Shoulder Instability protocol
For deep shoulder pain, dislocations/subluxations, labral tears and hypermobility. Active control from day one, no stretching, then progressive weight-bearing stability and finally overhead pressing.
- Pain deep in the shoulder joint
- Dislocations/subluxations
- Labral tears
- Hypermobility
Why these exercises · Mobilise overworking stabilisers, then AROM (instability affects passive restraints, so lifting hurts less than with a cuff injury and active work trains control), ending with isometrics in multiple planes.
- Alleviating shoulder pain
- Improving neuromuscular control
- Warm-up for phase 2 and 3 exercises
- Perform every day
- Tool: small massage ball
- Add phase 2 when you have no pain at rest and no more than mild pain (3/10) with the exercises
Soft tissue mobilizations
▶ 1–2 min per area, both sides; pause 10–20 s on tender points
Mobility exercises (AROM)
▶ 3 × 10–15; move as far as you can without pain; pause 2–3 s at end range
Isometric exercises
▶ 4–5 reps × 30–45 s; ≤ mild pain; elbow at 90° into a wall or rack
Why these exercises · Low-load resistance for antagonist scapular muscles (press and row), frontal-plane deltoid/supraspinatus (lateral raise), scapular depression (bench lift-off), then targeted cuff work—internal rotation helps resist anterior dislocation.
- Improving shoulder stability and neuromuscular control
- Warm-up for phase 3 exercises
- Perform 3 or 4 days a week
- Do 3 sets of 10–15 reps
- Tools: resistance tube band, dumbbells, bench, towel
- All banded exercises can be done using a cable machine
- Add phase 3 when you can do the exercises with control and no more than mild pain (3/10)
Resistance exercises
Why these exercises · Teach the neuromuscular system to compensate for passive laxity: biceps curl (anterior restraint), D2 flexion and prone 90/90 (strength away from the body), closed-chain stability (shoulder taps → clock → dolphin press), and the open-chain shoulder press last with a light dumbbell.
- Strengthening the shoulder with higher stabilization demands
- Improving shoulder stability and neuromuscular control
- Perform 3 or 4 days a week
- Do 3 sets of 10–15 reps
- Push sets to fatigue
- Tools: dumbbell, resistance band, bench, resistance loop
Resistance and stability exercises
Source: Rehab Science · Ch 16 · PDF pp. 397–408· 2 original research citationsshow sources ▾
- [Ch 16·10] Guerrero P, Busconi B, Deangelis N, Powers G. Congenital instability of the shoulder joint: assessment and treatment options. J Orthop Sports Phys Ther. 2009;39(2):124-134. find original ↗
- [Ch 16·12] Burkhead WZ Jr, Rockwood CA Jr. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am. 1992;74(6):890-896. find original ↗
Page numbers are those of the uploaded PDF edition. "Find original" opens a PubMed search for the cited study.