Home Exercises for the Unstable Shoulder.
Last updated Monday, October 09, 2006
IntroductionOptimizing shoulder function Your shoulder may demonstrate problems of instability after an injury
or a period of disuse. You may notice that your shoulder slips or feels
unstable with certain activities. Often, in these situations the most
effective treatment is to restore the normal strength and coordination
of the shoulder. The exercise program presented here can be helpful in
optimizing the function of your shoulder. As with all exercise
programs, it important that these exercises be comfortable and that
they be progressed gradually. Before beginning them,you should consult
with your physician.Three parts There are three parts to this exercise program.
The first is to do all you can to avoid having your shoulder "pop
out of place." Even if it feels like it "needs" to be popped, don't do
it. Each time you let it pop, it makes it easier for it to happen the
next time (just like blowing up a balloon repetitively makes it easier
on each successive occasion).
The second part of the reconditioning program concerns strengthening
the muscles that press the ball of the shoulder into the socket. These
muscles are called the rotator cuff muscles. They are strengthened by
working against resistance in rotation internally (toward the body) and
externally (away from the body).
The third component of the reconditioning program for your shoulder
is to train the muscles that balance the ball in the socket. These
muscles are primarily those which power your shoulder blade or scapula.
When your scapula gets lazy or weak, the shoulder tends to become
malaligned and unstable. The purpose of these exercises is to
strengthen the muscles and to eliminate bad habits that your shoulder
may have developed. List of exercises It is important that your shoulder have both strength and endurance
of internal and external rotation. This means that you need to carry
out at least five rotator cuff exercise sessions each day, each taking
only about five minutes.
Internal rotation
External rotation
List of exercises The scapular muscles are strengthened and trained as shown below.
Supine press
Shoulder shrugs to strengthen trapezius
Other important strengthening exercises
Coordination exercises
Many possible fitness exercises Regular fitness exercise helps keep your joints supple and
coordinated. This "lubricating" effect is optimized if you perform a
half-hour of aerobic exercise each day.
This exercise may take a variety of forms including brisk walking,
jogging, riding a stationary or mobile bicycle, rowing, climbing
stairs, or using a cross-country skiing simulator.
If you have concerns about your ability to carry out such an
exercise program, you should consult your general physician. It is not
important that these exercises be carried out vigorously, it is only
important that in addition to the stretching program, a half an hour of
your day be devoted toward some form of aerobic exercise. A guideline
for someone with a healthy heart, lungs and blood pressure is to work
up to 30 minutes of exercise at a target of two-thirds of his or her
maximum heart rate. Your maximum heart rate is estimated by subtracting
your age from 220. If you are over 35 and have not been exercising
much, or if you are not sure of your health, you should consult your
doctor before starting this aspect of the program.
If you have any questions about your shoulder or the proper treatment, let your doctor know. In summary If you have difficulty keeping your shoulder stable, try using the
"training tape" technique. Have someone apply some tape to the back of
your shoulder joint (from the shoulder blade to the back of the arm)
while you have your arm elevated straight out to the side. This tape
will tend to keep the shoulder blade and your arm lined up and stable
while you bring the arm forward. Just like with training wheels on a
bike, once you have learned the technique of balance, you can discard
the training tape.
As you gain strength and coordination, try to carry out
progressively more of your usual activities, concentrating on keeping
the ball of your shoulder in the socket. Avoid activities and positions
that threaten your shoulder's stability, while practicing those that
you can perform with confidence. Swimming, rowing, and using cross
country ski simulators are all good exercises for developing strength,
coordination, and endurance. They also have the advantage of exercising
both shoulders at the same time.
Persistent, regular sessions of these exercises are essential for
success. One cannot say that "exercises don't help" unless you have
adhered to a quality program for at least six months. Please keep a
daily log of your exercise sessions so your doctor can review it when
you return to the office.
In summary, the cornerstones of the rehabilitative program are
- avoid letting your shoulder pop out,
- strengthening the rotator cuff muscles,
- optimizing the strength and endurance of the muscles that control your scapula, and
- regaining the technique and confidence in normal use of your shoulder.
Remember that the shoulders of many athletes such as gymnasts are
quite lax yet are stabilized by excellent muscle strength and learned
techniques of neuromuscular control. Only exercises and training can
reestablish proper use of your shoulder.
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