Exercises to Improve Stability After a Shoulder Labrum Tear

Range of Motion Exercises

A labrum injury typically causes a "loose" feeling in your shoulder or may feel like your shoulder will fall out of the joint. Therapy may include range of motion work because sometimes the shoulder motion is abnormal after a labrum tear.

Exercise to restore the normal way your shoulder moves may be necessary before progressing to any strengthening exercises. Exercises for shoulder ROM may include:

• Passive ROM exercises where your therapist moves your shoulder and arm for you
• Shoulder pulley exercises
• Shoulder active range of motion exercises

Be sure to move your shoulder through its full ROM, and stop if you feel pain or shoulder instability as you perform the exercises. Perform 10 to 15 repetitions of shoulder ROM exercises two to three times each day.

Rotator Cuff Strengthening

The shoulder labrum helps maintain stability in your shoulder joint, and a tear may make your shoulder unstable. So how can you regain a stable shoulder joint? Rotator cuff strengthening can help improve the dynamic stability of your shoulder joint.

Exercises for your rotator cuff may be prescribed by your physical therapist after a shoulder labrum tear.

Exercises may include:

• Shoulder isometrics
• Resistance band rotator cuff strengthening
• Shoulder active range of motion exercises with a dumbbell
• Shoulder weight-bearing exercises

Each exercise can include 10 to 15 repetitions three or four times per week. Be sure to stop any rotator cuff exercise if you feel shoulder pain or if your shoulder feels like it may fall out of the joint.

Typically, exercises start with rotator cuff strengthening with your arm at your side; the shoulder joint is more stable in that position.

As you get stronger, your physical therapist may have you work on rotator cuff strengthening with your arm away from your body and up in the air. This is more challenging for your shoulder muscles, and it is a necessary progression to fully recover after a shoulder labrum tear.

Scapular Stability

Your scapula is a major component of your entire shoulder joint complex, and it should be included in your exercises after a shoulder labrum tear. Your physical therapist may prescribe scapular stabilization exercises to normalize your shoulder mobility and function.

Scapular stability exercises progress through exercises lying on your tummy to exercises performed in a side-lying position. The prone I, T, and Y and the prone row are standard scapular stability exercises; your PT can show you how to do them properly. You may also work on scapular strengthening and control using weight machines.

Each scapular stability exercise should be done slowly for 10 to 15 repetitions, and you can increase the challenge by holding a small weight or dumbbell in your hand as you do the exercises.

Shoulder Proprioception and Balance

You need good balance in your shoulders to effectively use your arms. Awareness of where your shoulder is in space as you move around is important, and this awareness—proprioception—may be impaired after a shoulder labrum tear. Your PT may give you exercises to improve shoulder balance and proprioception.

The isometric dynamic shoulder exercise may be done with a resistance band. To do it:

1. Lie down on your back with your arm up towards the ceiling.
2. Hold onto one end of a resistance band, and have a friend hold the other end.
3. Your friend can walk around you in various directions, altering the amount of resistance on the band as you hold your arm steady.
4. Perform the exercise for 30 to 60 seconds and then rest.

You can make the exercise more challenging by closing your eyes during the motion.

In the clinic, a BAPS board or wobble board may be used as an unstable surface to help improve your shoulder proprioception. Your PT may have you work in a push-up position or in quadruped—on all fours like crawling—to improve shoulder balance while using a wobble board.

These exercises can be replicated by performing the shoulder weight-bearing exercises in the quadruped position at home.

Return to Full Function

One of the most important components of your physical therapy program after a shoulder labrum tear is to help you return to your normal function and activity. Everyone's activity level is different, so this part of your rehab should be personalized to your needs.

If your work requires you to perform activities with your arms overhead, your PT may prescribe specific exercises that mimic your job responsibilities.

Athletes working to return to their respective sports may need specific exercises to get back to normal participation.

For example, if you are a tennis player, you may need to perform specific tennis swinging exercises, and golfers may need different exercises to get back on the course after a shoulder labrum tear.