8 - 2022 - Bergen Chiropractic

What is the Lower Crossed Syndrome?

Aug 25, 2022 | Exercises, General Chiropractic

Do you live a sedentary lifestyle? In today’s world, that’s not a surprise at all. However, if your career or living situation requires prolonged sitting, it is important to properly take care of your body and avoid painful health complications such as lower crossed syndrome. Even if you work a lovely desk job or enjoy your comfy couch time, be sure to spend some time exercising and moving your body. Humans are not designed to stay cooped up, so continue reading to learn more about lower cross syndrome and exercises designed to avoid or alleviate its symptoms!

What is Lower Crossed Syndrome?

Unterkreuz syndrome, more commonly known as Lower Crossed Syndrome, is caused by large muscle strength imbalances in the abdominal muscles and the gluteus maximus. According to the National Academy of Sports Medicine, the lower cross syndrome is one of the most common compensatory body patterns. It differs from the upper cross syndrome as it does not occur in the shoulders and neck but in the lower lumbo-pelvic region.

When muscles become lengthened or shortened over time, the lower muscular imbalance results in postural changes of the neutral spine, lower back pain, and overactive muscles. Postural changes are most commonly viewed as an increased forward bend of the pelvis coupled with an excessive lower back arch. The uneven pull on your muscles forces the back muscles and hamstrings to work harder, leading to injuries. Because the lower cross syndrome causes overactivity in certain muscle groups, there is intense tightness of hip flexors and lumbar erector spinae.

The Two Types of Lower Cross Syndrome

There are two different types of lower cross syndrome. While they are very similar and involve the same main muscle imbalances and common compensatory patterns, one mainly affects the hip flexors while the other affects the lower back. Unlike upper cross syndrome, which affects the upper trapezius, both lower cross syndrome subgroups are differentiated by how they alter the gluteal musculature’s postural alignment and change the myofascial activation patterns of the pelvic region, although they both result in tight muscles and a painful lower back. Often, physical therapy is the best option to resolve this painful condition and muscle weakness.

#1: Posterior Pelvic Cross Syndrome

The first subgroup is called posterior pelvic crossed syndrome and dominates the axial extensor. In this type of lower cross syndrome, the pelvis has an anterior tilt while the knees and hip region are put into a slightly flexed position with unnaturally lengthened muscles. Often associated with a compensatory hyperlordosis of the lumbar spine and hyperkyphosis between the thoracic and lumbar spine, the condition leads to a decreased ability to breathe and control one’s posture. The tightened hip flexors and lumbar spine may become painful as they take on more strain to compensate for the weak muscles.

Furthermore, due to the lack of stabilization within the abdominals and internal oblique, the thorax will move up to over 90 degrees, and the postero-inferior thorax will be hyper-stabilized. This means that exhalation becomes difficult as the rectus abdominis activation cannot lower the thorax into its neutral position. In short, the expiratory phase becomes shortened, and problems arise when the coordination between the transverses and the diaphragm is insufficient.

#2: Anterior Pelvic Crossed Syndrome

The second type of lower crossed syndrome is called the anterior pelvic crossed syndrome and occurs when the abdominal muscles are too weak or too short. In this condition, the muscles compensate with minimal hypolordosis of the lumbar spine, hyperkyphosis of the thoracic spine, and head protraction. Thus, the anterior pelvic tilt forces the knees into a hyperextension.

What Causes the Lower Crossed Syndrome?

The lower crossed syndrome is caused by either the shortening or lengthening of muscles within the pelvic or lumbosacral regions of the body. Often related to or caused by poor posture or prolonged sitting, the lower cross syndrome results from changing muscular length and increased stress on certain muscles and hip joints. When you maintain improper posture, training, or ability to perform daily tasks, the affected muscles bear the burden of one-sided stress or high tension. Although the lower cross syndrome is most often linked to poor posture, it can also be caused by general poor health or physical condition.

Another common cause of the lower cross syndrome is prolonged sitting. You can cause an imbalance between the muscles as weakness occurs due to reduced mobility or prolonged sitting.

What are the Symptoms of Lower Crossed Syndrome?

The most common symptoms of the lower crossed syndrome are lower back pain or pain within a pelvic or hip joint. Other symptoms include:

Difficulty moving or stiffness in the lumbar spine, hip, hamstring, or pelvic region;
Pain in the hip flexors, groin, spine, or gluteal muscles;
Protruding stomach due to an overly arched lower back;
Tension in the lower back or gluteal muscles.

Lower Cross Syndrome Exercises

One of the best treatment techniques for the lower cross syndrome is through an exercise program. Especially if you sit for prolonged periods, it is important to take time to exercise your body and loosen your sitting muscles or gluteus maximus. The first step toward treating this condition is to loosen your hip flexor muscles and joints and strengthen the weakened abdominal and gluteal muscles, particularly the gluteus medius. The goal is to loosen any possibly tight muscles and strengthen weak muscles. Certain floor exercises and stretches can work wonders at reducing pain in the lower body. However, if these exercises fail to reduce tension and pain, you should seek help from a physical therapist.

Muscle-Relaxing Techniques

Everyone should learn how to relax their overactive muscles. One way to do this is by using a foam roller to slowly roll parts of the body. Take the roller and use it on tight muscles such as the quads and inner thighs. If you find a tender spot, hold the position for 30 seconds.

Iliopsoas Stretch

After you have relaxed your overactive muscles, it is time to begin strengthening and lengthening your weak muscles. The iliopsoas stretch or single-leg squat uses static stretching to do just that. You can even increase the severity of the stretch with the rectus femoris.

To perform this hip flexor stretch and rectus femoris:

Assume a kneeling position with your back in line with the buttocks and knees.
Put one leg in front of you with the knee bent, the foot resting flat on the ground, and the toes facing forward.
Lean forward into a lunge position until you feel a gentle stretch in the hip flexors and the front and back of the thigh muscles.
Hold the hip flexor stretch for 15-30 seconds, then repeat using the other leg. You can increase this stretch with the rectus femoris by bending the knee more than 90 degrees during the iliopsoas stretch.

Erector Spinae Stretch

A similar gentle stretch is called the erector spinae stretch. In this stretch, you begin by lying in a supine position or an upright fetal position with your knees tucked into your chest and your arms wrapped around your knees. Exhale and stretch while staying balanced on your back. Hold the position for 15 seconds before releasing.

Muscle Strengthening Exercises

The last step is strengthening the muscles and hip flexor with little to no external resistance.

One exercise you can use is called the bridge:

First, lay flat on your back with your knees bent and your feet flat on the floor.
Lift your pelvis into the air with your heels a few inches from your buttocks and your arms extended towards your feet. You should form a straight line with the knees, pelvis, and shoulders by keeping your shoulders on the floor.
Hold the position for a couple of seconds before gently lowering the body. Repeat the exercise 10 to 15 times.

Another useful exercise is called hip extension:

Start on all fours with your hands directly under your shoulders, your knees under your hips, and your neck in line with your spine.
Stretch the right arm and left leg, keeping your hand and foot against the ground.
Once you feel balanced, raise the outstretched right arm and left leg until they are parallel with your back.
Hold the position for a few seconds and then slowly return to the starting position.
Again, repeat the exercise 10 to 15 times.

Once you have begun exercising and stretching your tight cross semi-regularly, you should begin integrated movement patterns to help your brain understand how to move the muscles. Follow the exercises your physical therapist advises you to complete to reach the ultimate goal of integration and resolving muscular imbalances.

Dr. Doerr is the Best Chiropractor in New Jersey for Treating the Lower Crossed Syndrome!

At the Bergen Chiropractic and Sports Rehabilitation Center, our chiropractic team, led by Dr. Gregory Doerr, follows the highest and most professional medical standards to provide superior chiropractic help. After all, our mission is to provide unparalleled patient care and services in a comfortable healing atmosphere. Contact us to learn more about our chiropractic services! Our chiropractic offices in Cliffside Park, Hackensack, and Fairfield, New Jersey, are ready to welcome you. Also, feel free to access our blog page for more information on chiropractic treatments!

Esports Injuries: What is Gamer’s Thumb?

Aug 18, 2022 | General Chiropractic

In the modern world, we are surrounded by new sources of technology and entertainment. Today, we enjoy various activities our ancestors could have never even dreamed of! Unfortunately, our bodies are not designed to complete the repetitive motions that gaming and texting require. If you are a gamer or avid typer, you should be aware of a condition colloquially known as Gamer’s Thumb or Texting Thumb. While modern technologies are mostly harmless, they have the unfortunate side effect of causing our thumbs to overwork, resulting in a “smartphone thumb.” Keep reading to learn more about this painful condition and how to prevent it from happening to you!

What is the Gamer’s Thumb?

The technical name for Gamer’s Thumb or Texting Thumb is De Quervain’s Tenosynovitis, but it is more commonly known as trigger finger, Nintendo Thumb, Playstation Thumb, and Nintendonitis. This injury is caused by repetitive movements of the thumb, resulting in irritated and inflamed tendons in the extensor pollicis brevis and abductor pollicis longus muscles. These muscles are responsible for pulling the thumb away from the hand and palm. When the sheath tendons become inflamed, they swell and begin to fill the narrow tunnel through which they run, causing increased friction and decreased range of thumb movement.

In console gaming, the trigger finger is usually due to the repetitive motion of thumb stick movements. While PC gamers can develop the condition, it is most prevalent in console gamers. More recently, the condition has also been linked to text messaging or typing on mobile devices, receiving the name ‘Texting Thumb.’

What are the Gamer’s Thumb Symptoms?

The first and foremost symptom of a Gamer’s Thumb or Texting Thumb is pain on the thumb side of your forearm and wrist. You may also experience grip weakness caused by the aforementioned pain.

General symptoms include:

Pain or swelling at the base of the thumb;
Difficulty grasping or pinching;
Pain when turning or flexing the wrist;
Pain when making a fist.

You may experience pain in your thumb due to inflammation when extending or abducting it and when bending your wrist towards the pinky side of your hand. Trigger thumb is a similar condition to Gamer’s Thumb that causes your finger to become stuck in a bent position and snap straight. Occurring due to inflammation of the tendons, trigger thumb, Gamer’s Thumb, carpal tunnel, and Texting Thumb all share similar symptoms and causes.

How Long Does a Gamer’s Thumb Last?

Gamer’s Thumb or Texting Thumb inflammation can have permanent effects if not dealt with properly or quickly. However, in most mild cases, the symptoms only last four to five hours after gaming or typing. If you are experiencing these mild symptoms, it is important you get it checked out before it worsens and becomes lasting. If your condition is more severe, your recovery may take four to six weeks.

How is Gamer’s Thumb Treated Conservatively?

If you believe you are suffering from Gamer’s Thumb or Texting Thumb, there are a few different exercises and methods to treat your symptoms and reduce inflammation conservatively. You can visit this video link explanation for a few different exercises, and below, you have an explanation of four exercises used to prevent and treat Gamer’s Thumb. If you take time to stretch after physical activity, then you can increase your range of motion and release chronic muscle tension.

You can also take anti-inflammatory medication to relieve pain caused by Gamer’s Thumb or Texter’s Thumb. However, it is highly recommended that you take the time to stretch and exercise your thumb properly before resorting to medication.

#1: Ulnar Deviation

Ulnar deviation is a type of exercise used to improve Gamer’s Thumb through Resistance Tubing. To complete this exercise:

Sit on a chair with feet hip distance apart and hold one end of the tubing in your right hand.
With your palm facing the floor, lean forward so your right elbow rests on your right thigh, and your forearm drops between your knees.
Take your left foot and step on the other end of the tubing.
Now, take your right hand and slowly bend your wrist up and away from your left knee.
If done correctly, you should feel a stretch at the back and inside of your hand.
Repeat these steps on your right hand ten times before switching to your left hand.

#2: Radial Deviation

If you want to condition your hand for those long gaming sessions, try radial deviation strengthening:

Start the exercise by extending your arm in front of your body.
Hold a weight with your palm facing inward.
If you need some extra support, you can balance your forearm on a table and hang your wrist over the edge.
Keep your forearm steady and focus on only moving the wrist.
Begin bending your wrist toward the ceiling to feel the stretch at the base of the thumb.
Gently lower your wrist to the starting position and repeat for two sets of ten repetitions each.

#3: Wrist Extension

The eccentric wrist extension is another exercise ideal for preventing Gamer’s Thumb:

Begin by holding a weight with your palm facing downward.
Next, curl your wrist toward the ceiling and then uncurl the wrist toward the floor.
Repeat this motion for three sets of 15 repetitions each.

#4: Wrist Flexion

If you suffer from wrist pain due to gaming, wrist flexion is the ideal exercise for stretching and strengthening your wrist. To complete this exercise, you will use a moderately heavy weight so that it is possible to finish multiple repetitions and build endurance:

First, hold the weight with your palm up and then curl your wrist toward the ceiling.
Slowly uncurl the wrist and bring it down toward the ground. Be sure to uncurl your fingers to target deeper forearm muscles at the end of the exercise.
Repeat the exercise for three sets of 15 repetitions each.

#5: Thumb Braces

While a thumb or hand brace may work for short-term pain relief, exercise should be the primary method to keep your hand healthy. You can ease the pain of Gamer’s Thumb or Texting Thumb by avoiding further tendon aggravation and inflammation. A thumb brace can be worn when you are not playing games to completely immobilize the thumb. You can likewise use Kinesiology Tape to support muscle and thumb joints without fully immobilizing your range of motion.

How to Prevent Gamer’s Thumb Pain

There are three main ways to prevent pain from Gamer’s Thumb or Texting Thumb. While it is difficult for most gamers and texters, spending less time playing and texting is the best way to decrease your risk of developing this injury. By reducing your gaming or texting session by one extra hour, you can save yourself from the pain of a life-long texter’s thumb affliction.

#1: Give Your Thumbs a Bit of Rest

The best way to prevent an injury is to give your thumbs some time to rest through frequent breaks. Some gamers can play for hours without taking a break, while some smartphone users can spend hours texting. However, all that gaming and smartphone use puts a lot of unnecessary strain on your thumbs.

#2: Corticosteroid Injections

If more conservative treatments and preventions have failed, you may consider taking corticosteroid injections to eliminate chronic inflammation. Steroid injections are widely used and can help prevent stenosing tenosynovitis and the need for surgery. A steroid injection is considered minimally invasive, as it delivers the medication by puncturing the skin and tendon sheath.

#3: Hand Surgery

If you cannot find relief for your gamers or texter’s thumb symptoms or your condition worsens, you may need to schedule a physical exam and speak with a hand surgeon about your options. By cutting the sheath around the thumb tendons and making more room, your surgeon can help relieve symptoms of Gamer’s Thumb and Texting Thumb.

Dr. Doerr is the Best Chiropractor in New Jersey for Treating Gamer’s Thumb Syndrome!

Are Chiropractors Good for Herniated Discs?

Aug 11, 2022 | General Chiropractic

A herniated disc or “slipped disc” occurs when the discs within your spine begin to wear down with age and use. Without these discs working properly to absorb shock, you can experience a lot of pain within your spine. While most people are not at risk of suffering from a herniated disc, it is not uncommon in young to middle-aged adults who overwork their bodies. Despite the pain this condition can cause, there are options for relief through chiropractic care!

What is a Herniated Disc?

Between almost all your spinal vertebrae lies an intervertebral disc. These discs act as cushions to help absorb and distribute shock. Without them, your spine cannot function. However, as with almost every part of the body, the discs show signs of wear and tear with age.

While the phrase “slipped disc” has become a popular term for bulging, ruptured, or herniated discs, intervertebral discs do not actually “slip.” The annulus fibrosus (the tough outer layer) and the nucleus pulposus (the soft, gelatin-like center) make up your discs. When cracks occur in the outer layer of the disc, the gelatin-like material found inside begins to ooze out. This process puts excess pressure on the spinal cord or spinal nerves and causes severe pain. Thus, not the entirety of the disc slips, but only the small area of the crack is dislodged from its proper place.

Am I Suffering from a Herniated or Bulging Disc?

Eventually, discs deteriorate, resulting in either a bulging or herniation. As time passes, discs dehydrate and their cartilage stiffens, causing the outer layer of the disc to bulge out. A bulging disc does not always affect the entire perimeter of a disc. However, at least a quarter or half of the disc’s circumference is generally affected. Only the outer layer of tough cartilage is affected when it comes to a bulging disc.

On the other hand, a herniated disc occurs when a crack in the tough outer layer of cartilage allows some softer inner cartilage to protrude out of the disc. Also called a ruptured disc or slipped disc, a herniated disc is not caused by an entire disc rupturing or slipping.

How do you know if you are suffering from a bulging or herniated disc? The best way to tell is by the pain level you are experiencing. As a herniated disc generally protrudes farther and irritates the nerve roots, its symptoms are more painful than a bulging disc. The irritation of a herniated disc is caused by the compression of the nerve or the painful inflammation of the nerve root.

What are the Different Disc Herniation Stages?

If you have a back pain condition, the symptoms will likely start small and gradually increase until you feel excessive back pain. There are four main stages of disc degeneration:

Degeneration;
Prolapse;
Extrusion;
Sequestration.

The first stage, degeneration, occurs when the disc loses its elasticity and becomes brittle with age.

Stage two, prolapse, occurs when tiny tears form in the outer fibrous ring of an intervertebral disc. These tears allow the gel-like central portion to bulge along with the tough fibrous outer layer.

Extrusion, stage three, is when part of the nucleus breaks through the tough outer layer but remains within the disc. Also known as a non-contained herniation or transligamentous herniation, an acute lumbar disc herniation is followed by sequestration.

In stage four, disc sequestration, the gel-like material breaks through the tough outer layer and leaks into the spinal canal, causing a free fragment. After all four stages are complete, you will feel full-fledged disc herniation symptoms and require chiropractic treatment.

How Does Chiropractic Care Address Disc Herniation?

Chiropractic care helps to relieve back pain and other herniated disc symptoms. After an initial assessment, your chiropractor can recommend the best treatment option for your situation.

Your Chiropractor Will Conduct an Initial Assessment

Before your treatment plan begins, your chiropractor will conduct an initial assessment. During this initial consultation, your chiropractor will examine your medical history, conduct a physical exam, and perform orthopedic and neurological tests. Even if you are only experiencing low back pain, your chiropractor will also examine your neck and other portions of the spinal column to evaluate the overall health of your spine. Similarly, if you are experiencing neck pain, your lower back will be evaluated as well.

Chiropractic Techniques for Herniated Discs

Chiropractors have several techniques to treat and relieve pain caused by herniated discs. While there are options for surgical chiropractic care, you can also receive nonsurgical treatments to ease back pain.

Flexion-distraction Technique

The flexion-distraction technique reduces herniated disc symptoms and offers back pain relief by reducing the pressure on your discs.

To conduct a flexion distraction, your chiropractor will use a specialized table to gently stretch the spine. They will isolate the affected area while slightly flexing the spine with a pumping rhythm. This treatment option is almost painless and allows the center of the intervertebral disc to assume its central position in the disc without excess pressure.

For the flexion-distraction to be successful, you must undergo a series of chiropractic care treatments alongside adjunctive ultrasound, muscle stimulation, physiotherapy, supplementation, and at-home treatments. Your chiropractor will monitor your progress throughout the entire process.

Spinal Manipulation

Often used for spinal conditions and disc problems, spinal manipulations are a type of chiropractic adjustments conducted under anesthesia. Luckily, the anesthesia puts the patient to sleep for only about six minutes, allowing your chiropractor to stretch and manipulate the area while the body is completely relaxed. Unlike the flexion-distraction technique, a spinal manipulation treatment plan requires only one to three sessions.

Pelvic Blocking Treatments

Herniated disc symptoms can also be treated through pelvic blocking techniques. Cushioned wedges placed under each side of the pelvis allow the use of gentle exercises to draw your disc away from the nerve it may be pressing on, easing spinal pain.

Additional Treatment Options

Chiropractors suggest you supplement the above treatment options with additional techniques to find relief. Such additional options include:

3D active traction;
Laser therapy;
Massage therapy;
Ultrasound-guided injections.

These more conservative chiropractic treatment options target your herniated disc at its root cause and help manage its other symptoms.

Dr. Doerr is the Best Chiropractor in New Jersey for Treating Disc Herniation!

What are the Best Range of Motion Exercises for Shoulders?

Aug 4, 2022 | Exercises, General Chiropractic

Do you experience limited shoulder movement? A rather common occurrence, limited range of mobility in the shoulder can make daily chores laborious and difficult. Whether the motion involves internal rotation or simply lifting our arm with the elbow bent, the simplest of tasks can become frustrating without our shoulders’ full range of motion.

If you experience limited mobility in this all-important joint, you can add certain exercises to your daily schedule to increase muscle strength and range of motion. Continue reading to learn how to properly complete shoulder range of motion exercises within the comfort of your home!

What Causes Limited Mobility in the Shoulders?

Mobility is the ability of the joint to extend through its full range of motion. Several causes lie behind decreased shoulder mobility, such as tightness within the shoulder due to a previous injury or lack of muscle strength. Some more common causes of shoulder mobility limitations include:

Impingement;
Rotator cuff tears;
Frozen shoulder joint;
Overuse of the shoulder joint;
Inactivity of the shoulder joint.

For a clear diagnosis of your limited shoulder mobility, you should contact your physical therapist and schedule a shoulder special test on your range of motion. A normal range of shoulder motion is attainable with proper care and diligent exercise!

Shoulder Range of Motion Exercises

Your shoulder is the most mobile joint in the human body! When in proper working order, most joints like your shoulder can provide an incredible active range of motion, performing shoulder flexion, external rotation, and internal rotation pain-free. However, this healthy range of motion is susceptible to shoulder pain conditions and limited mobility when overused or underused.

There are a few shoulder range of motion or shoulder ROM (i.e., range of motion) exercises for joint health and healing. Your physical therapist may also recommend certain exercise programs to help you restore your normal range of shoulder motion and decrease any active pain within the area. Use the following exercises with care during your daily living routine in addition to physical therapy to activate your full range of motion:

#1: Active Shoulder Abduction

Active shoulder abduction is the best exercise to begin your journey towards a normal range of shoulder motion. This exercise is less strenuous as it is performed while lying on one side with your troublesome shoulder on top.

Once you are lying comfortably with the upper arm elbow straight and your thumb pointed towards the ceiling, slowly lift your arm from your hip and into the air towards the ceiling until it reaches its abduction range. Keep your arm straight and in line with your body and your thumb pointed toward the ceiling.
Once in this position, move your shoulder through its pain-free shoulder ROM before slowly lowering your arm to its resting position on your hip.
Repeat the exercise 8 to 12 times and progress to the next exercise.
If you feel any worsening pain in your shoulder or arm at any point in your exercise routine, stop immediately and contact your healthcare provider before continuing any similar stretching exercises.

#2: Active Horizontal Abduction

The next exercise is similar to the first and is called a horizontal abduction.

To start this exercise:

Lie on your side with your target shoulder on top.
Keep your arm straight and your shoulder flexed so that your arm is out in front of you and parallel to the floor.
Slowly lift your arm until it is pointing towards the ceiling in an active external rotation and hold the position for one to two seconds before you slowly bring your arm to its starting position.
With your elbow straight, move through a pain-free shoulder ROM and repeat the lateral rotation 8 to 12 times.

#3: Active Shoulder External Rotation

An active shoulder external rotation is an easy and effective exercise to increase your active range mobility, improving shoulder range of motion.

Unlike our previous exercises, begin by lying flat on your back. It is easier to complete the exercise if your knees are comfortably bent toward the ceiling with your feet lying flat on the ground.
Keep the elbow of your target shoulder against your side with the elbow bent 90 degrees.
With a cane or long stick in your opposite hand, push the stick against the hand of your affected arm so it experiences an external rotation.
Hold the position for 10 seconds before relaxing and repeating the external rotation exercise 8 to 12 times.

#4: Sidelying Shoulder External Rotation

Try sidelying shoulder external rotation to exercise and improve the mobility of your rotator cuff muscles. This exercise improves rotator cuff strength and neuromuscular control of this muscle group when used after rotator cuff surgery or previous shoulder injuries. However, before performing the exercise, speak with your healthcare provider and physical therapist to ensure that this exercise is right for you.

Begin the external rotation exercise by lying in the same initial positioning as our previous exercises, on your side with your bad shoulder resting on the outer end of your body. This time, keep your upper arm elbow bent at a 90-degree angle and tuck it into your side. Your elbow should stay tucked at your side during the exercise stretch while your hand should be resting comfortably in front of your navel.
Slowly lift your arm upward so that your fingers face the ceiling and your shoulder is in a slight external rotation. Keep your elbow bent into your side as you lift into a lateral rotation.
Hold it there for a few seconds before slowly letting your arm return to its neutral position near your navel. Repeat this motion 8 to 12 times.

#5: Shoulder Internal Rotation

The next exercise will help you strengthen your normal shoulder range of motion through internal or medial rotation.

Shoulder internal rotation exercises are performed while lying on your side, but your target shoulder should be on the bottom of your body, and your unaffected arm should lie on top. For comfort, you may want to move your arm forward an inch or two, so you are not lying directly on your arm or elbow.
While keeping your elbow bent to 90 degrees and your palm facing up, slowly rotate your shoulder with your hand moving upward and your palm facing toward your navel in an internal rotation. This shoulder ROM should be pain-free.
Once your hand is up at your navel, hold the position for about two seconds before slowly lowering it to the starting position.
As always, repeat this medial rotation exercise 8 to 12 times.

#6: Arm Swings

Standing arm swings are a more dynamic exercise that increases blood flow to the shoulder joint and involves moving your arms in a rotational motion. This exercise is a great addition to any warm-up before upper arm and body exercises and can improve mobility and flexibility in your shoulders and upper back.

Begin by standing tall with each arm straight by your sides.
Engage your core and slowly rotate or swing your arms forward until they reach their abduction range without triggering shoulder pain. Raising your arms upward allows your joint to stretch into a comfortable shoulder flexion and normal ROM.
Do not raise your shoulders during this exercise. Return your arms to their starting position and repeat the motion for 30 to 60 seconds.

#7: Shoulder Pass-through

Try using the shoulder pass-through exercise to increase joint mobility and obtain a normal shoulder range while engaging the surrounding shoulder muscles such as the teres minor. This exercise requires holding a long, easily gripped stick such as a broomstick or PVC pipe.

Start this exercise in a standing position with your feet shoulder-width apart and your arms in front of your body.
Hold the stick with an overhand grip with your palms facing downward, and keep your arms a little wider than shoulder-width.
Make sure the stick remains parallel to the floor as you engage your core to slowly raise the stick above your head, exercising your teres minor.
Keep your arms straight and lift them to the highest point you are comfortable with.
Hold the pose for a few seconds and then return to the starting position.
Repeat the exercise 5 times.

#8: Reverse Fly

The reverse fly is a little more complicated exercise that targets the upper back and thoracic muscles, providing stability for the shoulder joint. You will need a light set of dumbbells to conduct this exercise.

Hold one dumbbell in each hand and position your feet shoulder-width apart to begin the exercise.
Slightly bend your knees and engage your core to lean forward at the waist. Keep your back straight and your arms extended with each elbow bent slightly.
With your palms facing the ground, carefully raise your arms away from your body by focussing on squeezing your shoulder blades together.
Stop and slowly return to the starting position when you reach shoulder height or the highest point you can painlessly attain with your shoulder blades.
Complete 3 sets of 10 repetitions and do not continue if you experience shoulder pain.

#9: Dumbbell Rotation

As the name implies, the dumbbell rotation requires a light dumbbell. You can use this exercise to warm up your shoulder before overhead and throwing motions with a normal shoulder range.

Begin by standing with your feet shoulder-width apart.
Hold the dumbbell and raise your arm until your elbow is shoulder height.
Keep the proper position with your palm facing the ground and your elbow bent at a 90-degree angle.
Slowly rotate your shoulder to raise your upper arm and weight to its highest point toward the ceiling.
Slowly return to the starting position and repeat 2 to 3 sets of 12 repetitions before changing sides.

#10: High-to-low Rows

High-to-low rows strengthen the upper back and thoracic muscles through a resistance band or cable machine.

Secure a resistance band to a sturdy object above shoulder height.
Kneel down on one knee and grab the band with your opposite hand. You can either rest your other arm at your side or on your hip.
As you slowly pull the band towards your body, keep your torso and arm straight. It is easiest to focus on squeezing your shoulder blades together while completing the motion.
Return to the starting position and repeat 10 times for 2-3 sets on each side.

If you keep up with these exercises and other recommendations from your physical therapist, you should be able to attain your normal range of motion within no time!