Shoulder Pain: exercise plan
Sore shoulders get better with load, not cotton wool. This plan builds up the small muscles that steady the joint, one sensible step at a time.
- Pain rules: pain up to 5/10 during exercise is acceptable. After each session your pain should settle back to its usual level. If it doesn’t, use a lighter weight next time.
- How often: strength exercises twice a day for the first 8 weeks, then once a day for weeks 8–12. The stretch is twice a day.
- How long: give it at least 12 weeks, then keep doing the exercises daily for another 2 months.
- Progress when: all 3 sets of 15 are manageable within the pain rules. Add weight or use a firmer band.
- Based on: the exercise program from a Swedish shoulder trial (Holmgren, BMJ 2012) and a 2021 review of rotator cuff rehabilitation.
Your exercises
- Slow lowering: outward rotationLie on your good side with the sore elbow bent to 90° and tucked against your ribs, holding a light weight. Use your other hand to help rotate the forearm up towards the ceiling, then lower it slowly on its own.3 sets of 15, twice a day
- Slow lowering: arm raiseStanding, thumb up, raise your arm halfway between straight ahead and out to the side, up to shoulder height. Help with your other hand if needed, then lower slowly on its own. Start with no weight, then add a light one.3 sets of 15, twice a day
- Band rowLoop a resistance band around a door handle. Pull your elbows back past your ribs, squeezing your shoulder blades together and down, then return slowly. Progress with a stronger band.3 sets of 15, twice a day
- Wall push-up plusHands on a wall at shoulder height. Do a slow push-up, and at the top push a little further so your shoulder blades spread around your ribs. Progress to a kitchen bench, then a lower surface.3 sets of 15, twice a day
- Face-down arm liftLie face down on the bed with the sore arm hanging over the edge. Keeping the shoulder blade drawn down, lift the arm forwards and up in a ‘Y’ shape, thumb up. Start with no weight.3 sets of 15, twice a day
- Back-of-shoulder stretchBring the sore arm across your chest and gently pull at the elbow with your other hand until you feel a stretch at the back of the shoulder.Hold 30–60 seconds, 3 times, twice a day
Form tips: keep your upper back tall and shoulders gently back during every exercise. Slow and controlled beats fast and heavy. Weights can be dumbbells, water bottles or a tin of beans to start.
Stop and see your GP or physio if
- You suddenly can’t lift your arm after an injury or fall (see your GP within a few days)
- A hot, red, swollen shoulder, or fever (same day)
- Shoulder pain with chest pain, shortness of breath or sweating (call 000)
- Numbness or tingling in your arm, or neck pain spreading down the arm
- Your shoulder is getting stiffer in every direction, not just painful
- No real improvement after 12 weeks of regular exercise
Want a supervised program?
A physio can check your technique, set the right weights and adjust the plan at regular reviews (the original program had a physio check-in every 2 weeks). An exercise physiologist can help with gym and work loading. If you have a chronic condition, ask your GP about a GP Chronic Condition Management Plan (GPCCMP): it gives a Medicare rebate for up to 5 allied health visits a year (physio, exercise physiologist or podiatrist).
Evidence and more information
- Holmgren et al, BMJ 2012: specific exercise strategy and need for surgery in subacromial impingement
- J Clin Orthop Trauma 2021: Current concepts in the rehabilitation of rotator cuff related disorders
maladywise.com/exercises/shoulder/