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Shoulder Rehabilitation: Tips, Exercises and Routines

mscldrew

mscldrew

Member
Sep 11, 2010
44
10
This article contains the following sections:

1: Introduction to Rotator Cuff

2: Stretches

3: Exercises

4: A sample routine

5: Exercises to be wary of

6: How to do certain exercises better

7: Further Reading

8: Final Thoughts

Section 1: Introduction

First off, let me explain something. I hesitate to call this a “complete” thread on shoulder injuries, as it is virtually impossible to cover everything. My hope is if you have a shoulder injury (or even if you don’t), that you will learn some valuable tips on how to rehab your shoulder and keep it healthy, what exercises to avoid, and how to do certain exercises better to minimize stress on the shoulders. But please keep in mind that you need to be careful doing any of these exercises. If you are in a lot of pain, then you should probably be going to a doctor or chiropractor. I cannot diagnose you. It may be your RC, it may be your AC. But if your shoulder has been a nagging injury (like it was for me) or if you just want to know how to take care of your shoulder better, then look no further.

As for me, I had a nagging RC injury for months and months. I trained through it (stupidly enough) and just went a little lighter on the weights. While my shoulder didn’t really get any worse, it didn’t get any better, either. So finally I decided to take action and really work on rehabbing my shoulder (or shoulders, I should say…I had impingement in both!)

Training the RC is extremely important for lifting. It gets used in most upper body exercises (even in tricep and bicep exercises to a certain extent) and constantly has to handle a lot of stress. If you keep it strong and healthy though, you can lift for a long time with no problems. I will not go into a detailed explanation of shoulder anatomy, as this is not the purpose of this article, but if you want more information on that then look HERE.

An obvious question becomes, how do I know if I even have an injured shoulder? If you have any pain, then there’s obviously something wrong. But there are other telltale signs, such as tenderness in the shoulder when you press on it, pain when lifting it overhead or to the side (i.e. lateral raise) or a limited Range Of Motion (ROM).

Here’s also a quick, easy test to try with which you can evaluate your shoulders. Stand facing a mirror, hands at your sides. If you can only see your thumbs and index fingers, then your posture is fine. If you can see your ring finger or even your whole palm, then your shoulders are out of whack. With the following exercises, your posture and your shoulders-hunched-forward look will improve.

According to a recent article in Men’s Health (yes, I’m referencing that magazine, don’t laugh ) shoulder impingement is the second most common sports injury behind a neck pull, so that will not only tell you how prevalent it is but then also how important it is to not be someone who adds to these statistics.

If you think and/or know that you have an AC injury, I’d recommend searching for posts by “Nainoa” on this board, he knows a lot of information about AC injuries. If it hurts to do overhead presses, then it is more likely an AC injury rather than an RC injury.

Well, that about does it for the intro, now let’s get down to business!

Section 2: Stretches

In case you didn’t already know, stretching is very important in lifting. Without it, you have a higher chance of injury (and who wouldn’t want to avoid that?) If you currently have shoulder problems, do them cautiously. You should feel a stretch when doing this, but not pain. Try holding the stretch for 15 seconds. I’d recommend doing them before and after every workout (even lower body work; squats place some stress on the shoulders as well).

Some great shoulder stretches are explained HERE (Go to the very bottom of the page).

Another great stretch is to bend your elbow so your forearm and upper arm create a 90 degree angle. Keeping this position, put your arm behind your back, palm facing away from you. The higher up you place your hand on your back, the greater the stretch. Experiment and see what position is comfortable for you. This is a great stretch that’s easy to do, and can be done in public without it looking awkward (I do these when I’m talking to someone all the time, although usually just when I’m sitting down).

Section 3: Exercises

Well, here we go. I will make a list of the best RC exercises that I know of, and in the next section I will post a sample routine.

First off, the “Broomstick stretch” from the infamous Dante AKA Doggcrapp over at http://www.intens************

This exercise was extremely vital for rehabbing my shoulder. It increased my ROM, stopped any clicking, and was well, just plain awesome. I highly recommend doing this. (I do it everyday, except for on the same day of my chest workout and my shoulder workout, 40-50 repetitions). As explained in the thread, you will need a long broomstick (about 6-7 feet long) for it to be effective. A towel or anything else just won’t cut it. When starting off, first try 25 repetitions, then slowly work your way up to 50. By the time you get there, your shoulders will feel a lot better and a lot more flexible, whether you had a shoulder problem or not. In case you haven’t already noticed, I absolutely swear by this exercise.

Internal and External Rotations

These are another must for working the RC. If you don’t have access to a cable pulley machine, you can try them with dumbbells (as explained HERE), but in my personal opinion dumbbells don’t work as well. Why? Doing them on a cable pulley allows you to keep constant tension in your shoulder, and with a cable I feel it is a lot easier to control the motion with strict, strict form (which of course is always important).

View a video of Internal rotations url=http://www.exrx.net/WeightExercises/Subscapularis/CBInternalRotation.html]HERE/url]

Personally, this isn’t my favorite representation of the exercise. I think it is more effective to do it standing up, but to each their own I guess. Your shoulder should act as a hinge. Your elbow should be right on your ribs and should NOT leave your side. The key with internal (and external rotations) is very low weight and very high reps. When I was rehabbing my shoulder (and even now) I never go higher than 10 or 15 pounds (if you’re doing these with dumbbells, try 5 pounds first). The point of training the RC isn’t a lot of weight. The point is to increase blood flow to the area and increase flexibility and ROM. The other important point is high reps. I usually do 2-3 sets of 30-50 reps. Doing that many reps will do wonders for your RC, trust me!

Here are some pics on how to do external rotations (http://www.bullz-eye.com/furci/2004/...l_rotation.htm)

Again, I recommend 10-15 pounds and 30-50 reps. The 2nd exercise shown there is slightly similar to the Cuban Rotation, explained next.

The Cuban Rotation:

This is another great exercise to improve your external rotation. For this one, go very light weight (I cannot stress this enough, working your RC is not about using a lot of weight!). For many a barbell may be too much weight when starting out. I used one of those pre-fitted EZ bars at my gym, only 25 pounds. Again, you don’t need a lot of weight. Make sure your form is strict and controlled. Shoot for about 10-12 reps.

Scapular Retraction:

This is a great exercise for your shoulder blades.. This will help you if you have rounded shoulders, as it works in pulling the shoulders back so that they’re in a more natural position. While this does not directly target the RC per se, I still found it to be a great exercise that worked really well. Again, use light weights anywhere between 5-20 pound dumbbells when you first try it. Shoot for about 10-15 reps and concentrate on really squeezing your shoulder blades together. If you go to heavy, you won’t be able to do this and you’ll compromise your form, which is always a no-no.

The Can Opener

I'm not sure of the actual name of this exercise, but I call it "The Can Opener" for lack of a better term.

Make sure to do it with a light weight and slow, controlled reps.

Other exercises:

Member Only Area: National Council on Strength and Fitness

This website has a bunch of rotator cuff exercises. I have tried a bunch of them, and personally I don’t feel that they did much for me, but of course I’m not like everybody else, so if you try them and you like them, then by all means use them. I think a better alternative to some of these is doing the rotations lying on your side, rather than on your back.

Note: The exercises I have outlined are by no means the only RC exercises. They are some of the most common ones though (especially the internal and external rotations) and they are what worked best for me (but again, I can’t speak for everyone).

Section 4: A Sample Routine

The following is a sample routine for the aforementioned exercises. Ideally you would do them before every upper body workout. But then again, this routine can also be time-consuming, so if you want, you could limit the routine to just internal rotation and then external rotation or Cuban rotation.

Exercise 1: Internal Rotation on a cable pulley machine (do both arms together at the same time) or with dumbbells (but again, cables are best)

2-3 sets, 30-50 reps, 10-15 pounds (20-25 reps and 5-10 pounds for dumbbells)

Exercise 2: External Rotation on a cable pulley machine or with dumbbells

2-3 sets, 30-50 reps, 10-15 pounds (20-25 reps and 5-10 pounds for dumbbells)

Exercise 3: Cuban Rotation

2-3 sets, 10-12 reps, start off somewhere between a 15 pound to 40 pound bar and go from there

Exercise 4: Scapular Retraction

2-3 sets, 10-15 reps, try dumbbells anywhere between 5-20 pounds and go up from there. Remember to really squeeze those shoulder blades

Section 5: Exercises to be wary of

This section of the article will probably be very controversial. I will give a list of exercises that I think should not be done at all (for someone with healthy or bad shoulders) and some that should be avoided if you have shoulder problems (granted, the best thing is to not be lifting at all if you have a bad shoulder, but if it is only minor and nagging, it is still very common to see guys just working through it). Ultimately, you have to be the judge. But remember—just because the exercise doesn’t cause pain, does not mean it can’t cause problems in the long run. Here are some of my suggestions:

1) Upright Rows: I think that these should be avoided entirely. Again, I will emphasize that this isn’t true for everyone, but they have a high probability of causing impingement

2) Pec Deck: If your shoulders are fine, go for it. But if you have any shoulder issues, steer clear.

3) Flyes: Same as above. If your shoulders are fine, go for it. If not, be wary

4) Dips: Same as above. If you have bad shoulders avoid them. Otherwise, go ahead. Just be sure to not go past parallel with your upper arms.

5) Shoulder and Chest Presses (including Bench Press): These will most certainly aggravate your bad shoulder. Try to avoid these if you have shoulder problems.

6) Overhead Tricep Extension (with barbell or dumbbell): These put a lot of stress on your shoulders, so if you have any issues, avoid them.

Realistically, I could go on forever, as almost every upper body exercise involves the shoulders, but I think these are some of the top ones to avoid. You could argue that Any type of lateral or front raise should be in there too, but since you do usually go lighter with them anyway, I’ll leave that for you to decide whether to do them or not if you have a bad shoulder. Only you can judge what your body can handle, not me.

Section 6: How to do certain exercises better

Through my training, I found ways to change an exercise a little bit so that if you have shoulder problems, and even if you don’t, you can perform them without putting too much stress on the shoulders. Again, you have to be your own judge. I could do most of these exercises without pain when my RC was bad, but that does not mean that this will be true for everybody. My point is, tread cautiously. Use these suggestions as a guide and hopefully they will help you.

1) Flat, Incline or Decline Dumbbell or Barbell Press: When lowering the barbell or dumbbell, don’t go all the way to your chest. The point of doing these exercises is mainly to work your chest, and if you go too low, your shoulders will start doing all the work. Try it out for yourself to see what’s comfortable for you, but I would stop 3-4 inches above your chest. This will keep the stress on your chest (good) and off your shoulders (also good).

2) Pullups or Chinups: On the negative part of these exercises, don’t quite go down all the way so that your arms are completely straight. This will put a lot of stress on your shoulders.

3) Pushups: Changing your hand positioning will reduce the stress on your shoulders. When my RC was bad, regular pushups caused me pain. But changing the hand position made them pain-free. For example, let’s say your right shoulder is your bad one. When you get into pushup position, move your right hand back a couple inches, but keep your left hand where it was. Although some will decry that this will work your muscles different from the classic pushup, if you have a bad shoulder pushups might be painful, but putting the arm with the bad shoulders a couple inches back will greatly reduce the stress on your shoulders.

4) Skullcrushers or Lying tricep extensions: Instead of doing them on a flat bench, which is the most common way, try doing them on a slight incline. This will greatly reduce the stress on your shoulders. Even now that my shoulders are OK, I still do extensions on a slight incline (the lowest the bench will go without being flat, I think that’s at 15 degrees).

That’s about all I can think of on how to perform certain exercises better to reduce stress on your shoulders. If I come up with anymore ideas I’ll add them, or if anyone else has suggestions I will gladly add them and credit you as the source.

Section 7: Further Reading

Here are some articles on shoulder rehabilitation if you’re interested in further reading:

http://www.findarticles.com/p/articl...18/ai_83343027

http://www.t-nation.com/findArticle....=body_145shldr

http://www.bodybuilding.com/fun/bbin...oulderInjuries

Section 8: Final Thoughts

If you’re reading this, well then thank you for making it this far! This took me a long time to write up, and I hope you have gained some new knowledge, whether you’re a novice or veteran of lifting, whether you have healthy shoulders or you don’t. I would just like to stress again that these exercises aren’t about how much weight you can do. Form and control are paramount. If you have any suggestions or comments or questions, please say something! If there’s something in here you disagree with, tell me why. As long as you give me a good reason, I’ll listen. But if you just say “your article sucks,” it’ll fall on deaf ears. I want to know why it “sucks” and what I can change. I wrote this as a service to everyone out there, healthy shoulders or not, and show you what has worked for me. If you even gain one tip or one exercise or whatever from this, then I’ll be happy. If not, that’s fine too. Good luck!
 
gerard

gerard

New Member
Apr 19, 2012
7
2
The first thing is... not to injure you shoulders, people think its part of the game, it's not. What i've notice in the past 50 years is, people don't respect the shoulder until the damage is done. Good Article...people need to Train smart
 
big bx

big bx

VIP Member
Nov 30, 2011
816
203
Good read.

I got a partial tear of the RC, gonna give some of that a try, along with my PT.
 
W

weezy102

Member
Mar 29, 2012
10
0
Good info, I've torn my shoulder twice in the past 7 years, always looking for good exercises.
 
Mconniff

Mconniff

Member
Nov 11, 2011
24
1
Very good, and well written where me the caveman can understand it. The only thing I would change is adding pictures of how to do the exercise, some of your descriptions are vague if you're not used to it.

Two months ago I experienced a pinch in my right shoulder on top, basically any overhead exercise hurt or would stop me from full motion. So I stopped doing the exercises and took a break, worked on cardio and abdominal exercises. Till tucking in my shirt and putting my hands behind my head to do sit-ups hurt. So after a two week break I went to see the doctor. He didn't even touch me and he gives me naproxen and a pamphlet on how to stretch and some exercises to do. After two weeks of medications and exercises I still feel it, though not as bad. I am off the medication and am still doing the exercises this week to see if it gets better before I see a different doctor. He said it was bursitis.

All I know is that every time I get into a good routine and start lifting heavier weight work, family, or injury sets me back. I haven't lost my motivation nor my focus. Just discouraged and frustrated.

Thank-you
Mconniff
 
Braw16

Braw16

MuscleHead
Aug 8, 2012
719
53
Great article mscldrew thanks for taking the time to post. I have had three shoulder surgeries in the past and I learned some new things from this. Your right it is so important to keep your shoulders in shape and flexible and to also know your body. I do most of those exercises but I now have some new ones to try. Thanks again because shoulders are just so common to hurt and can really put yo out.
 
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