Exercises for weak and painful shoulders
Exercise
Exercise has consistently been shown to improve symptoms associated with a painful shoulder, however it is important to remember that there is no magic recipe for what exercises you should perform.
No matter what the exercise is, the key to success and get the most out of your exercises is to:
You may find that these exercises slightly increase your symptoms initially. However you should find that the exercises themselves become easier to do and that you begin to move your shoulder more easily.
A rehabilitation programme starts with easier exercises and then needs to be progressed until you are able to do the activities you need to do with less pain, so don’t give up too early!
These exercises can take up around 12 weeks for you to notice a great improvement. If your shoulder does not improve over 12 weeks, or gets worse despite the exercises, then please contact your health professional.
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How much should I push my exercises?
Pain during your exercise
Aim to keep your pain under 5/10 during exercise. If your pain is over this, then you can modify the exercises by either; reducing the amount of movement during an exercise, reducing the number of repetitions, reducing the weights, reducing your speed or increasing how long you rest between sets.
Pain after Exercise
Your pain or other symptoms should return to your pre exercise baseline within 30 minutes of exercising. You should not feel an increase in your pain or stiffness the next morning. Although, sometimes it is normal to feel some muscle soreness from doing exercise that you have not been used to.
General Excercise
The recommended levels of physical activity for adults is 150 minutes of moderate intensity exercise every week (30 minutes, 5 days out of 7). Research has shown that general aerobic exercise can be an effective way of keeping us healthy by reducing the risk of developing diabetes, heart disease, cancers and mental health problems.
We also know that aerobic exercise keeps our joints and tendons healthy, and can actually help with your shoulder pain.
You might think there is no way you could exercise when you are sore however there are ways around this. For instance if your shoulder is sore and you are limited in what shoulder exercises you can do, then exercise a different part of your body. For example go for a 30 minute walk or cycle or perform some leg strengthening exercises such as squats or step ups. There is even evidence to show that exercising your unaffected side can help to reduce pain in your painful side.
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Section 1: Exercises for weak and painful shoulders
It is important to remember there is no magic recipe for exercises however strengthening exercises are particularly important, and have been shown to improve movement, reduce pain and build strength compared to stretching or range of motion exercises.
These exercises have been separated into 3 levels of difficulty. How sore you are will determine what exercise you will feel comfortable starting with.
TIP Remember though, it may be better to start with easier exercises then progress, than it is to deal with a flare up in your pain if you overdo things..
There is no clear agreement on how often exercises should be performed but higher reps and at least 3 sets are recommended, however these do not need to be performed every day. 4 times a week would be the minimum you should aim to perform.
Remember it is normal to have some pain and discomfort when exercising which should improve the more you practise. However if your pain worsens and does not ease by reducing your exercises or having more recovery time between sessions please contact your GP or physiotherapist.
TIP You wouldn’t run a full marathon straight away after an injury so don’t try to do too much too soon.
TIP Aim to start with a lower number of repetitions of exercises, and check how you feel afterwards as per the pain guide on page 16, then gradually build up to the number of exercises recommended below.
Level 1
Early painful stage
Isometric exercises are a type of strength training that causes a gentle static contraction of the muscle. These can be very helpful for pain relief.
Ideally stand for these exercises, but they can be done in sitting if you struggle to stand.
Exercise 1: Isometric Shoulder External Rotation
You can do this exercise in either sitting or standing. Bend your elbow to 90 degrees of the sore arm. Place a rolled up towel under your armpit of the sore arm. Bring the unaffected arm across your body and place this hand on the outside of the forearm at wrist level . GENTLY push your sore arm into other arm.
To start with gently hold for 10 seconds, repeat 5 times in a row and do this 4 times per day for the first week.
Then for the second week – do the same exercise but now gently hold for 20 seconds, repeat 5 times in a row and do this 4 times per day for a week
Then for the third week – do the same exercise but now gently hold for 30 seconds, repeat 5 times in a row and do this 4 times per day for a week
Then for the fourth week – do the same exercise but now gently hold for 40 seconds, repeat 5 times in a row and do this 4 times per day for a week.
**IF YOU FIND THIS EXERCISE INCREASES YOUR PAIN THEN YOU ARE PUSHING TOO HARD SO YOU MAY NEED TO EASE OFF SLIGHTLY**
You can also do this exercise by gently pushing your arm against a door or a wall and follow the same instruction.
Exercise 2: Isometric Shoulder Abduction
You can do this exercise in either sitting or standing. Have your sore arm hanging by your side. Place a towel under your armpit. Bring your other arm across your body and place on the outside of the upper part of your sore arm. GENTLY push your sore arm into other arm.
To start with gently hold for 10 seconds, repeat 5 times in a row and do this 4 times per day for the first week.
Then for the second week – do the same exercise but now gently hold for 20 seconds, repeat 5 times in a row and do this 4 times per day for a week
Then for the third week – do the same exercise but now gently hold for 30 seconds, repeat 5 times in a row and do this 4 times per day for a week
Then for the fourth week – do the same exercise but now gently hold for 40 seconds, repeat 5 times in a row and do this 4 times per day for a week.
**IF YOU FIND THIS EXERCISE INCREASES YOUR PAIN THEN YOU ARE PUSHING TOO HARD SO YOU MAY NEED TO EASE OFF SLIGHTLY**
You can also do this exercise by gently pushing your arm against a door or a wall and follow the same instruction.
Exercise 3: Isometric Internal Rotation
You can do this exercise in either sitting or standing. Bend your elbow to 90 degrees of the sore arm. Place a rolled up towel under your armpit of the sore arm. Bring the unaffected arm and place on the inside of the forearm at wrist level. GENTLY push your sore arm into other arm.
To start with gently hold for 10 seconds, repeat 5 times in a row and do this 4 times per day for the first week.
Then for the second week – do the same exercise but now gently hold for 20 seconds, repeat 5 times in a row and do this 4 times per day for a week
Then for the third week – do the same exercise but now gently hold for 30 seconds, repeat 5 times in a row and do this 4 times per day for a week
Then for the fourth week – do the same exercise but now gently hold for 40 seconds, repeat 5 times in a row and do this 4 times per day for a week.
**IF YOU FIND THIS EXERCISE INCREASES YOUR PAIN THEN YOU ARE PUSHING TOO HARD SO YOU MAY NEED TO EASE OFF SLIGHTLY**
You can also do this exercise by gently pushing your arm against a door or a wall and follow the same instruction.
Exercise 4: Shoulder Flexion in Lying with Assistance
To do this exercise lie on your back holding onto a walking stick in both hands. Keep both arms straight lift both arms up to the ceiling and move backwards towards your head or as far as pain allows.
To start with do 1 set of 15 repetitions 3 times per day and as you become fitter and stronger do 3 sets of 15 repetitions 3 times per day.
Exercise 5: Rowing
In a standing position tie the exercise band round the door handle of a closed door. Hold the exercise band in both hands with your elbows bent to 90 degrees. Pull the exercise backwards with both arms as you squeeze your shoulder blades together (these are situated at the back of your shoulders). Hold for 5 seconds and then slowly return to the starting position.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions.
Level 2
When the exercises in level 1 become too easy or if you do not find them helpful then add in or swap to level 2 exercises.
You can add in exercises 1 or 2 at a time and either progress or stop exercises that have become too easy
Exercise 1: External Rotation with Forward Flexion
You can do this exercise either in standing or sitting. Hold your exercise band in both hands. Tuck your elbows in at your side and bend to 90 degrees. Pull the band apart with both bands with your elbows in at your side. Then move your arms upwards in a smooth motion whilst still keeping the same tension through the band. Then slowly return to the starting position.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions. You may need to alter the colour of the exercise band depending on your pain and strength in your arm. Once you are able to do this then slowly increase the weight you are using.
Exercise 2a: Active External Rotation in Lying
To do this exercise lie on your non-painful arm with your sore arm uppermost. Bend your sore arm to 90 degrees. Hold a small weight in your hand (or if you don’t have weights then a bottle of water or a tin will be a suitable replacement). Rotate your arm up and downwards keeping your elbow tucked into your side.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions. Once you are able to do this then slowly increase the weight you are using.
Exercise 2b: Active External Rotation
To do this exercise either stand or sit with a good posture by keeping your back straight and your shoulders back. Have your elbows tucked into your sides and bent to 90 degrees. Hold an exercise band in both hands. Pull the band of your sore arm out to the side and slowly return to starting position. Do this exercise slow and controlled.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions. You may need to alter the colour of the exercise band depending on your pain and strength in your arm. Once you are able to do this then slowly increase the weight you are using.
Exercise 3: Wall Press-ups
This exercise is useful for core strengthening.
To do this exercise stand face on to a wall or door. Place your palms on the wall at shoulder height. Gently lower yourself towards the wall and back to the starting position. To make this harder you can step further away from the wall and raise onto your toes. To start with aim for 1 set of 15 repetitions and slowly increase this to 3 sets of 15 repetitions as you become fitter and stronger.
Exercise 4: Chair Press
To do this exercise sit in a chair with your palms placed down on the seat. Straighten your elbows and lift your bottom slightly off the chair. Squeeze your shoulder blades together (these are situated at the back of shoulder). Keep your shoulder relaxed whilst doing this exercise. Hold for 5 seconds and then slowly return your bottom back on to your seat.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions.
Level 3
Level 3 exercises should be performed if you have found the exercises in level 1 & 2 too easy or not helpful. These exercises are generally for patients who have good movement of the shoulder but have ongoing pain and weakness.
Exercise 1: Active Abduction
In standing have your sore arm by your side and hold a small weight in your hand (or if you don’t have weights then a bottle of water or a tin will be a suitable replacement). Raise your arm out to the side, but only move your arm as far as the pain allows.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions. Once you are able to do this then slowly increase the weight you are using.
Exercise 2: Scaption
In either standing or sitting hold your arms at the 2 o’clock and 10 o’clock positions with your thumbs facing upwards. Raise your arms upwards as far as your pain allows and slowly lower your arms back to original position.
To start with do 1 set of 15 repetitions and as you become fitter and stronger do 3 sets of 15 repetitions. To make this exercise harder place a hand weight (or if you don’t have weights then a bottle of water or a tin will be a suitable replacement)
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