Our shoulders are the bridge between the torso and the arms. Our arms are the gateway to our function, dexterity, expression and activities of daily life. When their use is impeded, it can hugely impact our quality of life. 

The shoulder joint is incredibly mobile, versatile and imperative for upper limb function. It can move in 3 planes of movement, with 9 singular movement patterns that can be combined to give us ultimate access to the world around us. Imagine you need to reach up and over the very top shelf to grab that final jam jar - without the flexibility and control at the shoulder, this movement would be impossible. 

Mobility vs stability

With greater mobility, comes reduced stability. The shoulder joint is a ball & socket joint but unlike the hip, there are some variations in its anatomy which give it more flexibility but decreased stability. For example, the socket is much shallower, the suction is therefore reduced and the ligaments are nowhere near as thick and strong. Therefore, the shoulder relies heavily on the musculature surrounding it to maintain stability. It also implements protective mechanisms to avoid damage (eg pain and stiffness). 

Struggling to reach behind your back to attack that itch or do up your bra? Can no longer reach the top shelf? Lack of range of motion is an indicator that the shoulder is protecting itself, 9 times out of 10 due to weakness. 

Adding resistance to your shoulder exercises is paramount to regain mobility AND stability. Give these 6 exercises a try!

1. Isometric Resistance Band Step Outs

This exercise is an amazing place to start when initiating strengthening work as the third and final stage of your shoulder rehabilitation. Remember, most injuries or ailments should be treated in a 3-stage approach; managing and reducing the pain, increasing range of motion and finally strengthening the area. Isometric muscle contractions are the perfect place to start when it comes to strengthening. The muscles contract without moving the joint through range which can help to prevent pain in the early stages. Ensure to hold your arm with your elbow pinched into your side and keep your forearm pointing forwards as you step out away from the resistance band. The band will want to snap your arm away from you, but as you resist this movement, the intrinsic muscles encapsulating the shoulder joint will contract isometrically. 

2. Shoulder Raises

The ability to reach up and over our heads is paramount to everyday function. This movement becomes increasingly difficult for people due to pain and stiffness at the shoulder. Both pain and stiffness can present due to common conditions such as osteoarthritis and adhesive capsulitis (frozen shoulder). By placing a resistance band around the wrists and pushing outwards to place tension on the band, you will activate the rotator cuff muscles which provide stability and increases space at the shoulder joint which often allows people to lift their arms higher above their head. You only need a really light resistance band initially to get that cuff engaged!

3. Shoulder Flexion

Similarly to the shoulder raise, the role of the resistance band during this exercise is to engage the rotator cuff whilst trying to lift the arms up overhead, this time keeping the elbows straight. Ensure the band is under tension for the entirety of the movement and you are likely to notice that your arms go higher than when trying this movement without the addition of the band. 

4. External Rotation

This exercise biases two of the rotator cuff muscles which are vital for shoulder stability; infraspinatus and teres minor. This exercise encourages the famous scapulohumeral rhythm. The shoulder blade and shoulder joint work in tandem to move the upper limbs seamlessly away from the trunk. If you notice that your shoulder blade protrudes or wings outwards, this exercise will be very beneficial to regain control!

5. Low Row

The muscles that sit between the shoulder blades are often lengthened and weakened due to the postures we adopt in our day to day life. As we croon over our phones and laptops, these muscles are underused and often atrophied. The low row aims to strengthen these muscles which can ultimately improve posture, allowing us to use our shoulder joint & shoulder girdle more efficiently.

6. Face Pulls

This exercise works alongside the low row, working the muscles between the shoulder blades. We also activate the rear portion of the deltoid muscle. This muscle is the powerhouse of the shoulder joint. We need the anterior, lateral and rear fibres of this muscle to be strong in order to ensure the joint is encapsulated by protective soft tissue. Think about squeezing your shoulder blades together each time you pull the resistance band towards your face.

A healthy shoulder joint is paramount to a good quality of life as it allows us to interact with our environment seamlessly and effortlessly. I hope these exercises can help those of you struggling with shoulder pain but remember to always consult a health professional in the first instance!

This blog is written by Lauren Jackson BSc (Hons) Physiotherapist HPC Registered. 

Lauren graduated from the University of East Anglia with a first class honours degree in Physiotherapy in 2020. After completing professional placements in a variety of specialities, she completed her last year of study working in the USA in a busy outpatient clinic, using innovative and advanced methods to treat a multitude of clients including athletes and post-operative patients.

Lauren incorporates manual therapy, therapeutic massage, rehabilitative exercise, gait re-education & valuable advice and support to address all kinds of conditions, to treat & prevent further musculoskeletal issues from arising.

Lauren is also a qualified gym & Pilates instructor and has qualifications in sports massage and sports taping which she utilises to aid her patients’ recovery. She has an avid passion for fitness & exercise so understands the importance of returning to full health as quickly as possible. Lauren is proficient in person-centred practice to ensure that her Physiotherapy treatment is tailored to her patients' goals and lifestyle.

Note: This article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.