Recurrent Shoulder Laxity and Instability Rehab After Surgery – Instructions

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed.

It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your shoulder. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Pendulum

1. Stand near a wall or a surface that you can hold onto for balance.
2. Bend at the waist and let your left / right arm hang straight down. Use your other arm to keep your balance.
3. Relax your arm and shoulder muscles, and move your hips and your trunk so your left / right arm swings freely. Your arm should swing because of the motion of your body, not because you are using your arm or shoulder muscles.
4. Keep moving so your arm swings in the following directions, as told by your health care provider:
   1. Side to side.
   1. Forward and backward.
   1. In clockwise and counterclockwise circles.

Repeat __________ times, or for __________ seconds per direction. Complete this exercise __________ times a day.

Exercise B: Shoulder flexion, active-assisted

1. Lie on your back. You may bend your knees for comfort.
2. Hold a broomstick, a cane, or a similar object so your hands are about shoulder-width apart on the object. Your palms should face toward your feet.
3. Raise your left / right arm over your head and behind your head, toward the floor. Use your other hand to help you do this. Stop when you feel a gentle stretch in your shoulder, or when you reach the angle that is recommended by your health care provider.
4. Hold for __________ seconds.
5. Use the broomstick and your other arm to help you return your left / right arm to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Active elbow extension

1. Sit in a chair without armrests, or stand. With your left / right elbow at your side, bend your elbow to an “L” shape (90 degrees).
2. Keep your left / right elbow at your side and straighten your elbow as much as you can, so your hand moves toward the floor.
3. Hold for __________ seconds.
4. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your shoulder. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise D: Scapular retraction, isometric

1. Sit in a stable chair without armrests, or stand.
2. Squeeze your shoulder blades together and move your elbows slightly behind you. Do not shrug your shoulders.
3. Hold for __________ seconds.
4. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Shoulder flexion, isometric

1. Stand or sit about 4–6 inches (10–15 cm) away from a wall, and face the wall.
2. Gently make a fist and place your left / right hand on the wall so the top of your thumb and the side of your index finger touch the wall.
3. With your left / right elbow straight, gently press the top of your fist into the wall. Gradually increase the pressure until you are pressing as hard as you can without shrugging your shoulder.
4. Hold for __________ seconds.
5. Slowly release the tension and relax your muscles completely before you repeat the exercise.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise F: Shoulder abduction, isometric

1. Stand or sit about 4–6 inches (10–15 cm) away from a wall with your right/left side facing the wall.
2. Bend your left / right elbow and gently press your elbow into the wall as if you are trying to move your arm out to your side. Increase the pressure gradually until you are pressing as hard as you can without shrugging your shoulder.
3. Hold for __________ seconds.
4. Slowly release the tension and relax your muscles completely before repeating the exercise.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise G: External rotation, isometric

1. Stand or sit in a doorway, facing the door frame.
2. Bend your left / right elbow and place the back of your wrist against the door frame. Only the back of your wrist should be touching the frame. Keep your upper arm at your side.
3. Gently press your wrist into the door frame, as if you are trying to push your arm away from your abdomen.
   1. Avoid shrugging your shoulder while you press your wrist into the door frame. Keep your shoulder blade tucked down toward the middle of your back.
4. Hold for __________ seconds.
5. Slowly release the tension, and relax your muscles completely before you repeat the exercise.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise H: Internal rotation, isometric

1. Stand or sit in a doorway, facing the door frame.
2. Bend your left / right elbow and place the palm of your hand against the door frame. Only your palm should be touching the frame. Keep your upper arm at your side.
3. Gently press your hand into the door frame, as if you are trying to push your arm toward your abdomen. Do not let your wrist bend.
   1. Avoid shrugging your shoulder while you press your hand into the door frame. Keep your shoulder blade tucked down toward the middle of your back.
4. Hold for __________ seconds.
5. Slowly release the tension, and relax your muscles completely before you repeat the exercise.

Repeat __________ times. Complete this exercise __________ times a day.