Assessment
Improving range of motion starts with an assessment. An assessment is essential for the following reasons:
- Identifying the specific shoulder mobility restrictions present
- Determining what needs improvement and what doesn’t
- Obtaining baseline measurements to track progress
- Identifying which specific structures are causing the deficit—whether it’s the muscle, the joint capsule, the joint itself, or something else
Stretching Exercises
Based on the assessment, if muscle tightness is identified as a contributing factor to the range of motion restriction, stretching may be prescribed. Some common shoulder girdle muscles that benefit from stretching include: latissimus dorsi, pectorals, anterior deltoid, and subscapularis.
There are numerous variations of stretching exercises for each muscle group, as well as types of stretching (e.g. static, dynamic, ballistic, PNF). Additionally, the programming of these stretches (e.g. number of sets, hold time, repetitions, frequency per week) should be tailored to the individual (e.g. stretching experience, strength, injury history, pain presence, motivation, time, and available resources).
What all these programs have in common is that stretches should be performed consistently for more than 4-6 weeks to see benefits. For reference, the most straightforward stretching protocol typically prescribed to beginners is holding a static stretch for 3 sets of 30-60 seconds daily.
Strengthening/Mobility/Range of Motion Exercises
Range of motion deficits often occur due to weakness in addition to muscle tightness. Non-stretching-based exercises may be prescribed in these cases. Common shoulder exercises in this category include:
- Y, T, W movements
- Stick dislocations
- Skin the cat
- Lower trap raises
- Shoulder external rotation exercises
These exercises are typically prescribed similarly to resistance exercises. A simple program would be: 3 sets of 8-12 repetitions for a 6-week period, progressively increasing in difficulty.
Application
Most people have a specific goal in mind when wanting to improve their shoulder range of motion. Common goals include:
- Performing activities of daily living (e.g. washing hair, reaching for the top cupboard, putting on a bra)
- Improving posture
- Sports-specific tasks (e.g. handstands, tennis serve, weightlifting, injury prevention)
While performing exercises to improve shoulder range of motion, it’s essential to practice using the newly gained mobility in tasks specific to your goal.
Reassessment
Perform the same assessments as you did before the program and compare the results. If improvements are satisfactory and your goal has been achieved, the program can be stopped. If improvements are satisfactory but your goal hasn’t been met, continue with the same program. If improvements are unsatisfactory, consider adjusting the program.
Summary
As with any treatment approach, a systematic method should be used when exercising to improve shoulder range of motion. Begin with an initial assessment, followed by a 4-6 week program designed to address the limiting factors identified in the assessment, then conclude with a reassessment. For a detailed assessment to improve your shoulder range of motion, reach out to our qualfied physiotherapists.
