Protocols Overview

Go to your body region, read the descriptions and pick the protocol that best matches your symptoms or diagnosis. Some protocols cover several conditions because the exercises are the same. Overlapping problems—like a labral tear and biceps tendinopathy, both causing front-of-shoulder pain—need different programmes, so read carefully.

The same exercises that heal also prevent. Everyone benefits from a few days a week of resistance training; you can cherry-pick protocol exercises as a prehab or maintenance programme.

Description (what and who), signs and symptoms (a symptom check), aggravating factors (what to modify for now—and a screening tool), prognosis, treatment strategy, then phases 1–3. Aggravating factors change as you heal, and the goal is to rebuild capacity so they stop hurting.

Speak with a doctor before starting if you have: recent serious trauma; unrelenting pain at rest and at night; numbness in the saddle area; progressive leg weakness; new bladder changes; a history of cancer; unexplained weight loss (over 10 lb in 3 months); fever, chills or night sweats; a recent infection; or you are over 50 with other flags. Serious causes are rare (around 1% of musculoskeletal problems) but must not be missed.

Expect small positive changes in about two weeks. If you have modified aggravating activities and followed the programme for at least six weeks without improving, get an in-person assessment.

A scan finding alone does not make you a surgical candidate. Consider surgery when 8–12 weeks of good rehab has not helped, when a joint keeps giving way, or when red flags appear—after a doctor's opinion and ideally a second one. Remember that flare-ups can make things look worse than they are.

0 = no pain, 10 = worst imaginable. Mild 1–3, moderate 4–7, severe 8+. Pain above 3/10 → start phase 1. Below 3/10 → phase 2. No flare-ups and all exercises easy with full control → phase 3. Even without pain, work through the phases in order. Setbacks are normal—step back a phase.

Do exercises in order, finishing all sets of one before the next. Rest 30–60 seconds between sets. Pick reps or holds that challenge you, and nudge range and effort up each week. If something hurts, shorten the range or lighten the load; if it still hurts, swap to a similar movement or move it to the next phase.

Two pains in one region: follow the protocol for the worse or more limiting one—doing both is too much volume. Two different regions: combine them in one session or alternate days, and do shared exercises only once.

Do single-limb exercises on both sides—start on the healthy side to learn the feel (cross-transfer). The protocols are general; adjust them to how your body responds.