Biceps/Front Line Stretch

Purpose: To improve mobility of and decrease tone in the muscles of the front line.

Points of Interest: Be gentle with these stretches and try to find a position in which you feel a pull in the front line muscles, but not pain.

Instructions: Stand 1-foot away from a wall with your opposite foot forward.  Place your hand on the wall at shoulder height.  Keep your abdominals engaged and slowly turn your head and chest away from the wall to feel a stretch down the arm.  Complete this stretch with your arm above and below shoulder height to determine where you feel the greatest stretch (without pain).  Hold these stretches for at least 20 seconds and repeat 2-3x.

Bilateral External Rotation

Purpose: To strengthen the rhomboids and lower trapezius muscles which cn improve posture and rotator cuff function.

Points of Interest: Make sure you avoid shrugging your shoulders and arching your low back.

Instructions: Stand tall with the back of your head touching the edge of a door frame.  Squeeze the door frame with your shoulder blades.  With your palms up and elbows bent at 90 degrees, pull outward while keeping your elbows tight against your sides.  Hold for 3 seconds and complete 10 repetitions.

Blackburn Exercises

Purpose: To improve scapular stabilization and rotator cuff function.

Points of Interest: For all variations:

  • Step 1: Squeeze the shoulder blades down and together (no shrugging)

  • Step 2: Lift the arms

  • Step 3: Maintain the position of the shoulder blades and lower the arms

  • Step 4: Relax the shoulder blades completely

Watch For:

  • Do not lift your head or chest

  • Do not allow your elbows to bend during "straight arm" exercises

  • Do not allow your arm position to be uneven from side-to-side

  • Do not shrug your shoulders

  • Do not move on to the next progression until you have mastered the previous level

1 - Palms Up

4 - "T" Thumbs Up

2 - Palms Down

3 - "T" Palms Down

5 - "W" Palms Down

6 - "W" Thumbs Up

8 - "Y" Thumbs Up

7 - "Y" Palms Down

Door Frame Stretch

Purpose: To stretch the anterior chest and shoulder.  This can improve shoulder range of motion and posture

Points of Interest: It is very important to maintain core stability (brace your abdominals) during this exercise to prevent lumbar extension and possible aggravation of the low back.  Breathe deeply and try to relax your shoulders.

Instructions: Place your arms at 90 degrees on the front edge of a door frame.  Ensure that your elbows, forearms, wrists and hands are flat and in contact with the frame.  Step forward with one foot, while keeping yourcore tight.  Push your chest forward and your head above your shoulders.  Repeat this exercise above and below 90 degrees to determine where you experience the greatest stretch.  However, avoid areas that cause pain.  This stretch can be completed multiple times per day unless otherwise instructed.

Push Up

Purpose: To strengthen the upper extremities horizontal pushing capabilities

Points of Interest: Before performing this exercise you should master core and scapular stabilization.

Instructions: Begin with your hands slightly wider than shoulder width and feet hip width apart.  The pressure on your hands should be focused to the thumb, index finger and middle finger.  Keep your head inline with your body so that when you are viewed from the side your body is a straight line from the top of your head to your heels.  Engage your abdominal musculature.  On the way down to the ground, bend your elbows and squeeze your shoulder blades.  On the way up, straighten your elbows and separate your shoulder blades.

Avoid:

* Shoulder shrugging

* Hips sinking or hiking up (deviating from a straight line)

* Elbows out uneven distances from the torso

* Head sagging down

Scapular Clock

Purpose: To improve scapular control and range of motion.

Points of Interest: It is very important to ensure that the core muscles remain engaged throughout this exercise to ensure true scapular movement.  It is normal to feel some pulling and/or stretching down the the arm when these movements are done correctly.

Instructions: Stand close to a wall with your arm directly out in front of you at shoulder height with your palm against the wall.  Engage the core muscles with a pelvic tilt. Fully protract your shoulder blade by pushing yourself away from the wall.  The fully retract your shoulder blade by pulling it down and toward your spine.

* Imagine that your middle finger is an hour hand on a clock. You should attempt this exercise at 3, 6, 9 and 12 o'clock,

Retraction

3 o'clock

6 o'clock

9 o'clock

12 o'clock

Protraction

3 o'clock

6 o'clock

9 o'clock

12 o'clock

Scapular Retraction/Protraction

Purpose: To improve scapular stabilization and re-train the muscles involved with shoulder movement

Points of Interest: To increase difficulty, this exercise can be performed in a quadruped position, push-up or on a wobble board/bosu ball.

Instructions: Begin with your arms straight out at shoulder height and your hands placed on the wall.  Push yourself away from the wall so that your shoulder blades spread apart.  Ensure that you do not shrug.  Next, squeeze your shoulder blades down and together.  Ensure that your core muscles continue to be engaged.  Your body should move slightly closer to the wall even though your elbows have remained straight through the entire exercise.

Retraction

Protraction

Short Axis External & Internal Rotation

Purpose: To dynamically strengthen the muscles of the rotator cuff to permit long axis exercise

Points of Interest: It is important throughout these exercises that your shoulder blade is retracted down and toward the spine.  Ensure your abdominal musculature is engage to prevent hyperextension of the lumbar spine (low back).

You can progress to the next level when the following conditions have been met:

  1. Scapular stabilization has been achieved

  2. Synchronous core and scapular activation are maintained in an upright posture

  3. A red band can be used for 25 repetitions at the previous level

  4. There is an absence of pain - aching is permitted provided it subsides when stopping

Level 1 - 0 degrees abduction

External Rotation

Stand with the band attached at waist height and your elbow bent to 90 degrees.  Your elbow should stay tuck tight against your side for the entire motion.  Your shoulder blades should stay retracted down and back and core muscles engaged.  Pull the band outwards, keeping your wrist locked and maintaining good posture.  Slowly return to the start position.

Internal Rotation

Stand with the band attached at waist height and your elbow bent to 90 degrees.  Your elbow should stay tuck tight against your side for the entire motion.  Your shoulder blades should stay retracted down and back and core muscles engaged.  Pull the band inwards, towards your bellybutton, keeping your wrist locked and maintaining good posture.  Slowly return to the start position.

Level 2 - 90 degrees flexion

External Rotation

Stand with the band attached at shoulder height and your shoulder in 90 degrees flexion and elbow bent to 90 degrees.  Your elbow should stay pointing directly in front of you during this exercise.  Your shoulder blades should stay retracted down and back and core muscles engaged.  Pull the band outwards, keeping your wrist locked and maintaining good posture.  Slowly return to the start position.

Internal Rotation

Stand with the band attached at shoulder height and your shoulder in 90 degrees flexion and elbow bent to 90 degrees.  Your elbow should stay pointing directly in front of you during this exercise.  Your shoulder blades should stay retracted down and back and core muscles engaged.  Pull the band inwards, keeping your wrist locked and maintaining good posture.  Slowly return to the start position.

Level 3 - 90 degrees abduction

External Rotation

Stand with the band attached at shoulder height and your shoulder in 90 degrees of abduction and elbow bent to 90 degrees.  Your elbow should stay pointing directly beside you during this exercise.  Your shoulder blades should stay retracted down and back and core muscles engaged.  Pull the band backwards, keeping your wrist locked and maintaining good posture.  Slowly return to the start position.

Internal Rotation

Stand with the band attached at shoulder height and your shoulder in 90 degrees of abduction and elbow bent to 90 degrees.  Your elbow should stay pointing directly beside you during this exercise.  Your shoulder blades should stay retracted down and back and core muscles engaged.  Pull the band forwards, keeping your wrist locked and maintaining good posture.  Slowly return to the start position.

Shoulder Set

Purpose: To activate the rhomboids and lower trapezius in order to improve shoulder stabilization and posture.

Points of Interest: It is very important to ensure that the upper trapezius muscles do not engage (i.e. you do not shrug your shoulders and tense your neck)

Instructions: Stand up tall.  Engage your core by initiating a pelvic tilt.  Ensure your ears are in line with your shoulders when viewed from the side.  Tuck your chin.  Retract your shoulder blades by pulling the shoulder blades down and together.  Pretend you are pinching a pencil between your shoulder baldes.

Watch For:

* Do not extend your back

* Do not shrug your shoulders

* Do not round your shoulders

* Do not allow anterior head carriage

Row

Purpose: To strengthen the rhomboids and lower traps which will improve scapular stabilization and posture.

Points of Interest: It is very important to ensure that the core muscles remain engaged throughout this exercise to ensure true scapular retraction.

Instructions: Stand with your feet shoulder width apart and core engaged.  Your elbows should be straight and palms facing inwards.  Retract your shoulder blades down and together while ensuring that your core remains engaged.  Pull the band toward you with a rowing motion, pulling your elbows behind your body and in towards each other.  You should feel a strong squeeze between your shoulder blades, but you should not be shrugging your shoulders up.

Sleeper Stretch

Purpose: To stretch the posterior capsule of the glenohumeral joint (shoulder) and improve internal rotation range of motion.

Instructions: Lie on one side with your arm straight out in front of your shoulder and the elbow bent to 90 degrees.  Actively bring your forearm down toward the floor until you feel a stretch.  Use your other hand to push down as you push up to match the resistance.  Hold this position for 20 seconds, relax and repeat.

Wall Push-Up

Purpose: The wall push-up decreases the demands of the upper body when compared to a normal push-up.  It can be used to improve scapular stabilization.

Points of Interest: It is very important to ensure that the core muscles remain engaged throughout this exercise to ensure true scapular retraction.

Instructions: Stand facing a wall with your arms outstretched and hands flat against the wall.  Ensure that your core is engaged.  Retract your shoulder blades by pulling them down and together.  Slowly bend at the elbows while maintaining the shoulder blade squeeze (avoid shrugging).  Push away from the wall to return to the starting position and attempt to bring shoulder blades around rib cage as far as possible.

Phone: (705)726-4331

Fax: (705)726-8588

48 Alliance Blvd, Building A, Unit 105, Barrie, ON, Canada , L4M 5K3

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©2018 BY DR. CHRIS GRANT