Here are the 6 core exercises our resident Physical Therapist, Tim Conley, uses for his patients. These follow the structure of the Moon Program, focusing on Range of Motion, Flexibility, and Strengthening. “These exercises are ideal for patients who are just starting to feel a little bit of pain in their shoulder. These are exercises to first increase flexibility in the muscles around the front of the body that limit flexibility and pull the individual into a forward head and rounded shoulder posture. Then there are 3 exercises to improve scapular strength and improve posture.”
Exercise #1: Chin Tuck
Have the patient stand up against a wall and place their heels at the base of the wall. Then have them take their hand and place it behind them on the small of their back with the palm against the wall, activate the core muscles. Finally, have them work, without arching their back, to have the base of their skull touch the wall. As they work towards this, make sure their chin tucks into their chest.
During this exercise, they are strengthening their posterior muscles while stretching their anterior muscles. Hold each for a count of 10 seconds and repeat 15 times.
This can be done with the patient sitting in a car with a head rest as well.
Exercise #2: Snow Angel
Have the patient lie on their back, with their arms outstretched. With their palms facing up, have them slide their arms up over their head without letting their elbows leave the ground. Have them go as far up as they can and hold that position for 15-20 seconds then slowly release back to starting position. Repeat 3-5 times
This can be done with them standing against the wall. The key is do not let the elbows leave the surface they are touching.
Exercise #3: Door Stretch
Have the patient stand in a doorway and place their forearms against the door frame with their elbows at shoulder height. Have them step forward with one foot, bringing their body through the doorway and pinching their shoulder blades together. Hold that position for 15-20 seconds and then slowly step back to starting position. Repeat 3-5 times.
Exercise #4 Shoulder extension with Scapular Retraction
Using an exercise band or tubing with a door anchor (Thera-Loop) , secure the anchor in the top of the door jam. Have the patient hold the ends of the band or tubing in each hand while facing the door. Standing with a neutral spine have them bring their hands down past their hips, while pinching their shoulder blades. The patient will repeat that 15-30 times.
Exercise #5 Low Row
Using an exercise band or tubing with a door anchor (Thera-Loop), secure the anchor above the top door hinge. Have the patient grasp the banding or tubing in each hand facing the door, stand with a neutral spine, and pull arms back keeping their elbows close to their body and moving them past their side. As they pull back, make sure they are squeezing their shoulder blades together, and then slowly release. Repeat 15-30 times.
Exercise #6 Scapular Depression or Dips
Using an exercise band or tubing with a door anchor (Thera-Loop) , secure the anchor in the top of the door jam. With the patients back to the door, have them hold the exercise band or tubing in each hand, and have them press their shoulder blades together against door. Have them shrug their shoulders up and then press down against the resistance of the band or tubing. Repeat 15-30 times.
Tim notes that the times and reps he has stated here are not set in stone. “We are working on stretching and strengthening patient’s muscles to gain improved Range of Motion/Flexibility and Postural Strength. In stretching, we want to make sure they are moving slowly and holding so that the muscle has time to relax into the stretch. If they go to quickly the muscle will retract and result in a worse injury. In strengthening, my focus is to work against a moderate resistance, but perform higher repetition, to build endurance for sustained posture.”