Generic

Shoulder
Physiotherapy
Exercises Sheet
Information for patients
Orthopaedic Shoulder Service
2 Shoulder physiotherapy instruction sheet
Shoulder physiotherapy instruction sheet
Physiotherapy plays a vital role in the treatment of all shoulder
conditions. The majority of common shoulder conditions can be
treated successfully with physiotherapy. This means that most
people can avoid having shoulder surgery by doing physiotherapy.
This will involve significant hard work on your part as the exercise
regime needs to be carried out daily and may take up to three
months for the shoulder to improve.

Your physiotherapy regime will depend on the type of shoulder

problem or injury you have. In the beginning you may be too sore
to complete the exercises fully; the exercises should not cause you
significant pain. They may feel like hard work, stretchy or achy.

Shoulder physiotherapy instruction sheet 3

It is important to take things step by step and build up gradually.

Stage one - Range of movement exercises

You should start with gentle movements and build up the range of
movement within your shoulder. This will help settle the pain you
are experiencing. Keeping the shoulder still for any length of time
will only prolong the pain you feel. You do not need to complete
all the exercises or all the number of repetitions when starting these
exercises; you should work to a level of discomfort that you can
tolerate. As things get easier, you can start to progress the range of
movement and number of repetitions.

It is common that for the first few weeks you won’t be able to
do any movement above shoulder height without experiencing
discomfort. There are some restricted exercises that people with
a particularly painful shoulder can start with. Once the shoulder
becomes less irritable you can progress onto the full exercise.

Stage two - Strengthening Exercises

You should only start to strengthen your shoulder once you are able
to complete all the stage one exercises fully. By strengthening the
muscles around your shoulder it should reduce the amount of pain,
prevent further injuries to the shoulder and allow you to get back
to using the shoulder normally again. Once you are comfortable
with the stage two exercises you can try adding in a lightweight
such as a small dumbbell (0.5 - 1kg) or a water bottle. Remember
to build up to this slowly. As the exercises become easier you can
progress the number of sets you complete. You can also add weight
in increments to a maximum of 2.5kg.

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Stage one
Range of movement exercises:
1. Pendulum
Repetitions: two sets of 10, three times per day.
Days per week - Daily
Equipment - Counter or table

Step by Step Instructions:

v Lean forward and place one hand on a counter or table for
support. Let your arm hang freely at your side.
v Gently swing your arm forward and back. Repeat the
exercise moving your arm side to side, and repeat again
in a circular motion. As you get more comfortable, try to
make the circles bigger.
v Repeat the entire sequence with the other arm.
Tip: Try to maintain a good posture whilst completing the
exercise. Do not round your back or lock your knees.
Shoulder too painful? Leaning forward on a table, just focus
on letting the arm hang straight down and relaxed by your side.

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2. Scapula Setting
Repetitions: two sets of 10, three times per day.
Days per week - Daily
Equipment - none

Step by Step Instructions:

Step by Step Instructions:

v Either standing or sitting. Relax your head and neck.

v Maintaining a good posture, squeeze your shoulder blades
together and down.
v Avoid shrugging your shoulders. Focus on your shoulder blades
coming back and down.
v Hold for 10 seconds and then relax.
Tip: Try to keep your abdominal and core muscles tight when doing
this exercise.

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3. Wall or table slide
Repetitions: two sets of 10, three times per day.
Days per week - Daily
Equipment - Wall and a towel

Step by Step Instructions:

v Stand in front of a wall. Gradually slide your hand up the wall
until you feel a stretch in the shoulder. A cloth or towel can help
the hand slide more easily.
v To begin with, you might need to use you other arm to assist
with this movement.
v Once you reach you maximum stretch, hold it there for a few
seconds and then gradually slide your hand back down the wall.
v You should be able to reach further and further up the wall as
your symptoms improve.
v Repeat the entire sequence with the other arm.
Tip: Try and keep your shoulder relaxed and not let it creep up.

Shoulder too painful? Start by sitting at a table and sliding your

hand out in front of you. Once you are able to do this then you can
progress to trying the wall slide.

Shoulder physiotherapy instruction sheet 7

4. External Rotation with door frame
Repetitions: four repetitions on each side three times per day
Days per week - Daily
Equipment - Door frame

Step by Step Instructions:

v Stand in a doorway facing the frame. Place your hand on the
inside of the frame and then twist your whole body to face out
the door. Try to keep your elbow bent at 90 degrees.
v You should feel the stretch on the front of your shoulder.
v Hold this position for 30 seconds and then relax for 30 seconds.
v Repeat with the other arm.
Tip: Remember to keep your elbow bent at 90 degrees
and tucked in at your side.

Shoulder too painful? Try the external rotation with stick stretch
first if the shoulder is painful.

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5. External rotation with stick
Repetitions: four repetitions on each side three times per day
Days per week - Daily
Equipment - light walking stick or umbrella

Step by Step Instructions:

v Grasp the stick with one hand and cup the other end of the stick
with the other hand.
v Keep the elbow of the shoulder you are stretching against that
side of your body. Push the stick horizontally to the point where
you feel a stretch on the shoulder.
v Hold this position for 30 seconds and then relax for 30 seconds.
v Repeat with the other arm.
Tip: Keep your hips facing forward and do not twist.

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6. Sleeper Stretch
Repetitions: four repetitions on each side three times per day
Days per week - Daily
Equipment - None

Step by Step Instructions:

v Lie on your side on a firm, flat surface with the affected shoulder
under you and your arm bent, as shown. You can place your
head on a pillow for comfort, if needed.
v Use your unaffected arm to push your other arm down.
Stop pressing when you feel a stretch in the back of your
affected shoulder.
v Hold this position for 30 seconds and then relax for 30 seconds.
v Repeat on the other side.
Tip: Do not bend your wrist or press down on your wrist
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Stage two
STRENGTHENING EXERCISES:
7. Forward arm raise
Repetitions: two sets of 10.
Days per week- 4 days per week
Equipment- Small weight (0.5- 1kg) or water bottle.

Step by Step Instructions:

v You can do this exercise standing or sitting. Perform the exercise
one arm at a time.
v With a small weight in your hand raise your arm straight out
in front of you.
v Aim to reach to shoulder height. If you are able you can stretch
slightly higher.
v Slowly lower your arm back to the start position to a count
of five seconds.
Tip: Make sure you are not extending at your lower back.
Focus on keeping your back flat whilst doing the exercise.

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8. Y raise exercise:
Repetitions: two sets of 10.
Days per week - four days per week
Equipment- Small weight (0.5- 1kg) or water bottle.

Step by Step Instructions:

v Sitting down on a chair with a small weight in your hand.
Perform the exercise one arm at a time.

v Raise your hand out to the side and reach up as high as you
comfortably can.

v Start by aiming to get to shoulder height and then if you

achieve that you can try to reach right up over your head.

v Slowly lower your arm back to the start position to a count of

five seconds.

Tip: Make sure you are not extending at your lower back. Focus on
keep your back flat whilst doing the exercise.

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9. External rotation strengthening:
Repetitions: two sets of 10
Days per week - four days per week.
Equipment -Small weight (0.5- 1kg) or water bottle.

Step by Step Instructions:

v Lie on your side on a firm, flat surface with you unaffected arm
under you, cradling your head.
v Hold your injured arm against your side as shown, with your
elbow bent at a 90 degrees angle.
v Keep your elbow against your side and slowly rotate your arm
at the shoulder, raising the weight, as shown.
v Slowly lower the weight to the starting position to a count of five.
Tip: Do not let your body roll back as you raise the weight.

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 Formatted: Centered

Useful Information and Contacts:

NHS Forth Valley website has other useful information and contacts:

www.nhsforthvalley.com/health-services/know-who-to-turn-to-when-
you-are-ill

https://nhsforthvalley.com/publications/patient-information-leaflets/

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details of services and support in your area.
Visit www.nhsinform.scot for general advice
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www.nhsinform.scot/msk for advice about muscles, bones and joints

The Chartered Society of Physiotherapy also provides useful

information at www.csp.org.uk/MSKadvice

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