Acute or chronic shoulder pain is a common reason a person might seek out the services of a therapist. In this blog post, we will cover the starting point of our favorite exercises for weak or painful shoulders. First, we will discuss different types of exercise and how we use each type to promote pain management. Then we will demonstrate shoulder alignment and give instructions for strong, healthy shoulder joints!
Sound like a plan? Here goes…
When we initiate a plan of action for either acute or chronic pain, we structure an exercise sequence in a specific order. The first goal is to calm down the pain response and bring more stability to the joint in order to allow for bigger movement. Once pain is addressed, we look at underlying movement patterns and reinforce patterns to promote optimal joint health! Let’s take a look at the difference between different types of strengthening exercise and discuss a starting point for weak or painful shoulder joints.
- Isometric: muscle length does not change throughout the exercise. These are completed in a static position not moving through a range of motion but generating force within a muscle.
- Concentric: muscle length shortens to generate force. These exercises move through a range of motion to generate movement. An example of this type of exercise is performing the upward portion of a bicep curl.
- Eccentric: muscle length elongates in response to an opposing force. An example of this type of exercise is the return to the starting position of a bicep curl.
Now that we covered the difference between each type of exercise, we will discuss what order we perform them in and why. For pain, we always start with isometric exercise which has inhibitory effect on acute pain. Isometric exercise starts to calm pain down from an irritable state. That being said, feeling a slight increase in pain with isometrics is perfectly normal.
We advise you to let pain be your guide throughout exercise, however we do not say this to instill fear that you are somehow harming your body if you in pain. Pain is normal at different times, but our goal here is to promote pain management. We use exercise to reinforce positive neural pathways through movement, so we do not want to associate pain with movement. Stop an exercise or movement that is bringing on moderate to severe pain.
Basic alignment for strong shoulders:
2. Avoid compensating by using your trunk instead of your core (as in picture 1, be like picture 2).
3. Keep shoulders relaxed down away from the ears, don’t shrug.
4. Avoid rounding shoulders inward and downward.
Isometric Bicep Curl
1. Sit forward in a chair facing a table.
2. Bend the elbows to 90 degrees, turn palms up toward the ceiling.
3. Sit with neutral pelvis and ribcage down, keep lightly squeezing elbows inward toward your trunk.
4. Place fingertips under table.
5. To perform the exercise, push palms lightly into the table as if you are trying to touch your shoulders with approximately 75–80% of your strength.
6. Stabilize throughout your core, shoulders, and wrists throughout the exercise.
7. Hold this position while taking 3 deep breaths (avoid holding your breath).
8. Relax to starting position.
Isometric Shoulder Adduction
1. Sit foward in a chair with a spacer (such as a pillow, cushion, or yoga block) under your arm between the arm and trunk.
2. Bend the elbow to 90 degrees and turn palm up toward the ceiling.
3. Pull your arm in against the spacer with about 75–80% of your strength.
4. Hold this position while taking 3 deep breaths (avoid holding your breath).
5. Relax to starting position.
Isometric External Rotation
1. Stand near an open wall space or in the frame of a door (optional: place a pillow or cushion between your arm and the wall for support).
2. Bend the elbow to 90 degrees, trunk palm toward your body (handshake position).
3. Apply pressure by pushing the back of your hand into the wall, using about 75–80% of your strength.
4. Hold this position for 3 deep breaths (avoid holding your breath).
5. Relax to starting position.
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