Arthritis in Shoulder Exercises - Where to Start

When dealing with arthritis in your shoulder, exercises are a great way to help manage some of the painful symptoms. Rheumatoid arthritis or osteoarthritis can make it hard to enjoy your normal daily activities and poor shoulder function can degrade your quality of life. That’s why our physical therapists have put together this exercise program with ways to stretch and strengthen the shoulder joints and keep shoulder arthritis pain at bay.

How Exercises Help Shoulder Arthritis

Whether you’re dealing with osteoarthritis or rheumatoid arthritis, a well-rounded program will include stretches, strengthening exercises, and moves that promote full body coordination. The benefits of exercises for shoulder arthritis include: 

• boost local blood flow for healing and arthritis pain relief 
• preserve and increase flexibility, strength, and overall daily function

Other ways to manage shoulder arthritis pain

6 Best Exercises for Shoulder Arthritis

Your home exercise program should include a mix of range of motion and strengthening exercises.

Shoulder Range of Motion

Range of motion exercises should always begin with good upper body posture to minimize strain to the neck and shoulder joint. Keep your shoulders pulled back and chin tucked to avoid slouching. Always stay in tune with how you’re feeling and don’t force anything that feels off or painful. 

1. Shoulder Pulley Range of Motion

A shoulder pulley is a way to comfortably stretch and increase both the shoulder joint and rotator cuff range of motion. 

• Attach your shoulder pulley to the door, and sit in a chair directly under the pulley. 
• Hold each end of the pulley in your hands with the palms facing each other. 
• Use your “good” arm to guide the stiff arm up by pulling the handle down toward your knee and beyond. 
• Guide your stiff arm up as high as you can go overhead and hold. Keep the arm you are stretching as relaxed as possible throughout. 
• Hold for 5 seconds at the top range of each move.

Repeat for 10 repetitions for 2-3 sets. You can move the arm straight up overhead, out to the side, or some other combination in the middle of these with the pulley. If you don’t have a pulley you can also try standing pendulum swings, use a cane, or even a yoga ball to do guided range of motion as well.

2. Internal Rotation Stretch

Being able to internally rotate your arm is important for daily tasks like reaching behind your back. For this stretch you’ll need a stretch strap or towel.

• Grab the handle with your stiff arm and bring the back of your hand to rest at the small of your back (if possible). 
• Grab the other end of the strap above your shoulder with the good arm so that the band is resting against your entire spine. 
• Use the upper hand to gently guide the lower hand up the back.
• Continue until a strong stretch is felt in the shoulder and hold.

Hold for 20-30 seconds for 3-5 repetitions. Do not let the shoulder shift forward or your neck tense up as you stretch.

3. Foam Roller 3-Way Range of Motion

This exercise and stretch is great for the shoulder and upper back since they both tend to be stiff in unison. 

• Lie on a foam roller (directly under the spine), rolled towel, or the floor to get started. 
• Make sure your entire spine and back of the head are touching the roller or floor before starting the arm movements. 
• Alternating between 3 moves: a “T”, “Y”, “I.” 
• The starting position is always with your arms straight out in front of you toward the ceiling. 
• Bring arms straight out to the side to form a “T.” 
• Return to the starting position and repeat with a “Y” and then “I.”

Alternate between all 3 moves 10 times for 2-3 sets total. You should notice an increase in mobility with each set. When finished, if you notice any particular stiffness in your mid back you can turn the foam roller horizontally and roll out the upper back as well.

Shoulder Strengthening

The focus with shoulder strengthening will be on the rotator cuff muscles and shoulder blades (scapula) for optimizing stability and biomechanics to decrease the potential for further wear. These are basic moves but do require tolerance for some range of motion. If you’re having a hard time tolerating them, start with isometric moves (where you push against resistance without actually moving the arm), a smaller range of motion, or lighter resistance. With time, you may be able to progress to further range and more dynamic moves.

4. Scap Squeezes

You can do this exercise with or without resistance depending on your needs. 

• Grab a light to moderate resistance band when you feel ready and secure it in a doorway or other sturdy spot at about hip height. 
• Hold the ends of the band in each hand with the elbows bent to 90 degrees and palms facing each other inward. 
• Squeeze the shoulder blades back and together as you pull the upper arms behind you toward the wall. 
• The neck should stay relaxed and you will feel a stretch in the front of the chest.

Hold for 3-5 seconds each time for 10 repetitions total. Repeat for 2-3 sets. Additionally, you can complete double arm external rotation while squeezing your shoulder blades in the exact same set up. Simply switch your hand position to palms facing up and keep your elbows tucked into your sides as you pull the hands away from each other.

5. Resisted Shoulder Flexion

Grab your band again, it’s always best to start with light resistance for this one since you will be attempting to move your arm overhead. This is great to complete after stretching to maximize your tolerated range and strength within that range.

• Hold the band in both of your hands about 3 feet apart. 
• To strengthen your left arm, bring the right arm and band to your rest on your right hip to use as an anchor. 
• Lift the left arm straight up toward the ceiling as high as you can go before returning to the starting position.
• Switch to the right arm when you have completed one set.

Repeat for 10-15 repetitions for 2-3 sets total one each arm. Keep the movement slow and controlled in both directions. Also, keep the neck relaxed and do not force any painful range of motion.

More Great Shoulder Stretches Here

6. Modified Wall Plank

Check out this video to see physical therapist, Dr. David Lee perform this exercise on the floor.

This targets all of the shoulder muscles at once; however with shoulder arthritis, we recommend performing this first against a wall rather than the floor. 

• Stand about 3 feet from the wall to get started. 
• Bring forearms to the wall so that they are parallel to each other at about shoulder width apart. 
• With your arms in place, tighten your abs and bring your entire body into a straight line from your head to toes at a diagonal to the wall. 
• Keep core tight and breathe
• Do not flex hips or let the low back slump

Hold for 30+ seconds for 2-3 sets.

When to Perform Shoulder Exercises

You should perform these exercises most days. As a general rule of thumb, always stretch when your shoulder starts to feel stiff (which is probably daily) and maintain your strength with a consistent program at least 3 times per week. Ultimately, what works for you will depend on your goals and symptoms.

• If your symptoms are moderate to severe, limit your workout to only 10-20 minutes but try to perform them on a daily basis 
• As strength and tolerance for daily activities improves, you can decrease frequency to 3 to 4 times per week. 

Lifting Weights with Arthritic Shoulders

Yes, it is safe to lift weights with shoulder arthritis. The strength exercises listed above could easily be modified and upgraded to the use of dumbbells. However, with shoulder arthritis, it is generally better to:

• keep the amount of weight you use light
• build endurance with high repetitions
• Avoid performing overhead range of motion exercises with weight

Yoga and Safe Stretching

Yoga is a very functional way to build shoulder strength and flexibility simultaneously and is generally safe (and recommended) for those with osteoarthritis pain in the shoulder. However, some movements may be uncomfortable and not appropriate for your condition. We recommend working with a certified yoga teacher or your physical therapist to learn which positions can benefit you the most.

Precautions with Shoulder Arthritis

When starting an exercise program, here are some general precautions and tips to keep in mind to maximize your outcomes.

• Start slowly and don’t push yourself too quickly to avoid symptom aggravation
• Move gently and with care to make sure each exercise is right for you
• Never force any move that increases your pain significantly- some discomfort is expected but it shouldn’t be excruciating 
• Always warm up the shoulder prior to any exercise
• To manage any pain, don’t forget home treatment modalities like ice, heat, TENs, and massage
• Don’t rehab your shoulder alone- it can feel overwhelming so get in touch with a physical therapist to get the education and personalization you need to recover and thrive

Shoulder Movements to Avoid

With shoulder arthritis, avoid exercises that include any overhead reaching with your thumbs pointing down. Plus, never force any stiff range of motion without physical therapy guidance, as this can stretch the wrong areas and reinforce bad movement patterns. Ultimately, there isn’t too much you need to avoid as long as you tune into your symptoms.

Follow These Safe Pain Management Options

Managing Shoulder Pain with Exercise

A shoulder arthritis diagnosis can feel devastating since there is technically no cure. Luckily, conservative treatment  and regular exercise can have great long term results for maximizing your shoulder function and life. If you can keep your shoulder well balanced with adequate strength, flexibility, and coordination, you will notice fewer hiccups in your daily routine. If you experience a sudden change in symptoms or your quality of life is decreasing, get in touch with your doctor or physical therapist immediately for further medical advice.

Sources:

https://creakyjoints.org/diet-exercise/exercises-arthritis-shoulder-pain/#:~:text=Precautions%20Before%20Exercising%20with%20Shoulder%20Arthritis&text=Push%20too%20hard%20too%20fast,your%20workout%20as%20you%20progress.&text=Always%20warm%20up%20or%20stretch,it%20again%20at%20the%20end

https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-shoulder

https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-arthritis

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