclusion
An injury can cause a serious disruption both to our personal and our professional lives. If you work for a roofing company that does works on shingle roofing, you may find that a knee injury makes it impossible to climb a ladder to complete roof repairs for your clients. Recreational activities, such as hiking or pickup basketball games, may also suddenly be impossible without serious pain. By following a strict regimen of specific and effective exercises for injuries, with the guidance of a licensed professional, you can get your body back to where it needs to be. Just be consistent, and don’t give up.