Exercise Booklet

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Weight-bearing forearm stretch
Therapist`s aim
To maintain or improve range of motion and stretch tight tissue in the
forearm and wrist.
Client`s aim
To stretch tight tissue in the forearm and wrist.
Therapist`s instructions
Instruct the patient to lean forward with hands supported on a wall.
Ensure hips remain extended.
Client`s instructions
Lean forward with your hands supported on a wall. Ensure that your
hips remain extended.

Passive shoulder flexion post shoulder surgery

Therapist`s aim
To maintain or improve range of motion of the shoulder.
Client`s aim
To maintain or improve range of motion of your shoulder.
Therapist`s instructions
Position the patient sitting in a chair with their arm out of the sling.
Use an assistant to slowly lift the arm into shoulder flexion. Ensure
that the movement is passive and that the patient does not assist at
all.
Client`s instructions
Position yourself sitting in a chair with your arm out of the sling. Use
an assistant to slowly lift the arm forwards. Ensure that the assistant
performs the movement and that you remain relaxed.

Hand behind the back

Therapist`s aim
To stretch or maintain length of the shoulder muscles.
Client`s aim
To stretch or maintain range in your shoulder muscles.
Therapist`s instructions
Position the patient holding on to a towel behind their back. Instruct
the patient to straighten their top arm. Instruct the patient to pull on
the towel to bring their bottom arm higher up their back.
Client`s instructions
Position yourself holding on to a towel behind your back. Straighten
your top arm. Pull on the towel to bring your bottom arm higher up

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 your back.
Progressions and variations
Less advanced: 1. Decrease the stretch. More advanced: 1. Increase
the stretch.

Neck flexor/extensor stretch

Therapist`s aim
To stretch or maintain range of the neck.
Client`s aim
To stretch or maintain range of your neck.
Therapist`s instructions
Position the patient with their head facing forwards. Instruct the
patient to flex then extend their neck.
Client`s instructions
Position yourself with your head facing forwards. Bend your neck
forwards then straighten your neck upwards.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.

Neck lateral flexor stretch

Therapist`s aim
To stretch or maintain length of the lateral neck flexors.
Client`s aim
To stretch or maintain length in the muscles at the side of your neck.
Therapist`s instructions
Position the patient with their head facing forwards. Instruct the
patient to laterally flex their neck to bring their ear towards their
shoulder. Ensure that the head faces forwards.
Client`s instructions
Position yourself with your head facing forwards. Move your neck to
the side to bring your ear towards your shoulder. Ensure that your
head faces forwards.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.

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Neck rotator stretch
Therapist`s aim
To stretch or maintain length of the neck rotators.
Client`s aim
To stretch or maintain length in the muscles at the side of your neck.
Therapist`s instructions
Position the patient with their head facing forwards. Instruct the
patient to rotate their head to the side. Ensure that the head remains
upright.
Client`s instructions
Position yourself with your head facing forwards. Turn your head to
the side. Ensure that your head remains upright.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.

Neck stretch
Therapist`s aim
To stretch or maintain length of the lateral neck flexors.
Client`s aim
To stretch the muscles on the side of your neck.
Therapist`s instructions
Position the patient sitting with their head facing forward. Instruct the
patient to laterally flex their neck. Instruct the patient to reach one arm
over to the opposite ear and to assist in lateral flexing the neck by
bringing the ear to their shoulder. Ensure the head faces forward.
Client`s instructions
Position yourself in sitting with your head facing forward. Reach one
arm over to your opposite ear and assist bending your neck to the
side by bringing your ear to your shoulder. Ensure your head faces
forward.

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Passive shoulder flexion
Therapist`s aim
To maintain or improve range of motion of the shoulder into flexion.
Client`s aim
To maintain or improve range of motion of your shoulder.
Therapist`s instructions
Position the patient in standing, leaning against a wall with feet
slightly apart and knees bent. Instruct the patient to use their
uninvolved arm to support the elbow of the involved arm. Instruct the
patient to lean forward, allowing gravity to passively flex the shoulder.
Client`s instructions
Position yourself standing, leaning with your bottom against a wall
and feet slightly apart and knees bent. Support the elbow of your
involved arm with your uninvolved arm. Lean forward, allowing gravity
to move your arms passively forward.

Pendular exercises after shoulder surgery - passive swinging in circle

Therapist`s aim
To maintain or improve range of motion of the shoulder after shoulder
surgery.
Client`s aim
To maintain or improve range of motion of your shoulder after
shoulder surgery.
Therapist`s instructions
Position the patient standing, holding onto the back of a chair with
uninvolved arm. Instruct the patient to lean forward allowing the
involved arm to flex with gravity. Instruct the patient to sway their body
in clockwise and counter clockwise directions to initiate circular
passive shoulder movements. Ensure the exercise remains passive.
Client`s instructions
Position yourself in standing holding onto the back of a chair with your
uninvolved hand. Lean forward letting your involved arm hang
relaxed. Sway your body slowly in clockwise and counter clockwise
directions to initiate movement in the arm. Ensure to keep your arm
relaxed.

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Active assisted shoulder ROM exercises - position 2
Therapist`s aim
To stretch or maintain range of motion of the shoulder.
Client`s aim
To stretch or maintain range in your shoulder.
Therapist`s instructions
Position the patient in sitting with hands clasped together in their lap.
Instruct the patient to raise their hands upwards together to rest on
the top of their head. Instruct the patient to slide their hands behind
their head as far as they can. Instruct the patient to push their elbows
back as far as they can. Instruct the patient to return their hands to
their lap.
Client`s instructions
Position yourself sitting in a chair with your hands clasped together on
your lap. Raise your hands upwards to rest on the top of your head.
Slide your hands behind your head as far as you can. Push your
elbows back as far as you can. Return your hands to your lap.

Active assisted shoulder ROM exercises - position 3

Therapist`s aim
To stretch or maintain range of motion of the shoulder.
Client`s aim
To stretch or maintain range in your shoulder.
Therapist`s instructions
Position the patient in sitting with hands clasped together in their lap.
Instruct the patient to raise their hands upwards together to rest on
the top of their head. Instruct the patient to slide their hands behind
their head as far as they can. Instruct the patient to reach upwards
and slightly backwards with both hands. Instruct the patient to
straighten their elbows and hold the position for 5 seconds. Instruct
the patient to return their hands to their lap.
Client`s instructions
Position yourself sitting in a chair with your hands clasped together on
your lap. Raise your hands upwards to rest on the top of your head.
Slide your hands behind your head as far as you can. Reach
upwards and slightly backwards with both hands. Straighten their
elbows and hold the position for 5 seconds. Return your hands to your
lap.

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Active assisted shoulder ROM exercises - position 4
Therapist`s aim
To stretch or maintain range of motion of shoulder.
Client`s aim
To stretch or maintain range in your shoulder.
Therapist`s instructions
Position the patient in sitting with hands clasped together on lap.
Instruct the patient to place their hands on top of their head. Instruct
the patient to return their hands to their lap.
Client`s instructions
Position yourself sitting in a chair with your hands clasped together on
your lap. Place your hands on top of your head. Return your hands to
your lap.

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