Exercise program for painful shoulder
Exercise program for painful shoulder (supraspinatus tendinopathy, subacromial syndrome, frozen shoulder). Shoulder rehabilitation requires patience — improvement is gradual over weeks. Progressive loading exercise is the treatment with the strongest evidence for rotator cuff tendinopathies.
Warning signs — consult your physiotherapist if you experience:
- •Pain radiating to the hand or causing tingling in the fingers
- •Complete inability to raise the arm (cannot lift it away from the body)
- •Shoulder that dislocates or feels unstable
- •Intense night pain that prevents sleep in any position
Phase 1 — Pain reduction
Goal: reduce pain and restore passive mobility. Gentle movements within the pain-free range. Do not raise the arm above shoulder level during this phase.
Codman pendulum
2 minutes in each directionLeaning forward with your healthy hand resting on a table, let the affected arm hang and swing it gently in small circles (like a pendulum). Clockwise and counterclockwise.
The arm should be completely relaxed — gravity does the moving.
Table slide
3x15 repetitionsSeated at a table, place your forearm on a towel and slide your hand forward (shoulder flexion) as far as is comfortable. The towel makes sliding easier.
External rotation with stick
3x15 repetitionsStanding with elbows close to your body and bent at 90 degrees, hold a stick with both hands. Use the healthy hand to push the affected hand outward (external rotation). Gentle movement.
The elbows must NOT lift away from the body at any point.
Scapular retraction
3x15 repetitionsStanding or seated, squeeze your shoulder blades back and down (as if trying to tuck them into your back pockets). Hold for 5 seconds and relax.
Do not shrug your shoulders toward your ears — the movement is back and down.
Phase 2 — Isometric and concentric strengthening
Goal: begin loading the tendons progressively. Mild discomfort (3-4/10) during the exercise is acceptable. It should not hurt more afterward.
External rotation with band
3x15 repetitions each armStanding, elbow close to the body and bent at 90 degrees. Hold a resistance band and rotate your forearm outward against the resistance. Return slowly (3 seconds).
The slow return (eccentric phase) is the most important part of the exercise.
Internal rotation with band
3x15 repetitionsStanding, band anchored to the side. Elbow close to the body, pull the band by rotating your forearm toward your abdomen. Return slowly.
Lateral raise to 90 degrees
3x12 repetitionsStanding with a light weight (0.5 L bottle), raise your arm away from your body to 90 degrees (horizontal). Lift in 2 seconds and lower in 4 seconds. Thumb slightly pointing upward.
If it hurts before 90 degrees, raise only as far as pain-free and increase progressively.
Shoulder flexion on wall
3x10 repetitionsStanding facing the wall, walk your hands up the wall (finger-walking) as far as you can without pain. Hold for 5 seconds at the top.
Phase 3 — Functional strengthening
Goal: regain full strength and return to overhead activities (hanging laundry, reaching shelves, sports). Only when you can raise the arm without pain.
Dumbbell shoulder press
3x12 repetitionsSeated or standing, weight in hand at shoulder height. Push upward until your arm is fully extended. Lower slowly (4 seconds). Start with 1-2 kg and progress.
Row with band
3x15 repetitionsBand anchored in front of you. Pull back with both arms, squeezing your shoulder blades together. Elbows close to the body. Return slowly.
Eccentric lateral raise
3x10 repetitionsRaise the arm with help from the healthy hand to 120 degrees (with a light weight). Lower VERY SLOWLY using only the affected arm (5-second descent). This is a pure eccentric — the best evidence-based approach for tendinopathy.
The slow descent should produce a tolerable discomfort (4/10). If it is painless, increase the weight.
Waiter exercise
3x12 repetitionsStanding, arm at 90 degrees of flexion and elbow at 90 degrees, as if carrying a tray. With a light weight in your hand, rotate the forearm outward and inward in a controlled manner.
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