Rotator Cuff Program

Rotator Cuff Program

Starting Position

Begin with your shoulder blades back in good position. Your knuckles should be pointed forward with weights in hand. Begin with only a one pound weight, and if a one pound weight is not available, you may use a can of soup.

Forward Flexion

  1. Raise arms to shoulder height as shown.
  2. Return to start position.
  3. DO NOT SHRUG SHOULDERS.
  4. Perform 3 sets of 15 repetitions, 2 times per day.
  5. Add two repetitions per time you perform the exercise until you reach 3 sets of 40.

 

Diagonal Flexion

  1. Raise weights so your arms are in a diagonal position, and make sure your arms are half way between out-in front of you and out to the side, as shown.
  2. DO NOT SHRUG SHOULDERS.
  3. Return to start position.
  4. Perform 3 sets of 15 repetitions, 2 times per day.
  5. Add two repetitions per time you perform the exercise until you reach 3 sets of 40.

Side Flexion

  1. Raise your arms out to your sides and bring to shoulder level, as shown.
  2. DO NOT SHRUG SHOULDERS.
  3. Return to start position.
  4. Perform 3 sets of 15 repetitions, 2 times per day.
  5. Add two repetitions per time you perform the exercise until you reach 3 sets of 40.

Extension

  1. Turn your hands so your palms are facing forward and knuckles are facing backwards.
  2. Squeeze your shoulders together and lift your arms slightly behind you, without allowing your shoulders to come forward.
  3. Lower your arms back to start position.
  4. Perform 3 sets of 15 repetitions, 2 times per day.
  5. Add two repetitions per time you perform the exercise until you reach 3 sets of 40.

External Rotation

Begin by lying on your side with the arm that is not against the floor tight on your side, elbow bent to 90 degrees, and palm resting on your stomach, as shown.
Rotate your arm upward, without taking your upper arm off of your side or rotating your shoulder.
Return your arm back to start position.
Perform 3 sets of 15 repetitions, 2 times per day.
Add two repetitions per time you perform the exercise until you reach 3 sets of 40.

Swiss Ball Program

Swiss Ball Program

Upper Back

Starting Position: Kneel behind ball and lie with trunk over ball. Fold hands and place them on the ball. Relax your neck and put your head on the ball.

Exercise: Dig toes into floor or place feet against wall. Straighten and bend knees to gently rock body forward and backward over ball. Allow head to hang.

Keeping arms extended, roll ball from side to side stretching shoulders. Hold 5 seconds on each side. Repeat 10 times.

 
 

 

From kneeling, stretch to one side. Hold 5 seconds. Repeat to opposite side. Repeat 10 times.

 
 

Roll ball forward and hold 5 seconds. Return to starting position. Repeat 10 times.

 
 
 

Bend arms and lift, pulling shoulder blades together. Hold 5 seconds. Repeat 10 times.

 
 

With stomach over ball and knees on floor, extend arms and lift to pull shoulder blades together. Hold 5 seconds. Repeat 10 times

 
 

Forearm Program

Forearm Program

Wrist Flexor Stretch

Stand with arms outstretched and fingers pointed down. Place palm against the wall at approximately waist height. Slowly move palm up wall until a stretch is felt in the forearm. Do not elevate shoulder during this exercise. Hold 10 seconds. Repeat 3 times on each arm. Perform 3 times a day.

Wrist Extensor Stretch

Stand with arms outstretched and fingers pointed down. Place the back of the hand against the wall at approximately waist height. Slowly move hand up wall until a stretch is felt in the forearm. Do not elevate the shoulder. Hold 10 seconds. Repeat 3 times on each arm. Perform 3 times a day.

Other Forearm Stretches

Begin with your elbow straight, palm facing away from you, and fingers pointed down. Loosely grasp your fingers with the opposite hand. Pull fingers back towards your body and hold for 10 seconds. Release and rest for a few seconds. Repeat 2 more times. Perform on the other arm.
Now, turn you forearm around so that your palm is facing you. Grasp hand behind the knuckles and pull back towards your body, holding for 10 seconds. Repeat 2 more times. Perform on other arm. Perform 3 times a day.

Hammer Stretch

Rest arm on table keeping elbow straight. Hold a hammer with the head of the hammer at the thumb side of the hand. Let the forearm rotate so the head of the hammer points toward the ceiling. Repeat 10 times with each arm. Perform 3 times per day.

Wrist Flexion Strengthening

Rest arm on table with palm facing up. Hold a 1lb. weight in hand or use a 16oz. can of food. Keeping elbow straight, bend wrist up as shown. Lower and repeat for 10 repetitions. Perform 3 times a day.

Wrist Extension Strengthening

Rest arm on table with palm facing down. Hold a 1lb. weight in hand or use a 16oz. can of food. Keeping elbow straight, bend wrist up as shown. Lower and repeat for 10 repetitions. Repeat 3 times a day.

Radial Deviation Strengthening

Rest arm on table with your thumb up. Hold a 1lb. weight in hand or use a 16oz. can of food. Keeping elbow straight, bend wrist up as shown. Lower and repeat for 10 repetitions. Perform 3 times a day.

Scapular Stabilization Program

Scapular Stabilization Program

Scapular Adduction

Pinch shoulder blades together as shown. Do not elevate shoulders.
Hold for 15 seconds. Repeat 3 times.

 

Shoulder Circles

Roll shoulders backward 15 times. Roll shoulders forward 15 times. Use a large range of motion.

Pectoralis Stretch

Stand as pictured in the corner of a room or in a doorway with your hands against the wall at shoulder height. Raise your elbows up so that they are even with the hands and shoulders. Elbows should be at 90 degrees and fingers pointing upward. Then take small steps into the corner until a stretch is felt. Hold for 30 seconds while taking deep breaths. Step back and relax arms. Repeat 3 times.

Pectoralis Stretch

Keep palm of hand against door frame and elbow bent to 90 degrees. Turn body from fixed hand until stretch is felt. Do not let  elbow come away from your side. Turn your head and look over the opposite shoulder. Hold 5 counts. Repeat 5 times on each side.

Towel Stretch

Roll up a towel and place vertically on a hard surface such as the floor. Lay on your back over the towel so that towel is placed between your shoulder blades. Lay your arms out to your side with palms facing up.

Wall Slide

Raise your arms to shoulder level. Bend elbows 90 degrees. Touch the wall with your arm, forearms, and hands. Slide your arms up the wall toward your head. Straighten your elbows as your arms move overhead.  STOP IF PAIN IS EXPERIENCED ON TOP OF YOUR SHOULDER. Hold position for 5 to 10 seconds. Return your arms to shoulder height.

10 reps two times a day. Add 1-2 reps each.

Arm Raise

Stand with your feet shoulder width apart. Turn your right palm down and left palm up. Arms are outstretched as if someone is pulling on your middle fingers. Hold arms out for as long as you can. (Time yourself to see how long you can do it.) When you cannot hold your arms out any longer, inhale and bring your arms above your head. Exhale and bring your arms down.

Perform two times per day.

CV4 Exercise

Lay on your back. Bend your knees and bring your knees together. Feet shoulder width apart. Place approximately 4” of books under “bump” on back of head. (Books should not touch your neck.) Eliminate all distractions if possible (TV, etc.) Close your eyes and deep breathe for 20 minutes.

Perform once per day before bedtime.

Partner Stretching

ITB Stretch

Support the leg at the shin and thigh and pull the leg across the body, not pulling from the ankle. Prevent the hip from rolling up off the table when crossing the leg by stabilizing the hip with your hand. Hold for 30 seconds. After 30 seconds, have the patient take a deep breath, and on the exhale, the partner is to push a little farther into the stretch. Hold for another 30 seconds. After 30 seconds, have the patient take a deep breath, and on the exhale, the partner is to push a little farther into the stretch. Hold for a final 30 seconds. Repeat on the opposite leg.

Side-lying ITB Stretch

Have the patient lie on their side while you stand or kneel behind them. Stabilize their hip with one hand. With the other hand grasp near the knee and pull the leg back into extension. Apply downward pressure on the thigh, pushing the knee toward the table or floor. DO NOT allow the hip to roll back. DO NOT allow the leg to rotate inward. Keep the hip and knee aligned as shown in the picture. The patient should feel a stretch on the outside of the thigh. Hold for 30 seconds. After 30 seconds, have the patient take a deep breath, and on the exhale, the partner is to push a little farther into the stretch. Hold for another 30 seconds. After 30 seconds, have the patient take a deep breath, and on the exhale,the partner is to push a little farther into the stretch. Hold for a final 30 seconds. Repeat on the opposite leg.

Hamstring Stretch

Support the leg by placing it on the partners shoulder. The partner should use their hand and place it above, not on, the knee cap to keep the leg straight. Hold for 30 seconds. After 30 seconds, have the patient take a deep breath, and on the exhale, the partner is to push the leg farther into the stretch toward the patients head, while keeping the leg straight. Hold for another 30 seconds. After 30 seconds, have the patient take a deep breath, and on the exhale, the partner is to push a little farther into the stretch. Hold for a final 30 seconds. Repeat on the opposite leg.

Hip Flexor Stretch

Lie on a bench with one leg hanging over the edge and pull your other knee up to your chest. Have a partner press downward on the thigh of the leg that is hanging downward. Hold for seconds. After 30 seconds, have the patient take a deep breath. On the exhale, push down, just slightly, on the thigh while also pushing the opposite leg closer to the patient’s chest. Hold for another 30 seconds.



Level 2 Swiss Ball Program

Opposite Arm & Leg

Begin by lying with your stomach on the ball. Keeping the ball very still and without arching your back, lift your right arm and your left leg at the same time. Lower both extremities back down and switch to the left arm and right leg. Repeat 10 times.

Same Arm & Leg

Begin by lying with your stomach on the ball. Keeping the ball very still and without arching your back, lift your right arm and your right leg at the same time. Lower extremities back down and switch to the left arm and left leg. Repeat 10 times.

Knee Bends on the Ball

Begin with the ball under your stomach and then walk forward on the ball until it is supported underneath of your shins. Focusing on keep your torso still and supporting your weight on your hands, bend your knees up toward your chest bringing the ball under belly button. Hold for one second and then slowly straighten your legs moving the ball back behind you. Repeat 5 times.

Bridging on the Ball

Lying on your back, place your calves and ankles on the ball with your legs tight together. Your arms can be on the ground to the side of you for support. Raise your buttocks off the ground, squeezing through your buttocks and tightening your core. Your body should make a straight line from the ground to the ball. Hold for 10 seconds keeping as still as you can. Then, lower back to the ground. Repeat 10 times.

Level 1 Swiss Ball Program

Ball Bounces

Sit on the ball in neutral position and bounce up and down for 2 minutes.

Pelvis Rotations

Gently rotate pelvis forward and backward, 10 times.

Gently rotate pelvis side to side, 10 times.

Gently rotate pelvis clockwise and then counterclockwise, 10 times each.

Opposite Arm & Leg

Slowly raise your left arm and right leg. Hold for one second and then slowly lower them back down. Focus on keeping the ball from moving and keeping your core tight. Switch to the opposite arm and leg and do the same thing on the other side. Repeat 10 times on each side.

Same Arm & Leg

Slowly raise your left arm and your left leg. Hold for one second and then slowly lower them back down. Focus on keeping the ball from moving and keep your core tight. Switch to the right arm and leg and do the same thing on the opposite side. Repeat 10 times on each side.

Twists

Sitting tall on the ball, extend your arms out to the side. Rotate through your torso keeping your legs and the ball still and turning so you are facing the wall to the side of you. Then, rotate through your torso to the opposite wall. Repeat 10 times.

Diagonal Twists

Sitting tall on the ball, start with one arm slightly bent to your side. Move the arm across the front of your body and over the opposite shoulder, rotating through your torso so that your shoulders turn as your arm moves across the body. The ball should not move. Repeat 10 times and then switch to the opposite arm rotating the opposite direction.

Face-down Ball Stretch

Begin by sitting on your knees, with your buttocks resting on your heels. Put your hands on the top of the ball and stretch the ball out in front of you as far as you can, pressing your chest toward the ground. Hold for 30 seconds.

Twist your torso to the lift, turning the ball on to its side so your hands reach toward the ground. Hold for 30 seconds.

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Twist your torso to the right, turning the ball on to the opposite side, so your hands reach toward the ground. Hold for 30 seconds.

 

Face-up Ball Stretch

Begin by lying on the ball with the ball placed underneath your shoulder blades. Your feet are flat on the ground and your knees are bent at a 90 degree angle. Stretch your arms out to the side and let them relax down over the ball. Take three deep breathes filling up your stomach with air each time you inhale.

Still lying on your back, lift your arms up closer to your ears. Allow your arms to fall over the ball and stretch toward the ground. Take three deep breathes filling up your stomach with air each time you inhale.

For the final position you will stretch your arms over your head towards your ears. Allow your arms to fall over the ball and stretch toward the ground. Take three deep breathes filling up your stomach with air each time you inhale.


Lower Abdominal Strengthening

Starting Position

Lying on your back with knees bent and feet flat on the floor. Pull your abdomen up and in as if you are tucking it under your ribs. Do not concentrate on pushing your back flat, but rather lengthening your torso while you pull your stomach up and in.

Phase 1

Keep your stomach pulled up and in. Slowly lift one leg and then the other. The abdomen must remain tight and do not allow it to pooch. This will ensure that the lower abdominal muscle is contracting and is strong enough to anchor the pelvis against the weight of the legs.

Phase 2

Repeat level one, but instead of placing the foot back down flat on the floor, slide one leg down and back keeping the heel of that leg on the ground the entire time. The opposite leg should remain bent position off the floor. Repeat on the opposite leg.

Phase 3

Repeat level one, but instead of sliding your leg down and back, glide your leg in the air, down and back. Be sure not to let your abdomen “pooch” or back arch while your leg is moving . The non-moving leg should remain in the flexed position elevated off the floor. Repeat on the opposite leg.

Patellar Femoral Program

Straight Leg Raise

Lying on your back, begin with on leg bent and the other one straight. Tighten the muscle of the straight knee so that it is ‘rock hard’. Lift the straight leg 6 inches, keeping it perfectly straight. Pause at the top and retighten the muscle. Lower the leg back to the ground, keeping it straight the entire time. Relax once it is on the ground. Repeat for 3 sets of 15 repetitions, on each leg. Rest for 1 minute between sets. Each time you do this, add 2 extra repetitions per set until you achieve 3 sets of 40. Once you have achieved 3 sets of 40, add a 1 pound ankle weight and start again at 3 sets of 20 repetitions. Build back up to 3 sets of 40. Do this once a day.

Short Arc Quad

Place an ankle weight on one leg. Position that leg over a pillow so that the pillow is underneath the knee, and the leg is bending about 30 degrees at the knee. Straighten the knee completely and tightening the muscle in that leg. Return the knee to the start position. Perform 3 sets of 10 repetitions, twice a day on each leg. Rest for 1 minute between sets.

Hip Adductor Strengthening

Lying on one side, bend the knee of the upper leg and place the foot flat on the floor in front of the lower leg. Keep the lower leg straight and lift the leg upward and then return to starting position. Try not to move the pelvic area during the leg lift. Perform 3 sets of 20 repetitions, once a day on each leg. Rest for one minute between sets.


Foot and Ankle Program

Seated Gastroc Stretch

Sitting on the ground with one leg out in front of you, loop a towel around the ball of your foot. Gently and steadily pull on the towel, keeping your knee straight. Hold for 30 seconds, then rest. Repeat 3 times and do twice a day on both feet.

Standing Gastroc Stretch

Stand facing the wall with your hands on the wall. Step one leg forward with a bent knee and foot on the ground. The other leg should remain straight with the heel on the ground. Lean your hips toward the wall. Hold for 30 seconds, then rest. Repeat 3 times and do twice a day on both feet.

Ankle Range of Motion – ABCs

Keeping your leg still slowly move your foot spelling out the alphabet. Do not let your hip or knee move. Spell out the entire alphabet and repeat twice a day on both feet.

Toe Intrinsic Strengthening

Begin by sitting on the floor with your leg straight. Pull foot back toward your shin while bending your toes downward. Then point your foot downward while separating your toes and upward. Repeat 30 times twice a day on both feet.

Toe Flexion – Towel

Seated in a chair begin by placing a towel on the floor under your foot with your heel on the ground. Without moving your heel, pull towel towards you using only your toes. Repeat 10 times, twice a day. on both feet.

Marble Pick-Up

Place 10 marbles on the floor to the side of your foot. Pick up each marble, one at a time and place them on other side of the foot. Perform 3 sets of 10 repetitions, twice a day on both feet.

Single Leg Standing

Stand in between a doorway for balance as needed. Stand on one leg with the foot of the other leg braced against the inside of the lower thigh and knee with the knee of that leg pointed out to the side. With your eyes open stand trying to keep your balance, without using arm support, for 60 seconds. Then repeat the same pose for 30 seconds with your eyes closed. Repeat on the opposite leg. Do each of these five times on each leg once a day.

Lower Quarter Stretching

Seated Hamstring Stretch

Sit on the edge of one chair with one leg straight and resting on another chair of the same or lesser height. Sit up perfectly straight and keep your head up. You can use a towel wrapped around your foot, as shown, to help keep your back straight. Begin to lean forward from your hips KEEPING YOUR BACK STRAIGHT AND HEAD UP until a stretch is felt in the back of your thigh. Maintain this position of stretch for 30 seconds. After 30 seconds, take a deep breath, exhale, and stretch from that position a little further until you feel the stretch a little more into the hamstring region. Maintain this position for 30 seconds. Repeat one more time. Do the same on the other leg

Repeat 3 times a day.