Shoulder Impingement Rehabilitation Protocol
- Always practice good posture throughout the day. “Neutral position” of the back, shoulders, and spine should be maintained during standing, sitting, and lifting activities.

3 - 5 times a day, perform the following series of exercises:

Blade squeezes—Sitting or standing-up straight, pinch shoulder blades together as if pinching a peanut between them. Hold 5 seconds and repeat 10 times.

Rotations—Sitting or standing-up straight, arms down at sides, rotate arms outward while trying to extend downward at the same time. Hold 5 seconds and repeat 10 times.

Pec stretching—Standing in a doorway with hand holding onto doorframe just below shoulder height, turn body away from your arm until a stretch is felt in the chest. Hold 15 seconds and repeat 5 times.

Once a day, perform these exercises:

- Distraction—holding onto a table with fingertips and arm relaxed, stand up and away from arm to distract arm from shoulder. Go until tension and hold for 3 seconds and repeat 5 times.
- Theraband rows—holding the band with both hands and with it wrapped around a doorknob, pinch shoulder blades and pull back towards you as if rowing a boat. Perform 15 - 20 reps.
- Theraband external rotation—stand with a towel rolled under arm, your elbow bent 90º, and the Theraband across the front of you and attached to a door. Rotate arm outwards away from band making sure to keep shoulders back and do not hike shoulder. Perform 15-20 reps.

NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process.