11 Exercises for Shoulder Rehab and Injury Prevention from NYC Experts
Shoulder, neck and upper back pain are all too common in athletes, exercise enthusiasts, construction workers and anyone who sits at a desk all day. And often times, nagging neck pain, chronic shoulder pain and a stiff upper back / thoracic spine will occur at the same time, for many reasons, and thus exercises and treatments to prevent and recover from these injuries can overlap.
About 40% of our Active Release and Clinical / Medical Massage Therapy clients here in New York come to us for one or more of these injuries. It's a staggering number that reflects the prevalence and frequency with which people injure their shoulder and neck, whether it is from working out, job requirements, recreational activities or poor posture.
There’s no one size fits all approach to shoulder pain and injury recovery. This goes for pretty much any acute or chronic sports injury. On Your Mark NYC uses a team of licensed and certified professionals in clinical massage and personal training for injury repair. Whether you come to see us or a different provider, it is very important to keep this mind and to educate oneself and ask questions. The more informed and proactive you are in your road to recovery and injury prevention, the better the outcomes are likely to be.
There are countless exercises available that can help improve and maintain shoulder health and that can be used in the shoulder injury recovery process. Below are some instructional videos for safe, easy to learn and effective shoulder exercises to help get you moving in a positive direction.
Which ones you'll want to use depend on whether you have had shoulder injuries in the past, prior surgeries if any, which injury you currently or previously had, how long it has lasted and how severe it is.
Your goals are also very important; if you want to rock climb versus just being able to lift your arms overhead to put the plates away, your shoulder injury recovery and injury prevention programs will differ significantly. If your goal is to swim aggressively 4 x week for 60 minutes, you may need to approach shoulder rehab differently than if you are a hair stylist, a golfer or don't exercise regularly but want to live pain-free.
Knowing what your goals are will always help you safely and effectively reach them when it comes injuries and rehab. Choosing an appropriate and practical strategy is vital to injury recovery, pain reduction and injury prevention.
Before we get into my top 11 exercises for shoulder injury prevention and recovery, it’s important to keep the following guidelines in mind. These guidelines apply to pretty much any injury recovery program, pain patterns and orthopedic goals.
Prevention Vs Recovery: Prevention and recovery from shoulder injury may require different exercises and protocols. Some exercises that are optimal for shoulder joint(s) health in specific athletes and those with no previous shoulder injuries may NOT be appropriate if you have already had shoulder surgery or are experiencing acute shoulder pain.
What is your diagnosis? Whether you have experienced chronic and repetitive shoulder pain over a long period or whether it is a new but very painful injury, your next step (if you haven’t already) may be to see a sports medicine doctor, orthopedist or physical therapist. This is especially the case if you have already tried some conservative treatments such as sports massage, dry needling and Active Release therapy.
No one-size-fits-all approach: The treatment and exercise protocols for a rotator cuff strain, labrum tear and frozen shoulder can be vastly different. Each person’s unique anatomy, symptoms, medical diagnosis and goals should direct one’s choice of exercises and treatments. So whether it is the exercises below, stretches a friend shows you or a video you saw of a professional athlete doing to get back on the field, make sure you are customizing the injury rehab and prevention program to your unique needs and goals.
This is where personalized massage therapy and personal training are crucial to alleviating long pent up aches and pain.
Before doing any of these or other exercises to reduce shoulder pain, consult your doctor or injury recovery therapist for approval and proper technique. This is especially the case if your symptoms are particularly acute and severe. If you can't lift your arm over your head without pain or cannot sleep at night due to the pain, be careful not to just go it alone once you have a diagnosis and think you know what to do. It's always best to ensure you're doing things correctly, so don't be hesitant to get some guidance at first, even if you know that you can pretty much do it on your own long-term.
If it hurts, don’t do it. Whether it is the exercises below or yoga poses, an exercise in physical therapy or something your friend shows you, pain is always your guide. If it hurts, stop. There are a lot of other options out there for you. Muscle fatigue from exercise and tightness during a stretch are fine, but if a movement exacerbates your symptoms, it's probably not a good one to do at that time in the injury recovery process.
It's important to remember that it can be counterproductive to apply a one-size-fits-all approach to shoulder injury recovery or rehabilitation from any orthopedic or sports injury. So as you consider which of the exercises below to try, if you're not sure whether it's a good exercise for your specific shoulder injury, seek professional help from a injury recovery specialist. Performing exercises improperly or choosing the wrong ones for your specific goals may work against you in the short and long term.
Mark has treated thousands of clients to reduce physical pain from shoulders, lower back, neck, and more.
1. Shoulder EXTERNAL Rotations: Part 1
Benefits: This exercise isolates 2 of the 4 rotator cuff muscles, the Infraspinatus and Teres Minor. A strong and flexible rotator cuff is essential for shoulder joint health and shoulder injury prevention. Performing EXTERNAL rotation with the elbow by one's side is a relatively basic and beginning way to strengthen these muscles. These two muscles are important specifically for positioning the head of the humerus posteriorly (backwards) in the joint socket.
Caution: This is a very safe exercise. If you feel pain talk to your injury recovery therapist about finding an easier modification.
How: Begin with your elbow and upper arm by your side and hold a resistance cable or exercise band. Keep your elbow close to your body and slowly rotate your hand and forearm away from your body while keeping your elbow connected to your body. Be sure not to arch your low back, dip a shoulder to one side or lean forward with your upper body. Hold for 1-2 seconds at the end range before slowly rotating your arm and hand back in.
2. Shoulder INTERNAL Rotations: Part 1
Benefits: This exercise isolates 1 of the 4 rotator cuff muscles, the Sybscapularis. A strong and flexible rotator cuff is essential for shoulder joint health and shoulder injury prevention. Performing INTERNAL rotation with the elbow by one's side is a relatively basic and beginning way to strengthen this important shoulder joint stabilizer.
This is a very important muscle for shoulder stability, especially for those who have had shoulder dislocations, shoulder joint laxity, labrum tears and rotator cuff tears. Even though this muscles internally rotates the shoulder, which for a lot of people is already part of their problem, this is still an important muscle to strengthen because the muscle might be short and weak. In this case, it will also be necessary to release any trigger points and adhesions by getting clinical massage therapy from an expert manual therapist.
Caution: This is a very safe exercise. If you feel pain talk to your injury recovery therapist about finding an easier modification.
How: Begin with your elbow and upper arm by your side and hold a resistance cable or exercise band. Keep your elbow close to your body and slowly rotate your hand and forearm towards your body while keeping your elbow connected to your body.
Be sure not to arch your low back, dip a shoulder to one side or lean forward with your upper body. Hold for 1-2 seconds at the end range before slowly rotating your arm and hand back in.
3. Shoulder EXTERNAL Rotations: Part 2
Benefits: This is the next step up for increasing strength and neurological coordination of the Infraspinatus and Teres Minor. Since so many of our daily and athletic activities require our arms and shoulders to be elevated to and above shoulder height, this exercise is more functional (and more advanced) than doing it with the arm by the side of the body. More stability and control is required to performing this movement pain-free.
Caution: Sop or modify if you feel any pinching, uncomfortable clicking or pain. You either may not be ready for this progression or just need a physical therapist or personal trainer to help correct your technique
How: Begin with your upper arm parallel to the ground at shoulder height with the elow flexed to 90 degrees. Hold a resistance cable or exercise band and begin with the forearm also parallel to the ground. While keeping your shoulder blades retracted and your elbow in line with or just in front of your shoulder, rotate your forearm backwards until it is perpindicular with the ground. Be sure not to arch your low back, dip a shoulder to one side or lean forward with your upper body. Hold for 1-2 seconds at the end range before slowly rotating your arm and hand back down.
Please keep in mind, the On Your Mark team are licensed and certified professionals in these techniques employed to reduce pain, activate muscles, increase mobility, and alleviate many common symptoms that clients have.
4. Shoulder INTERNAL Rotations: Part 2
Benefits: This is the next step up for increasing strength and neurological coordination of the Supraspinatus. Since so many of our daily and athletic activities require our arms and shoulders to be elevated to and above shoulder height, this exercise is more functional (and more advanced) than doing it with the arm by the side of the body. More stability and control is required to performing this movement pain-free.
Caution: Stop or modify if you feel any pinching, uncomfortable clicking or pain. You either may not be ready for this progression or just need a physical therapist or personal trainer to help correct your technique.
How: Begin with your upper arm parallel to the ground at shoulder height with the elbow flexed to 90 degrees. Hold a resistance cable or exercise band and begin with the forearm perpindicular to the ground. While keeping your shoulder blades retracted and your elbow in line with or just in front of your shoulder, rotate your forearm forwards (internally) until it is parallel with the ground. Be sure not to arch your low back, dip a shoulder to one side or lean forward with your upper body. Hold for 1-2 seconds at the end range before slowly rotating your arm and hand back down.
Benefits: This exercise isolates the Supraspinatus muscle, which is one of the four rotator cuff muscles and is specifically responsible for stabilizing the shoulder joint when you lift your arm over your head. Before the Upper Traps and Deltoids go into action when lifting your arm up, this muscle fires first and creates a downward force on the head of the humerus which prevents compression and impingement at the top of the joint. When this muscle is injured and weak/under-active, it can result in a very painful and debilitating shoulder impingement.
Caution: If you have an acute shoulder impingement, AC joint injury or recent dislocation, this exercise can exacerbate symptoms. To avoid doing so, start by using very light weight, as low as 1 lb. If you experience sharp pain during or after a set, you should stop, try using a lighter weight and consult your injury recovery therapist or sports medicine doctor.
It's very important to keep in mind that this is an activation/strength exercise for a very small muscle (Supraspinatus) and thus heavy weight is not necessary and can lead to further injury. This is NOT a lateral dumbbell raise in which the large Deltoid and Trap muscles are doing a lot of the work, so be careful!
How: Your arm should lift up at a 30 degree angle in front of your body and should not raise higher than shoulder height. Keep your shoulder blades gently retracted (pulled back / squeezed), be sure not to hyperextend your neck or low back, keep your chest open and upper body tall.
6. Shoulder Retractions
Benefits: This exercise is great for improving posture by activating the upper back muscles that keep the spine upright and the shoulder blade muscles that keep the shoulder blades from collapsing forward and internally.
How: Keep your arms straight at all times throughout the entire exercise. Be sure not to let your head shift forward as the shoulder blades and arms move backwards. Also be sure not to hunch over or overarch the low back.
Squeeze the shoulder blades together (retraction) without shifting any other part of your body (head, neck, low back, elbows bending). Hold for 3 seconds and repeat 10-15 times.
Doing this exercise correctly is much harder than it looks!
7. Wall Angels
Benefits: This is a uniquely effective exercise at engaging many muscles responsible for shoulder stability, proper head and neck positioning, upright posture and smooth scapulo-humeral rhythm.
Caution: As with any exercise for injury rehabilitation and therapy, if you experience pain and excessive clicking, consult your physical therapist or other type of injury recovery therapist. It can be difficult just to get yourself into the starting position.
How: Begin with your head, elbows and hands in contact with the wall. Expect to keep these contact points throughout the entire exercise. Your low back won't be in contact with the wall which is ok but make sure the space between your low back and the wall isn't more than equivalent one to two fists. Slowly slide your arms up the wall just a few inches and then slide your arms back to the starting position. Repeat slowly for about 10-15 repetitions or until you fatigue or feel pain.
8. Wall Push-ups
Benefits: Modified push-ups can safely help create shoulder stability, strength and neuromuscular coordination in the shoulder complex. As you get stronger you'll be able to increase difficulty by orienting your body more horizontally.
Caution: If you experience pain while doing this exercise, decrease the resistance by standing closer to the wall.
How: Keep your shoulders in neutral, slightly depressed or slightly elevated depending on what's comfortable for you; you can experiment and see what feels best. Throughout the entire movement try to maintain a connection to your shoulder blade muscles in the back. You should aim to keep the shoulder blades from "winging" too much. If you're not sure what that means or feels like, definitely consult an injury rehabilitation specialist.
Mark and the team are highly experienced with shoulder pain.
Benefits: This exercise is one of the most important and fundamental exercises in low back pain prevention and treatment. It is very safe and although it looks simple, it actually requires a lot of stability, flexibility and mobility in the hip, abdominals, spine and shoulder. This is great to do directly after a series of Cat/Cow.
Caution: This is one of the safest low back and abdominal strengthening exercises anyone can do. The only caveat here is that, if it hurts, either modify or stop. It just means you may not be ready for it in general or just on that particular day.
How: Begin on your hands and knees with your back parallel to the floor. Lift one arm out in front of you while lifting the opposite leg behind you. Sounds pretty easy, right? Not so fast! I often see people doing this exercise incorrectly and even find myself sometimes rushing through it without good form. Repeat with each side 5-15 times. Doing this exercise correctly can prove to be very difficult and require a lot of concentration for many people, especially when first learning.
Try not to shift your body weight to one side as you move. Instead, try to keep your pelvis completely still and let the movement occur within your hip and shoulder joints.
Maintain a neutral spine. In other words, try not to let your low back arch or round too much. Letting this happens defeats one of the main purposes of this exercises, namely to use your deep core musculature to stabilize your spine during movement. The lumbar spine has a natural curve which should be maintained throughout the entire exercise. One great way to ensure this is to place a tennis ball or something similar or slightly larger in size on your low back and not let it move or fall onto the floor as you perform the movements.
Move your arm and leg away form one another, that is, outward rather than upward. If you bring your arm and leg too high up, chances are you’ll over-arch your low back and/or neck, lose stability in your shoulder or shift your body weight to on side. Pointing your toes and fingers as your limbs move can help.
10. Shoulder Extensions (straight arms)
Benefits: This is a great exercise to help activate and strengthen many of the muscle groups that stabilize and move the lumbar and thoracic spine as well as the posterior shoulder muscles. In essence, as you pull the resistance cable (or exercise band) down to your sides, the following muscles are recruited: Transverse Abdominus (the deepest abdominal muscle which is important for lumbar spine stability), the lumbar and thoracic erector spinae group, middle and lower traps, latissiumus dorsi and posterior deltoid as well as the glute max which acts as a fixator.
Caution: This is a very safe exercise as long as you remember not to over-arch your low back. As with any exercise, if your low back tightens up or becomes painful, then stop.
How: Anchor a cable pull or exercise band somewhere between eye level and two feet above your head. Keep your palms facing the ground and arms straight at all times. Exhale and bring your hands down to line up with your body. Keep your arms straight, shoulders relaxed, shoulder blades squeezed together gently, maintain the natural curve in your low back (don’t flatten or over-arch), bend your knees slightly and gently squeeze your butt muscles (glute max in particular). Maintain these postures while slowly letting your arms raise back up. Keep your shoulder blades gently squeezed back and resist the tendency of the head to shift forward.
11. Overhead Ball Raises
Benefits: This exercise focuses on the spinal stabilization musculature from your low to upper back. By performing this exercise while on your knees, the lower body is removed from the picture and thus targets the back and shoulder muscles.
How: With straight arms, raise the exercise ball overhead, hold at the top for 1-2 seconds and slowly lower. Be sure not to overarch the lumbar spine or shift your head forward while raising the ball. Engage your glute muscles and keep your belly button drawn in towards your spine. Be careful not to shrug your shoulders or tense the neck.
In summary, the exercises above are meant as a guide to helo you through your injury recovery journey back to optimal health and function. These videos are not intended to be a complete substitute for seeking treatment with an injyry rehabilitation specialist or medical consultation but rather as tools for you to have at your disposal so you can be self-sufficient, safe and knowledgeable in the injury prevention and recovery spectrum.