Shoulder Strengthening Exercise Protocol (Rockwood)

1. External rotation with a Theraband attached to the wall

Purpose

• Strengthening the external rotator muscles of the shoulder (infraspinatus, teres minor)

How to do it

• Attach the band to the wall at elbow height.
• Start with the elbow bent at 90° and held against the body.
• Rotate outwards – move the forearm away from the body – until the band is fully stretched.
• Hold the stretched position for 3–5 seconds, then slowly return to the starting position.
• You can start with the exercise against a wall (without a band) and progress to the exercise with a weight.

Precautions

• Keep the elbow against the body throughout the exercise.
• Do not push beyond the limit of pain.

2. Internal rotation with a Theraband attached to the wall

Purpose

• Strengthening the internal rotator muscles of the shoulder (subscapularis)

How to do it

• Attach the band to the wall at elbow height and stand side-on (the affected side away from the wall).
• Start with the elbow bent at 90° and held against the body.
• Rotate inwards – bring the forearm towards the abdomen – until the band is fully stretched.
• Hold the stretched position for 3–5 seconds, then slowly return to the starting position.
• Once you have good control, you can progress to the exercise with a weight.

Precautions

• Keep the elbow against the body throughout the exercise.
• Slow, controlled movement – avoid swinging.

3. Deltoid strengthening – anterior, middle and posterior

Light lifting only – up to the limit of pain

Purpose

• Strengthening all three parts of the deltoid muscle: anterior, middle and posterior

The three exercises

• Anterior deltoid – forward raise (Anterior Raise): raise the arm forward in a straight movement, up to shoulder height. Hold 3–5 seconds and lower slowly.
• Middle deltoid – side raise (Lateral Raise): raise the arm to the side up to shoulder height. Hold 3–5 seconds and lower slowly.
• Posterior deltoid – backward extension (Posterior Extension): raise the arm backwards in a controlled movement. Hold 3–5 seconds and lower slowly.

Precautions

• Light lifting only – up to the limit of pain, without forcing.
• You can do the exercises without a weight at first and progress gradually.
• Slow, controlled movement in both directions.

4. Additional exercises as instructed by the physiotherapist

Note

• Additional, individually adjusted exercises will be given at the discretion of the treating physiotherapist.
• Progression between difficulty levels depends on strength and pain – keep the treating team informed.
• The protocol is provided by: Dr. Avi Chezar – Shoulder Service, Department of Orthopedics, Emek Medical Center.