Dr. Steven Ward · Orthopedic Surgery

Shoulder Exercise Guide

Home exercises for rotator cuff pain treated without surgery, and a phased program after shoulder surgery. Use pain as your guide. Quality of motion matters more than forcing range.

How to use this guide Non-operative rotator cuff After surgery When to stop
These exercises are general education for Dr. Ward’s patients. Your plan may be different after rotator cuff repair, instability surgery, biceps work, or shoulder replacement. Follow the written restrictions you were given. If an exercise increases sharp pain, night pain, or swelling the next day, stop that exercise and call the office.

Non-operative rotator cuff program

For tendinitis, impingement, and many partial-thickness tears. Do the mobility work daily. Add strengthening when the shoulder is calm enough that you can move with good control and only mild discomfort (about 3/10 or less).

Mobility and posture

1 · Pendulum

Codman pendulum

  1. Lean forward and support yourself with the opposite hand on a counter.
  2. Let the sore arm hang completely relaxed.
  3. Sway your body so the arm makes small circles — about 1 foot across — 10 each way.

2–3 times daily

2 · Stretch

Posterior shoulder stretch

  1. Bring the sore arm across your chest.
  2. Use the opposite hand to gently hug it closer, keeping the shoulder blade down.
  3. Hold 20–30 seconds. Repeat 3 times.

Daily · do not yank the elbow

3 · Stretch

Sleeper stretch

  1. Lie on the sore side with the arm in front of you, elbow bent 90°.
  2. Use the other hand to gently press the forearm toward the table.
  3. Stop at a mild stretch, not a pinch. Hold 20–30 seconds × 3.

Skip if this causes sharp front-of-shoulder pain

4 · Scapula

Shoulder blade squeezes

  1. Sit tall. Gently draw the shoulder blades down and together as if tucking them into back pockets.
  2. Do not shrug. Hold 5 seconds.
  3. Repeat 10–15 times, 2–3 sets.

This is the foundation for every other exercise

Early strengthening

5 · Isometric

External rotation press

  1. Elbow bent 90°, tucked at your side, standing in a doorway.
  2. Press the back of the hand outward into the frame. The arm should not actually move.
  3. Hold 5 seconds. Repeat 10–15 times.

6 · Isometric

Internal rotation press

  1. Same setup, now press the palm inward into the door frame.
  2. Keep the elbow glued to your side.
  3. Hold 5 seconds. Repeat 10–15 times.

7 · Band

Band external rotation

  1. Elbow at 90° against a rolled towel at your side.
  2. Rotate the hand outward against a light band. Pause. Return slowly.
  3. 2–3 sets of 12–15. The band should feel easy for the first 8 reps.

8 · Band

Band internal rotation

  1. Anchor the band to the side. Elbow tucked.
  2. Rotate the hand across the body, then control it back out.
  3. 2–3 sets of 12–15 with a light band.

9 · Sidelying

Sidelying external rotation

  1. Lie on the opposite side. Sore arm on top, elbow bent 90°, small towel under the elbow.
  2. Raise the hand toward the ceiling, stopping when the forearm is about vertical.
  3. Lower in 3 seconds. Start with no weight, then 1–2 lb. 2–3 × 12.

10 · Scapula

Row and “W”

  1. Band rows: pull elbows back along your sides and squeeze the blades. 2–3 × 12.
  2. Wall slides: backs of hands and forearms on the wall, slide up into a narrow “Y” without shrugging.

Avoid heavy overhead pressing, upright rows, and behind-the-neck work until the shoulder is quiet and strong. Ice 10–15 minutes after exercise if it feels worked, not injured.

Exercises after shoulder surgery

This follows a typical rotator cuff repair timeline. Shoulder replacement, labral repair, and fracture fixation use different limits — especially for turning the arm out and lifting the hand behind the back. Do not “push through” to catch up.

Phase 1 · Protection · often weeks 0–4 to 6

Protect the repair

Sling as instructed except for hygiene and these exercises. The goal is a comfortable, quiet shoulder — not range records.

Usually allowed
  • Pendulums, small and relaxed
  • Elbow, wrist, and hand motion out of the sling several times a day
  • Shoulder blade squeezes
  • Passive or assisted elevation only if your protocol says so
  • Ice and walking
Usually not allowed
  • Active lifting of the arm away from the body
  • Reaching behind the back
  • Supporting body weight on the operated arm
  • Driving until you are out of the sling and off narcotics
  • Forcing external rotation past the limit written for you

Home · 3× daily

Pendulum

Keep circles small. The arm is a rag doll — your body does the moving.

Home · 3× daily

Hand, wrist, elbow

Fist pumps, wrist circles, and gentle elbow bend/straighten. This limits swelling in the hand.

If cleared

Table slide

Sit at a table. Place a cloth under the operated hand and slide the hand forward as the body hinges. Stop before a sharp pinch.

Phase 2 · Motion · often weeks 4–8

Restore motion without loading the repair

Sling weaning is individual. Assisted motion comes before active motion.

Wand or cane elevation

Lying on your back, hold a cane with both hands. Let the good arm lift the operated arm overhead as tolerated. Hold 10 seconds. 10 reps, 2–3 sessions a day.

Wand external rotation

On your back, elbows tucked, cane across both hands. Good arm gently rotates the operated hand out only to the degree allowed. No bouncing.

Pulley flexion

Over-door pulley: good arm pulls the operated arm up. Keep the shoulder blade quiet. Stop if the shoulder shrugs hard toward the ear.

Wall walk

Fingertips on the wall, walk the hand up slightly forward of straight out to the side. Gain height by the week, not by the hour.

Phase 3 · Active motion & light strength · often weeks 8–12+

The arm starts to work for itself

Begin active elevation and very light rotator cuff work when you are cleared. Light weight, high repetition.

Active elevation in scapular plane

Raise the thumb-up arm between front and side, only as high as you can without a hike of the shoulder. Lower slower than you lift. 2 × 10.

Sidelying external rotation

No weight first, then 1 lb. Elbow on a towel. Use only when cleared.

Band IR / ER

Elbow tucked, light band, 2–3 × 12–15. Pain during the motion means the band is too heavy.

Low row / blade setting

Band rows and gentle wall isometrics to rebuild shoulder-blade control.

Phase 4 · Strength and return to activity · often 3–6 months

Build capacity

Progress bands, add light dumbbells, and return to work or sport in steps. Full strengthening and overhead athletics after rotator cuff repair are often closer to 4–6 months, sometimes longer for larger tears. Golf, swimming, and gym pressing get a specific plan — do not guess.

When to pause and call

Stop the exercise

  • Sharp, catching, or electric pain
  • Pain that lingers into the next day or wrecks sleep
  • New numbness, growing hand swelling, or calf pain

Call the office

  • Fever, drainage, or spreading redness at an incision
  • Sudden loss of motion you already had
  • Questions about sling use, work notes, or which phase you are in
Dr. Steven Ward, Orthopedic Surgeon
This page is for patients in our practice and does not replace your operative instructions or physical therapist. Ask Alison or the clinic team if you need your specific protocol sent again.