Top Exercises for Shoulder Pain

Shoulder pain is one of the most common musculoskeletal complaints, affecting around 18 to 26 percent of adults at any given time.¹ For occupational therapists, addressing shoulder pain is critical in helping patients regain functional independence and quality of life. By incorporating effective exercises for shoulder pain into treatment plans, OTs can help patients regain mobility, reduce discomfort, and build strength.

In the OTPF-4 (AOTA, 2020), exercise is recognized as a meaningful occupation under “Health Management,” emphasizing its role in promoting physical and mental well-being.² It aligns with the framework’s focus on empowering individuals to engage in purposeful activities that enhance their overall quality of life and functional independence.

In this article, we will explore essential exercises for shoulder pain, leveraging evidence-based protocols from Medbridge’s Pathways MSK program. These exercises follow a phased approach, helping patients progress from gentle movements to gradually more challenging exercises as they rebuild strength and function.

Understanding shoulder pain

Shoulder pain typically stems from issues such as rotator cuff injuries, impingement syndromes, and stiffness in the surrounding musculature. This pain can significantly impact daily activities like reaching, lifting, and even sleeping comfortably.

The unique anatomy of the shoulder joint—with its high mobility and less stable structure—can make shoulder pain persistent and challenging to resolve. Early intervention with controlled, low-impact exercises can reduce pain and lay the groundwork for more advanced recovery, setting patients on a course to regain full shoulder function.

Top shoulder exercises for pain

1. Standing backward shoulder shrug circles

Shoulder shrug circles are a gentle way to reduce tension and improve blood flow, helping alleviate stiffness and pain in the shoulder area.

• How to perform: Instruct the patient to stand with arms relaxed at the sides. Slowly shrug the shoulders up toward the ears, then roll them backward in a controlled, circular motion. This movement should be smooth and steady.
• Tip: Encourage patients to inhale as they raise their shoulders and exhale as they lower them.

2. Standing scapular retraction

This exercise is aimed at strengthening the upper back muscles to promote better posture and stability, which support pain reduction and shoulder alignment.

• How to perform: Have the patient stand with arms at their sides. Guide them to slowly squeeze their shoulder blades together, holding this retracted position as if trying to hold a pencil between the blades. Encourage holding for a few seconds before relaxing.
• Tip: Remind patients to focus on engaging the upper back muscles, to support posture and shoulder stability.

3. Circular shoulder pendulum with table support

Shoulder pendulums promote shoulder joint mobility and blood flow with minimal strain, making this exercise ideal for pain relief in early stages of rehabilitation.

• How to perform: Direct the patient to lean forward slightly, with one hand resting on a table or other sturdy surface for support. Their opposite arm should hang relaxed, using gentle momentum to swing the arm in small circles. Guide them to start with clockwise rotations, then switch to counterclockwise.
• Tip: Remind the patient to keep their arm fully relaxed and let natural movement drive the exercise.

4. Active-assisted supine shoulder flexion

Active-assisted shoulder flexion improves the shoulder’s range of motion without forcing movement, helping to gently stretch and mobilize the joint.

• How to perform: Position the patient lying down on their back. Ask them to hold the wrist of the affected arm with the opposite hand, using the stronger arm to assist in lifting the affected arm overhead. This active-assisted range-of-motion exercise should be done slowly to a comfortable range.
• Tip: Encourage patients to focus on a gradual stretch, relying on the healthy arm for assistance.

5. Shoulder scaption wall slide with towel

This exercise strengthens shoulder stabilizers and encourages mobility, which can help reduce pain and increase shoulder functionality.

• How to perform: Have the patient stand facing a wall with a small towel under their hands for easy sliding. Position their hands on the wall in a “Y” shape, slightly wider than shoulder-width. Instruct the patient to slide the towel upward while applying slight pressure, then slide back down.
• Tip: Guide patients to keep their shoulders relaxed and avoid shrugging during the movement. A slight bend in the elbows provides control and reduces strain.

How to motivate patients in shoulder rehabilitation

Consistency is one of the biggest challenges patients face in shoulder rehabilitation. Motivating patients to stay committed to their exercises, both in the clinic and at home, is essential to their long-term success. Implementing a few simple strategies can make a significant difference in their adherence and, ultimately, in their recovery outcomes.

Set clear, achievable goals

Breaking down the rehabilitation journey into smaller, achievable goals helps patients stay focused and see progress over time. For instance, set a goal for improved range of motion by a certain session, or encourage patients to note any reduction in pain during performance of meaningful daily activities. When they meet these goals, acknowledge their progress—it reinforces their commitment.

Encourage patience and resilience

It’s common for patients to experience periods where progress seems slower, or they might encounter minor setbacks. Discussing this possibility early on can help patients remain patient and resilient when challenges arise. Remind them that consistency is more important than rapid progress and that each effort, however small, brings them closer to pain-free movement.

Offer positive reinforcement

Recognizing small improvements and encouraging patients during challenging times can provide valuable support and motivation. Simple phrases like “Great job” or “I can see you’re improving your range” can build confidence and promote a positive outlook on recovery. A study on factors influencing adherence to physical exercise found that positive feedback and reinforcement of efforts are crucial for boosting motivation and helping patients stay committed to their rehabilitation goals.³

Provide meaningful patient education

Patient education can help foster a sense of ownership and commitment to rehabilitation. When patients understand their condition and how each exercise targets specific muscles, improves joint stability, and reduces pain, they see the purpose behind their efforts. By linking exercises to their ability to perform daily activities, patients are more likely to stay motivated and engaged. Educating them on these connections empowers them to take an active role in recovery and reinforces the impact of consistent effort on lasting results.

By focusing on patient engagement and motivation, you create a supportive environment that keeps patients on track, empowering them to follow through on their shoulder rehabilitation exercises and achieve lasting results.

Pave the way for effective shoulder pain rehabilitation

As an occupational therapist, you know firsthand that personalizing home exercise programs makes a significant difference in patient engagement and adherence. With Medbridge’s HEP builder, you can save time by creating customized exercise plans in minutes, adjusting and monitoring them as needed to meet each patient’s unique needs.

Pairing these prescribed exercises with a patient-friendly mobile app provides a seamless experience that benefits both therapist and patient. With easy access to their exercises through Medbridge GO, patients can stay engaged with daily reminders and achievable goals, enhancing adherence and helping them stay on track—ultimately making the journey smoother for both OT and patient.

With sustained effort, personalized guidance, and tools that support consistent engagement, you can pave the way for successful and lasting shoulder pain recovery.

References

1. Linaker, C. H., & Walker-Bone, K. (2015). Shoulder disorders and occupation. Best practice & research. Clinical rheumatology, 29(3), 405–423. https://doi.org/10.1016/j.berh.2015.04.001
2. American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Supplement_2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001
3. Collado-Mateo, D., Lavín-Pérez, A. M., Peñacoba, C., Del Coso, J., Leyton-Román, M., Luque-Casado, A., Gasque, P., Fernández-Del-Olmo, M. Á., & Amado-Alonso, D. (2021). Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. International journal of environmental research and public health, 18(4), 2023. https://doi.org/10.3390/ijerph18042023