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Shoulder instability is a result of laxity of connective tissues within the shoulder. This can include the shoulder joint itself (glenohumeral joint), shoulder blade (scapula), and/or collar bone (clavicle). There are various reasons that instability may be present in the shoulder, ranging from a traumatic shoulder injury like a dislocation to overuse or genetics. Having a high-quality exercise program in place can help improve shoulder stability and reduce your risk of injury and long-term issues. Keep reading to learn more about shoulder instability exercises that can help your shoulder feel as stable as possible.
The goal of exercise for shoulder instability is to restore as much innate stability as possible in the joint. The shoulder becomes most dependent on muscle strength to protect the joint with daily activities. The two primary areas of focus for rehab for instability include the rotator cuff muscles that directly support the shoulder and supporting muscles in the mid-back and shoulder blade area.
There are four muscles that comprise the rotator cuff: the supraspinatus, infraspinatus, teres minor, and subscapularis. When properly coordinated and utilized, these muscles keep the ball of the joint (head of the humerus) in an optimal position as the arm moves within the socket (glenoid). This keeps it stable and prevents unnecessary joint damage and strain.
An isometric exercise means that you are activating specific muscle groups without actually moving the joint itself. This makes it possible to strengthen muscles while keeping it relatively pain-free and avoiding unnecessary strain to the shoulder joint capsule.
For each position, hold for 5-10 seconds for 10 repetitions and repeat 2-3 times total.
Push your fist forward into the wall and hold.
Place your opposite hand on the inside of your forearm near your wrist and apply pressure as if the forearm was going to rotate away from the body.
Place your opposite hand on the outside of the forearm by reaching across/above and apply pressure as if you were going to rotate your forearm toward your belly button.
The key is to keep your muscle activation relatively pain-free and joint stable throughout.
Once you have mastered isometrics and they are getting too easy, it’s time to progress to active motion against resistance. If the resistance feels like too much to start, you can also focus on shoulder range of motion while keeping good form first instead.
Complete 10-15 repetitions for 2-3 sets for each exercise. Stay within a range of motion that is tolerable for you and doesn’t make your shoulder feel unstable.
When you’re ready, you can progress to a higher range of motion.
The setup is the same as abduction for this move. However, this time you are lifting your arm straight up in front of you. Once again, start with a goal of shoulder height and progress from there. Make sure your thumb is facing upward or inward (not downward to prevent pinching).
Alternatively, you can focus on one shoulder at a time by securing the band to a door or other sturdy surface and completing the same move.
Additionally, you can add movements like bicep curls by standing on the band and tricep curls by securing the band overhead.
If you’re trying to move your arm and don’t have adequate shoulder blade strength and coordination, you are putting your shoulder at risk for re-injury and aggravation. Addressing the shoulder blades and mid-back is a part of the shoulder rehab program that is often neglected. Incorporating these few exercises will make a huge difference in your overall shoulder function.
This is one of the most basic moves you can start with to strengthen the muscles between the shoulder blades, particularly the middle and lower trapezius muscles (that are often overpowered by the upper trapezius muscle along the top of the shoulder and neck). It might seem simple but can be hard to coordinate with an injured shoulder or chronic bad posture.
This traditional move is essential for shoulder blade coordination and is the next step in progression from the exercise above.
Progress the band resistance as tolerated. Plus, you can utilize row machines at the gym to complete this move as well
These final three moves can feel quite difficult with an injured and unstable shoulder. You should not attempt these until you’re in the later stages of recovery and have better control of your shoulder movements.
To progress, hold small weights in your hands or hold for 5-10 seconds with each repetition
Following a shoulder dislocation or when dealing with chronic wear and tear that has left your shoulder unstable, physical therapy is the best option for restoring shoulder function. When you work with a physical therapist, they will do a full shoulder (and body) assessment to determine your unique deficits. From there, they can work with you to design a personalized rehabilitation program for the clinic and a home program to expedite your recovery. In general, your PT will help you with the following:
Now that you have a grasp of where to start and how to progress with exercise for shoulder instability, let’s review a few tips for maximizing your efforts.
As your shoulder heals, you do not want to return back to square one because of faulty mechanics that re-strain affected tissues. The primary goal is to optimize the position of the ball in the socket and of shoulder blade movement on the ribcage. From there, you can gradually progress without risking reinjury.
When re-training your shoulder mechanics, it can be hard to self monitor your progress. Utilize tools like kinesiology tape (talk to your PT to get started) or a mirror.
It’s always best to start with the easiest exercises and give your shoulder time to adjust gradually. Then, only progress when you feel in control of your shoulder mechanics, don’t experience shoulder impingement (pinching), and your symptoms don’t get worse. Be patient!
Use home remedies to manage any pain, stiffness, or swelling- both before and after your exercises. Once again, this might include ice, heat, and/or electrical stimulation (with a home unit).
Your PT will help you with stiffness, pain, and joint mobility as needed. At home, you can work on this independently with tools like a foam roller for thoracic mobility (a common cause of poor shoulder biomechanics) and a massage cane for addressing tension in the neck and mid-back.
As you get back to reaching activities or even a sport, you may consider wearing a brace for additional support and biofeedback. Talk to your sports medicine doctor or PT about what type of shoulder brace is right for you.
Shoulder instability can make it feel impossible to complete your regular activities. It will definitely take time and patience to restore stability and confidence in your shoulder. However, with the right plan and strengthening exercises in place you can gradually make progress on your way to a full recovery. If symptoms get worse, we recommend seeking medical advice from your healthcare professional.
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