Following on from our blog last week on subacromial bursitis and shoulder impingement, I thought it would be useful to provide some information on two exercises I have found to be very helpful for my patients with various forms of shoulder pain.
Stretches are beneficial to keep soft tissue structures flexible, but strengthening is really the key to enabling the shoulder to move correctly and be stabilised. Strengthening increases the capacity of the muscles to perform the tasks we demand of them, in a pain-free manner.
1. Resisted External Rotation
This is an excellent and very popular exercise to strengthen the rotator cuff muscles, and will generally form part of the initial rehabilitation phase in most clinics.
With your elbows by your side at 90 degrees, hold a length or resistance band between both hands. Keep one arm still as an anchor point, and slowly rotate the opposite arm away from your body. Alternatively, you can tie the band onto a pole or hook. It is important to keep your elbow up tight against your body with the movement, to ensure the rotator cuff muscles are doing the work and not the torso trying to help out. Also ensure that the wrist stays straight, as it too can try to compensate for a weakness in the rotator cuff. The body will look for ways to cheat and avoid using the shoulder if it is painful, so keep an eye on your form!
This exercise helps to strengthen the muscles of the upper back that help support the scapula(shoulder blade). The scapula forms the base of support from which the upper limb operates, so it important that we have a strong, stable foundation here. Issues with scapular control and stability, can often have a significant flow-on effect down the chain.
It is best to start with this exercises in a seated position, with your arms slightly elevated out to your sides. With the resistance band in each hand, have it looped around a pole or a hook in front of you. Focus on squeezing the shoulder blades together in the middle of your back, without shrugging your shoulders. Try to focus most of the strength and movement at the shoulder blades, and not the arms/elbows. Also, be careful not to jut the neck/chin forward!
These exercises are meant as a guide only. It is recommended that you consult with your usual healthcare practitioner prior to commencing exercises, to rule out any contraindications or underlying pathology that may need to be addressed.