Shoulder Exercises: What are you strengthening?

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Shoulder Exercises: What are you strengthening?

Internal rotation of the shoulder

Strengthens: Subscapularis, Teres major

Position: Standing or seated elbow tucked into the side with elbows at 90 degrees flexion. Keeping elbow in, thumb on top. Rotate inwards taking the theraband away from your body.

Important: shoulder should be in ‘neutral position’ with activation of lower fibres of trapezius to avoid excessive protraction of the scapula.

External rotation

Strengthens: Infraspinatus, Teres minor,

 Position: Standing or seated elbow tucked into the side with elbows at 90 degrees flexion. Keeping elbow in, thumb on top. Rotate outwards taking the theraband away from your body.

Important: shoulder should be in ‘neutral position’ with activation of lower fibres of trapezius to avoid excessive protraction of the scapula.

 

Shoulder Abduction to 30 degrees

Strengthenens: Supraspinatus.

Position: Standing, keeping elbow straight, lift arm to side. It should not move forward or back.

Internal and external rotation can be progressed by moving into larger degrees of abduction.  A patient should be competent with exercises close into the side before progressing to longer lever arms away from the body to ensure good control. 10 exercises with perfect technique are better than 200 rubbish ones.

What a lot of patients find difficult to understand is that the shoulder needs to be kept in an optimal position, which is where your communication and coaching  skills are so important.

 

“Golden Nugget from Motivational Molly”

 

Before giving these exercises it is important to formulate a hypothesis on why they are getting their pain and therefore what needs to be strengthened or stretched to allow optimal position. If you give basic exercises to anyone/condition then you are no better than them looking on the internet and self diagnosing. It should not be a lottery. Find the muscle that is tight and stretch, test the muscles that are weak and strengthen and don’t forget to tap into myofascial, neuromuscular and movement patterns to reduce re occurrence.

 

As clinicians we should be giving clear advice and if you have asked a patient to complete exercises 2-3 x a day and they can’t. What are their barriers?  Are you not selling it enough? Break the barriers down. Not enough time – explain how to do exercises at work, stress the importance of the exercises in their recovery “traffic light exercises/ cup of tea exercises.” Do they truly not have time or are they prioritizing other things ie work/tv/hobbies. If we all ask can we fit 3 lots of 5 minutes of exercises in the day the answer is YES if we MAKE time.

 

People at home signed off can certainly achieve 15mins per day. So what motivates them? “You need to do these exercises so we can get you back to work, back to walking, back to golf”. You need to demonstrate their reward which may be as simple as reducing pain or improving function.

 

Physiotherapists need exceptional communication skills to be able to educate patients on the importance of exercise, stretches and compliance with treatments, which will improve results.

 

 

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