» Stage 1
This stage begins immediately after injury. This is known as the acute stage where the injury is fresh and most likely painful. The aim of shoulder rehabilitation in the acute stage is to allow the tissues to heal, reduce pain and inflammation, begin to regain pain free range of movements, prevent muscle wasting and begin shoulder blade or scapula exercises.
Rest is important for allowing tissues to heal and applying ice, heat or both may be indicated depending upon your injury and how old it is. A professional practitioner may apply other techniques such as electrotherapy or massage to aid healing.
Range of motion is re-established with pendulum exercises staying within the pain free range. Pole exercises, manual therapist stretching and mobility can also be done to increase the normal range of motion in the shoulder joint
Isometric or static exercises should be done to prevent muscle wasting. These are exercises where the muscle is contracted against an immovable resistance such as a wall, held for a short time then relaxed. This type of exercise works on the muscles without moveing the joint. Scapular stabilizing exercises should also be done if they can be performed without pain.
» Stage 2
Mid stage shoulder exercises aim to regain full, normal range of movement, improve shoulder blade control and regain normal upper body strength in both sides.
Mid stage exercises can be progressed once the early stage exercises are comfortable. The patient is ready to move out of the acute stage exercises when active exercises involving movement can be done pain free and range of motion is at least three quarters that of the uninjured shoulder. There is no hard and fast rule that any particular exercise should be early, mid or late. If in doubt consult professional advice.
Flexibility is improved by progressing pole or wand exercises, using the pole to increase range of motion in a stretch or exercise. More advanced scapula exercises are performed and strengthening exercises involving movement with resistance bands are used to increase strength.
» Stage 3
Late stage shoulder exercises
aim to restore full strength to the injured shoulder and begin functional or sports specific exercises that bridge the gap between basic shoulder rehabilitation exercises and normal sports specific training. Medicine balls are used and more rotational, explosive exercises are included which use the combined muscle groups.
This will increase the muscle power which is more relevant to sport. Often late stage exercises will become more sports specific and will depend on the requirements of the sport. For example footballers will kick balls, racket sports will involve using rackets but building up gradually in a controlled environment.