Eric Tannenbaum, MD

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Shoulder Instability

When the shoulder feels loose or has slipped out, the goal is to train the rotator cuff and shoulder blade muscles to hold the ball centered in the socket. Start with the arm close to your body and gradually work into more challenging positions.

Prepared by Dr. Eric Tannenbaum, MD · Board-certified orthopedic surgeon, Southern Indiana Orthopedics

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Use this program for

  • Multidirectional instability (a loose shoulder)
  • Subluxation (the shoulder partly slips out)
  • Recovery after a first-time dislocation treated without surgery

Before you start

  • Check with Dr. Tannenbaum or your physical therapist that this program fits your condition.
  • Warm up with 5 minutes of easy movement.
  • Move slowly and with control. Quality matters more than speed.
  • Use the pain guide below to decide how hard to push.
0 to 3 out of 10Safe. Keep going.
4 to 5 out of 10Acceptable if it settles by the next morning. Otherwise ease off.
Above 5, or worse the next dayToo much. Reduce the reps, range or weight.

Phase 1: Control

Weeks 0 to 3

Activate the stabilizing muscles with the arm at your side.

1Shoulder blade squeeze

  1. Stand or sit tall with your arms relaxed or elbows bent.
  2. Gently squeeze your shoulder blades back and down, as if into your back pockets.
  3. Hold without shrugging, then relax.

10 to 15 repetitions, hold 5 seconds, 1 to 2 times a day

Think "back and down," not "up toward the ears."

2Outward press into a wall (isometric)

  1. Stand sideways next to a wall with the elbow bent to 90 degrees and tucked at your side.
  2. Press the back of your wrist gently into the wall, as if rotating your arm outward.
  3. Hold the push without moving the arm.

5 repetitions, hold 30 to 45 seconds at a moderate effort, 1 to 2 times a day

Isometrics often calm a painful tendon. Effort should feel moderate, not maximal.

3Inward press into a door frame (isometric)

  1. Stand in a doorway with the elbow bent to 90 degrees at your side.
  2. Press your palm into the door frame, as if rotating your arm inward toward your belly.
  3. Hold the push without moving the arm.

5 repetitions, hold 30 to 45 seconds, 1 to 2 times a day

Keep the shoulder relaxed and down while you push.

Phase 2: Strength

Weeks 3 to 8

Build rotator cuff and shoulder blade strength.

4Outward rotation with a band

  1. Anchor a band at elbow height on the side opposite the sore arm.
  2. Keep the elbow at your side, bent to 90 degrees, with a small towel roll under it.
  3. Rotate the forearm outward, away from your belly, then return slowly.

3 sets of 10 to 15, once a day or every other day

The return should take 2 to 3 seconds. Slow lowering builds the tendon.

5Inward rotation with a band

  1. Anchor a band at elbow height on the same side as the sore arm.
  2. Keep the elbow at your side, bent to 90 degrees.
  3. Pull the forearm in toward your belly, then return slowly.

3 sets of 10 to 15, once a day or every other day

Keep the wrist straight and the elbow tucked.

6Rows with a band

  1. Anchor a band in front of you at chest height.
  2. Pull your elbows straight back, squeezing the shoulder blades together.
  3. Slowly return to the start.

3 sets of 10 to 15, once a day or every other day

Stand tall and keep the shoulders down away from your ears.

7Wall push-up with a plus

  1. Stand facing a wall with your hands at shoulder height.
  2. Do a slow push-up against the wall.
  3. At the top, push a little further so your shoulder blades spread apart.

3 sets of 10 to 15, once a day

The extra "plus" at the end trains the muscles that steady the shoulder blade.

Phase 3: Advanced

Weeks 8 and beyond

Build strength away from the body.

8Side-lying outward rotation

  1. Lie on your good side with a small towel roll under the elbow of the top arm.
  2. Hold a light weight (1 to 3 pounds) with the elbow bent to 90 degrees.
  3. Rotate the forearm up toward the ceiling, then lower slowly.

3 sets of 10 to 15, every other day

Start with a soup can or water bottle and progress slowly.

9Raise in the "Y" (scaption)

  1. Stand holding light weights with thumbs pointing up.
  2. Raise the arms forward and out at a slight angle, about 30 degrees in front of your body.
  3. Lift to shoulder height or lower if painful, then lower slowly.

3 sets of 10, every other day

Stay below shoulder height until this feels easy.

Avoid for now

  • The position where your arm is out to the side and rotated back, like throwing, until cleared
  • Contact or overhead sports until your strength has returned
  • Stretching the front of the shoulder

When to move ahead

Advance only when you can do the current exercises with good control and no sense of the shoulder slipping.

Stop and call our office at (812) 376-9353 if you have

  • Pain that is getting worse week to week, or severe pain at night
  • New numbness, tingling or weakness
  • Significant swelling, redness, warmth or fever
  • A joint that locks, gives way or will not move
The research behind this program
  1. Warby SA, Pizzari T, Ford JJ, Hahne AJ, Watson L. The effect of exercise-based management for multidirectional instability of the glenohumeral joint: a systematic review. J Shoulder Elbow Surg. 2014;23(1):128–142.

Need more help?

Work with our physical therapists

Our physical therapists at the SIO Physical Therapy & MRI building, 745 Schnier Street in Columbus, work alongside Dr. Tannenbaum and can tailor this program to you.

Request an appointmentCall (812) 376-9353

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