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Shoulder Internal Rotation Stretch with Stick

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Step-by-Step

Stand with your feet shoulder-width apart.

Reach your affected arm behind your back to hold the stick or towel.

If using a stick, your affected hand’s back should be against your body (palm facing inward).

Grab the other end of the stick or towel with your unaffected arm.

Gently pull upward with the unaffected arm until you feel a stretch in the affected shoulder.

Hold the stretch, then relax.

Repeat as needed.

How many time?

3 sets X 10 times

Hold for 20-30 secs

Rest for 10-20 secs

Once a day

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Step-by-Step

Stand at open doorway in a forward lunge position.

Brace each arm against the frame with shoulders and elbows at 90 degrees, palms facing forward.

Instead of leaning forward with your body, focus on dropping your chest and head 45 degrees towards the ground.

The stretch should be felt in your anterior shoulder and chest.

Hold the stretch, then relax.

Repeat as needed.

How many times?

2 sets x 10 repetitions

Hold for 20-30 secs

Rest for 10-20 secs

Once a day

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Step-by-Step

Start leaning your back against a wall.

Raise target limb to 90 degrees abduction with elbow bent at 90 degrees as well.

Position yoga block between the back of palm and the wall.

Externally rotate shoulder posteriorly into the block creating an isometric contraction.

How many times?

2 sets x 10 repetitions

Hold: 10 seconds

Rest: 5 seconds

Frequency: 3x/ daily

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External Rotation Isometric Exercise (Wall or Door Frame Press)

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Step-by-Step

Stand sideways next to a wall or door.

Bend you elbow to 90° and keep it next to your side (if you are having a hard time you can place a towel).

The are closest to the wall is the working arm.

Press the back of your hand into the wall, as if you were to rotate your hand away from you. Do not let move your arm move.

How many times?

Once a day

3 sets

10 reps per set

Hold for 5-10 seconds and rest for 5 seconds

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GE (reduced) Supported External Rotation

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Step-by-Step

Sit next to a table or counter.
Position yourself so that your working arm is closest to the surface.

Tuck your elbow at your side and bend it to 90 degrees.
Your forearm should rest comfortably on the surface.

(Optional) Place a towel under your forearm
This reduces friction and allows smoother movement.

Start in a neutral position
Your hand should be in line with your elbow, thumb pointing up toward the ceiling.

Slowly rotate your forearm outward, away from your body.
Keep your elbow glued to your side — the motion should happen only at the shoulder.

Pause briefly at the end range, then slowly return to the starting position.

How many times?

1-2 times a day

3 Sets

10 Reps

3-5 times a week

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GE (reduced) Supported ER with resistance

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Step-by-Step

Sit next to table top. Target limb should be resting on surface.

Anchor resistance band parallel to 90 degree bent elbow.

Start in neutral position with neutral grip.

With elbow tucked into your side, slowly rotate your forearm outward, away from your body.

Maintain points of contact of both elbow and forearm throughout motion.

Hold for 5-10 seconds at end range for added isometric contraction, then slowly return to starting position.

How many times?

1-2 times a day

3 Sets

10 Reps

3-5 times a week

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Step-by-Step

Grasp resistance band with hand as it is wrapped around target limb's wrist and foot on same side.

Externally rotate the shoulder with the ipsilateral leg elevated

As you bring your leg down, slack is immediately taken off and resistance increases

Maintain isometric hold at end range and slowly internally rotate shoulder from 90 degrees to 0 degrees.

Repeat as needed.

How many times?

2 sets x 10 repetitions

Rest for 10-20 secs in between

3-5 times a week

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Step-By-Step

Lie on the unaffected side

Affected arm resting on your stomach with elbow at 90°

Slowly raise the arm into external rotation hold for 5 secs, the hand should be moving away from you. If you can not raise the arm up, use the other hand to assist.

Remove helping hand and allow affected shoulder/arm to slowly lower back down to starting position.

How many times?

Once a day if it starts to get too easy do it twice a day.

Start with 3 sets and if it is too painful to do 10 resp decrease to 5 reps and as you increase in strength return back to 10 reps.

3 times a week

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Step-by-Step

Starting position is long sitting with resistance band loop around bottom of feet.

While grasping ends of band raise elbows at shoulder height.

Simultaneously rotate both shoulders externally- at end range mimicking a cactus in the hot Sonoran Desert.

With control slowly lower arms back to shoulder height for another rep. Be mindful of compensations throughout ROM of exercise- back extension & trunk flexion.

How many times?

2 sets x 12 repetitions

3 times a week

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Step-by-Step

With minimum to moderate weight prop elbow of dumbbell hand on a slightly inclined bench.

With elbow supported on bench edge rotate limb laterally.

Slowly internally rotate back to starting position.

With the weight of the dumbbell you can truly focus on the engagement of the external rotators of infraspinatus and teres minor muscle concentrically on the way up and eccentrically lowering it down.

Repeat as needed.

How many times?

3 sets x 10 repetitions

30-60 second rest/ reset between sets

3 times a week

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Step-by-Step

Stand with your entire back, head, and hips against the wall.

Bring arms up into a goalpost/field goal position, elbows at shoulder height, bent 90°.

Press elbows, wrists, and backs of hands into the wall.

Slowly slide arms upward, then back down, maintaining contact with the wall throughout.

How Many Times?

1-2 times a day

3 set 10 resp

3-5 times a week

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Progression of exercise in week 4 of IR of shoulder in side-lying with weight

Step-By-Step
• Lie on the unaffected side
• Affected arm resting on your stomach with elbow at 90° with weight
• Slowly raise the arm into external rotation hold for 5 secs, the hand should be moving away from you. With slow and controlled movement
• Use the affected arm unsupported now to bring the weight from start to finish position.

How Many Times?

1-2 times day

3 set 10 resp

3-5 times a week

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Step-by-Step

Anchor resistance band directly across from a 90 degree abducted shoulder & bent 90 degree flexed elbow knuckles pointing forward.

Adjust accordingly, but tension of band should be taught at this start position.

With control and speed, rapidly externally rotate shoulder into available active ROM & then slowly internally rotate eccentrically back to start position.

How many times?

3 sets of 60 second timed intervals

60 second rest in-between sets

3-5 times a week

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Step-by-Step

Seated in chair with feet planted securely on floor.

Neutral shoulders and elbows flexed to 90 degrees

Theraband folded in half then rolled in on itself to match shoulder width length- grab band with both hands.

With control/ speed, rapidly externally rotate both shoulders apart from each other at same time- be mindful to display equal strength/force in both limbs. Imagine splitting a newspaper clean down the middle.

Slowly internally rotate shoulders eccentrically back to start position.

How many times?

3 sets of 60 second timed intervals

60 second rest in-between sets

3-5 times a week

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Step-by-Step

1. Position Yourself

Stand approximately 2 feet away from the wall, facing sideways so the affected arm is closest to the wall.

2. Set Arm Position

Raise the affected arm to 90 degrees of shoulder abduction and 90 degrees of elbow flexion.

Ensure the forearm is parallel to the ground and facing the wall.

3. Perform the Movement

Using a small ball, gently toss it against the wall and catch it with the same hand.

Focus on controlled movement with a slight release and soft catch to promote shoulder and scapular control.

How Many Times?

-2 times a day

-One minute per round with rest between rounds.

-3 rounds

-4-5 times a week

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A regression to the Wall Ball Rotation Standing

Step-by-Step

1. Position Yourself

Lie prone with affected arm off the table/bed.

2. Set Arm Position

Raise the affected arm to 90 degrees of shoulder abduction and 90 degrees of elbow flexion.

Ensure the forearm is parallel to the ground and palm is facing the floor.

3. Perform the Movement

Using a small ball, gently toss it against the wall and catch it with the same hand.

Focus on controlled movement with a slight release and soft catch to promote shoulder and scapular control.

How Many Times?

-2 times a day

-One minute per round with rest between rounds.

-3 rounds

-4-5 times a week

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Purpose: The SSP assess upper extremity function and power

Assessment Type: Physical Performance Measure

Population: Age Ranges (18-64 Years)

Description: Subjects sits in standard armless 18 in. chair. Second chair is placed directly in front of 1st chair- to position hip, knee, ankles in straight line parallel to ground.

Subject places non-throwing arm across chest. Giving 6 lb. medicine ball and instructed not to throw overhand, but instead thrust in shot-put fashion.

3 maximal effort shot-puts are recorded. Two minute rest/ recovery is giving before testing opposite arm in same manner.

Healthy Recreationally Active Adult

Standard Error of Measurement

Dominant: SEM= 7 in.

Non-Dominant: SEM= 8 in.

Minimal Detectable Change

Dominant: MDC= 17 in.

Non-Dominant: MDC= 18 in.

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Purpose: The Constant-Murley Score is a standardized tool used to assess shoulder function by measuring pain, daily activity, range of motion, and strength. It helps track recovery, guide treatment, and compare outcomes in clinical and research settings.

PT or PTA will perform ROM reading with a goniometer and record measurements.

Populations:

Arthritis and Joint Conditions

Minimal Detectable Change (MDC):

Supraspinatus Tear (Henseler, et al., 2015)

MDC: 18

MCID for the entire group - 6.1

Normative Data: Supraspinatus Tear (Henseler, et al., 2015)

mean score: 44 (SD: 14.7)