Shoulder Instability  Advance Rehabilitation Programme 

Working on speed of muscle activation, plyometrics, deceleration of fast movement

Drop & catch 1kg weight at 90° scaption. Aim 100 reps. Progress to doing the exercise with eyes closed or standing on one leg.

  Aim 100 reps. Progress to doing the exercise with eyes closed or standing on one leg. Drop & catch 1kg weight in AER (anterior instability) or AIR (posterior instability). Aim 100 reps

AER

AIR

Falling press up in standing. Aim 50 reps.

 The patient falls against the wall and uses 2 hands to absorb the impact. They then push away fast from the wall to the original standing position.

Falling press up to waist level. Aim 50 reps. 

 

The patient falls against their kitchen worktop and uses 2 hands to absorb the impact. They then push away fast from the wall to the original standing position.

Plyometric push up with hand clap. Aim 20 reps.

 

Doorway fall. Aim 20 reps.

 The patient stands one step away from a doorway. They fall through the doorway and catch their bodyweight with two hands on the frame of the door. They then explosively push back up to the original standing position.

1:    Working on speed of muscle activation, plyometrics, deceleration of fast movement 

         

      Prescribe maximum repetitions until fatigue or the specified target. 👉Two sessions per day. 

  Target Reps 

Drop & catch 1kg weight at 90° scaption   Target Reps100 

Drop & catch 1kg weight at 90° scaption on 1 leg (opposite side)   Target Reps100 

Drop & catch 1kg weight at 90° scaption with eyes closed   Target Reps100

 Drop & catch 1kg weight in AER/AIR  Target Reps 100

 Falling press up in standing   Target Reps50

 Falling press up to waist level   Target Reps50 

Plyometric push up with hand clap   Target Reps 20

 Doorway fall   Target Reps 20 

 Ⅱ 👉Working on proprioception, muscle balance, trunk stability

Single handed ball roll on wall. Aim 60 seconds.

The patient leans on a ball in a standing position. They roll the ball up and down slowly and as smoothly as possible. Once they can do this easily for 60 seconds they progress to the next exercise.

 

Single handed kneeling crosses. Aim 60 seconds.

The patient kneels and weight-bears on their affected arm. They shift their bodyweight through the affected arm by pointing with the other hand in the shape of a cross.

Kneeling single handed ball roll. Aim 60 seconds.

The patient kneels with their weight on a ball. They roll it up and down slowly and as smoothly as possible. Once they can do this easily for 60 seconds they progress to the next exercise.

Single handed crosses in push up position. Aim 60 seconds. 

The patient starts in a one-handed press up position weight-bearing on the affected arm. They shift their bodyweight through the affected arm by pointing with the other hand in the shape of a cross.

Double handed ball roll in push up position. Aim 60 seconds.

The patient adopts a press up position with their hands on a ball. They aim to do a smooth slow rolling action up and down for 60 seconds.

 Double ball roll in push up positions. Aim 60 seconds

The patient adopts a press up position with each hand on a ball. One ball is rolled upwards whilst simultaneously rolling the other downwards and vice versa

2: Working on proprioception, muscle balance, trunk stability

         Prescribe 5 repetitions of the patient’s maximum ability or specified target time. 

 👉Two sessions per day.

Single handed ball roll on wall 60s target time. 

 Single handed kneeling crosses 60s target time. 

Kneeling single handed ball roll 60s target time. 

Single handed crosses in push up position 60s target time. 

 Double handed ball roll in push up position 60s target time.  

Double ball roll in push up positions 60s target time. 

 Note: For patients with significant posterior instability modify the position for the single hand exercises to do with the shoulder in an abducted rather than flexed position. 

Assumptions: Normal isometric muscle power 

                       No true scapula winging

                       Normal gym ball sitting balance

>Only prescribe one exercise from each section at any one time. Each set of exercises is listed in order of treatment progression and can also be used for functional assessment. If the patient can achieve the target then progress to the next exercise.