6 science-based physical therapy exercises for shoulder pain (2024)

Are you wondering what physical therapy exercises for shoulder pain you can do to relieve your shoulder pain?

In this article, I present six exercises that have been tested by scientific research. And as a bonus:

• I answer the question “Is it really effective?”
• For those who are a bit lazy, I also talk about an alternative to exercises, which has also been scientifically tested!

Happy reading! 🙂

(Any questions, remarks, or experiences to share? Your comments at the bottom of the article are welcome!)

♻️ Last update : February 2024. Written byAlbin Guillaud, physical therapist and PhD in public health
👨‍⚖️ Disclaimer : no affiliate links. Complete disclosure in legal notices.

Six shoulder physical therapy exercises tested by science

Here, I describe 6 exercises for shoulder pain (or rotator cuff tendinopathy / tendonitis).

These exercises have been tested by a Danish research team composed of physical therapists and physicians (Ingwersen, 2017).

These exercises are part of a supervised rehabilitation program lasting 12 weeks. This program consists of 30 sessions to be done at home alone and 6 sessions supervised by a physical therapist:

⚫ The first session lasts 60 minutes where the physical therapist teaches the person:

• The general instructions for all exercises

• Each of the 6 exercises, along with their specific instructions.

⚫ Five sessions last 30 minutes where the person performs the exercises under the supervision of the physical therapist. These sessions take place in the 2^nd, 3^rd, 4^th, 6^th, and 9^th weeks of the program.

The home exercise sessions are to be performed at a rate of 3 sessions per week, except for weeks that include a physical therapy session: during these weeks, only 2 home sessions are required.

General instructions

Movements should be performed slowly enough so that you feel like you are controlling your movements well.

The 6 exercises are to be done at a rate of 3 sessions per week for 12 weeks.

⚫ If you experience pain during an exercise, don’t panic, as long as:

1. The pain is mild to moderate; between 0 and 5 on a scale of 0 to 10
2. This pain disappears immediately at the end of the exercise.

⚫ Regarding the end of the session:

1. If your post-session pain is greater than before the session, then it should return to its initial level within a maximum of 30 minutes
2. Your pain should not increase in the days following the session.

If you cannot control your pain despite following these instructions, contact your physical therapist.

All these rules apply similarly if you are taking painkillers.

Exercise n°1: Round the back, puff out the chest

➡️ Starting position: Standing

➡️ Movement instructions (see images 1 & 1 bis):

1. Round your back by projecting your shoulders forward
2. Then puff out your chest by pulling your shoulders backward (aiming to squeeze the shoulder blades together)
3. Hold the position for 5 deep breaths (approximately 15 seconds)
4. Completely release your shoulders (in other words, return to a normal position).

➡️ Work load: Repeat this movement 3 times with approximately 30 seconds of rest between each repetition.

If the pain is too intense, try reducing the range of motion. In other words, project your shoulders less far forward and backward each time.

Exercise n°2: Stretching the back of the shoulder

➡️ Starting position: Standing

➡️ Movement instructions (for example, to work the right shoulder; see image 2):

1. With your right hand, grab your left shoulder
2. Raise your right elbow until it’s horizontal
3. Grab your right elbow with your left hand from behind, at the level of the arm (not the forearm)
4. Now pull your arm backward.

➡️ Work load: Hold the position for approximately 15 seconds (or 5 deep breaths). Then completely release your arm along the body.

Repeat this 3 times with 30 seconds of rest between each repetition.

Exercise n°3: Strengthening the front of the shoulder

➡️ Starting position: Standing, back straight, shoulders slightly back

➡️ Equipment needed: a dumbbell whose weight can vary as you progress (see the adjustment instructions below)

Note: any type of weighted object can work. For example, you can use a water bottle that you fill more or less to adjust the difficulty.

➡️ Movement instructions (for example, to work the right shoulder; see images 3 & 3 bis):

1. Hold the dumbbell in your right hand, arm down by your side, palm slightly facing forward.
2. Lift the dumbbell up to horizontal if you can. Be careful not to raise the right arm in front of you or to the side. Aim to be halfway between these two options.
3. With each movement, aim to take about 2 seconds to lift and 2 seconds to lower.
4. When you reach the bottom, stop your arm just before the completely relaxed position, then raise it again for the next repetition.

➡️ Work load: 3 sets of 20 to 25 repetitions (your choice) with 30 seconds of rest between each set.

➡️ Instruction for adjusting the weight of the dumbbell: You should use a weight that does not allow you to do more than the required 20 or 25 repetitions.

The assistance of your physical therapist during supervised sessions can be valuable in determining the starting load and adjusting it according to your progress.

Exercise n°4: Strengthening the back of the shoulder

➡️ Starting position: Lying on the side on a firm support (for example, a mat on the floor), back straight, and legs slightly bent for stability.

➡️ Equipment needed: a dumbbell whose weight can vary as you progress (see the adjustment instructions below).

Note: any type of weighted object can work. For example, you can use a water bottle that you fill more or less to adjust the difficulty.

➡️ Movement instructions (for example, to work the right shoulder; see images 4 & 4 bis):

1. Dumbbell in the right hand, your elbow is tucked against your side and forms a right angle, your forearm rests against your belly.
2. While keeping your elbow in the position described above, you will lift the dumbbell as high as possible towards the ceiling (if you are flexible enough for that; it’s not my case!)
3. With each movement, aim to take about 2 seconds to lift and 2 seconds to lower.

When you are near the end of the descent, stop just before, then raise it again for the next repetition.

➡️ Work load: 3 sets of 20 to 25 repetitions (your choice) with 30 seconds of rest between each set.

➡️ Instruction for adjusting the weight of the dumbbell: You should use a weight that does not allow you to do more than the required 20 or 25 repetitions.

The assistance of your physical therapist during supervised sessions can be valuable in determining the starting load and adjusting it according to your progress.

Exercise n°5: Punching towards the sky

➡️ Starting position: Lying on your back on a firm support (for example, a mat on the floor), knees bent at approximately a right angle.

➡️ Equipment needed: a dumbbell whose weight can vary as you progress (see the adjustment instructions below)

➡️ Movement instructions (for example, to work the right shoulder; see images 5 & 5 bis):

1. Dumbbell in the right hand, arm extended vertically towards the ceiling. You can use your other arm to help you reach this position. The back of your shoulder rests against the floor.
2. Imagine trying to bring the dumbbell as close as possible to the ceiling by lifting your shoulder off the floor. Note: only the shoulder should move; your back should remain still.
3. With each movement, aim to take about 2 seconds to lift and 2 seconds to lower.
4. When you come back down, stop your shoulder just before the completely relaxed position, then raise it again for the next repetition.

➡️ Work load: 3 sets of 20 repetitions with 30 seconds of rest between each set.

➡️ Instruction for adjusting the weight of the dumbbell: You should use a weight that does not allow you to do more than the required 20 repetitions.

The assistance of your physical therapist during supervised sessions can be valuable in determining the starting load and adjusting it according to your progress.

Exercise n°6: Pulling the elastic band

➡️ Starting position: Standing or sitting

➡️ Equipment needed: Elastic band (also called power band or resistance band; in images 6 & 6 bis, I use an elastic taken from a modular exerciser).

➡️ Setup: The band is attached in its middle to a fixed point, roughly at shoulder height (see images 6 & 6 bis).

You should be able to pull both ends downwards and backwards, over a distance allowing the described movement below.

➡️ Movement instructions:

1. You are seated about 1.5 m from the attachment point of the elastic band.
2. Keep your back straight, shoulders slightly back, and hold both ends of the band in your hands.
3. With arms extended, pull both ends of the band until your arms are alongside your body.
4. With each movement, aim to take about 2 seconds to descend and 2 seconds to ascend.
5. When you are close to the starting position upwards, stop just before the completely relaxed position, then lower for the next repetition.

➡️ Work load: 3 sets of 15 to 25 repetitions (your choice) with 30 seconds of rest between each set.

➡️ Instruction for adjusting the difficulty: You should grip the elastic band in a way that you cannot do more than the required 15 to 25 repetitions.

If it’s too easy, grab the band a little higher on the right and left for more resistance. If it’s too hard, use a more flexible band.

The assistance of your physical therapist during supervised sessions can be valuable in determining the elastic band to select and where to grip it.

Sources: Ingwersen, 2017

Effectiveness of physical therapy exercises for shoulder pain

What you need to know:

✅ Physiotherapy exercises are effective in (moderately) relieving shoulder pain lasting more than 3 months in the medium and long term.

✅ For shoulder pain of less than 3 months, it is uncertain whether physical therapy is beneficial.

✅ For shoulder pain of more than 3 months, physical therapy exercises are as effective (or not more effective) as educational sessions including:

• Knowledge about the anatomy and functioning of a normal shoulder.
• Information about how pain works.
• Advice for better pain management.
• Information about stress and its management.
• Advice and information on lifestyle (physical activity, sleep, and nutrition).

✅ At equal effectiveness, educational sessions require much less time and investment than physical therapy exercises.

Regarding this last point, a study recently compared two programs [Dubé, 2023]:

This study found that these two programs were equally effective in the medium and long term.

In other words, with the right amount of information and education, we can achieve the same effects as exercises while spending less time and energy!

Now, all you have to do is find a physical therapist who supports this approach… (not necessarily easy).

If you have any questions, remarks, or experiences to share, feel free to do so in the comment section below! 🙂

📚 SOURCES

Ingwersen KG, Jensen SL, Sørensen L, Jørgensen HR, Christensen R, Søgaard K, Juul-Kristensen B. Three Months of Progressive High-Load Versus Traditional Low-Load Strength Training Among Patients With Rotator Cuff Tendinopathy: Primary Results From the Double-Blind Randomized Controlled RoCTEx Trial. Orthop J Sports Med. 2017 Aug 28;5(8):2325967117723292. doi: 10.1177/2325967117723292. PMID: 28875153; PMCID: PMC5576542.

DubéM,DesmeulesF,LewisJS, et al Does the addition of motor control or strengthening exercises to education result in better outcomes for rotator cuff-related shoulder pain? A multiarm randomised controlled trial British Journal of Sports Medicine2023;57:457-463. doi: 10.1136/bjsports-2021-105027.

Franco ESB, Puga MEDS, Imoto AM, Almeida J, Mata VD, Peccin S. What do Cochrane Systematic Reviews say about conservative and surgical therapeutic interventions for treating rotator cuff disease? Synthesis of evidence. Sao Paulo Med J. 2019 Nov-Dec;137(6):543-549. doi: 10.1590/1516-3180.2019.0275160919. PMID: 32159641; PMCID: PMC9754280.

Written by Albin Guillaud

Physical Therapist and PhD in public health, I really want to give you the best answers possible. For this, I willingly dive into the depths of the international scientific literature.

Between deep dives, I love exploring the beautiful Alpine mountains around me! 🌞❄️

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