Shoulder and Elbow

Instability Exercises

These exercises ore designed to strengthen the internal rotators (against anterior dislocations), external rotators (against posterior dislocation), and deltoid (against inferior dislocation) but without causing irritation of the glenohumeral joint.  Since the lower portions of the; internal and external rotators are also depressors of the humeral head, these same exercises may be used to relieve subacromial impingement for tone against the ascent of the head (upward instability).

In either case, no exercise should be done with such force as to cause pain. With each movement set the muscles five seconds and relax five seconds. Repeat each exercise five times. One or two exercise sessions are advised daily as directed.

1. INTERNAL ROTATORS: Hold the elbow forward well in front of the shoulder and bent 90°, grasp the wrist with the good hand, attempt to rotate the weak arm inward pressing against the good hand. (Note: the good hand is supported by the front of the chest).

2. EXTERNAL ROTATORS: Hold the elbow straight down at the side and bent 90. Grasp the wrist with the good hand and attempt to rotate the weak arm outward against the good hand. Do not allow the elbowto drift backward of the dotted line.

3. INTERNAL ROTATORS & EXTENSORS: Hold the elbow forward well in front of the shoulder and bend 90 degrees, loop rubber around door knob and hand, hand in front of chest. Lean back to generate resistance and hold for five seconds.

4. EXTERNAL ROTATORS & MIDDLE DELTOID:   Hold the elbow off the sides and bend 90 degrees. Loop rubber around wrists, move arms apart equally, while looking in a mirror. Hold for five seconds. Do not allow elbows to drift backward of the dotted lines shown in Fig.2.

5. ANTERIOR 6. MIDDLE DELTOID & SUPRASPINATUS:   Loop the rubber around a low cabinet knob, hold with the bent arm in front, raise the arm forward and upward (like an upper cut), hold 5 seconds.