Taking Care of Your Shoulders After a Spinal Cord Injury ... · Posterior Shoulder Capsule Stretch • Lay on your back in order to stabilize the shoulder blade. • Gently pull the

Taking Care of Your Shoulders After a Spinal Cord Injury

© Vancouver Coastal Health © Vancouver Coastal Health

Shoulder pain is very common after a spinal cord injury. You use your shoulders for many more tasks in your day than most people, and the muscles and ligaments can often get tired or injured. The best thing you can do for your shoulders is to take care of them using:

• Posture – improve the line-up of your neck and shoulders to create a solid base on which your arm can move

• Stretching – maintain muscle length to maintain muscle balance.

• Strengthening – protect the joint and handle the increased load.

• Rest – sometimes the best thing you can do is to take a rest during the day.

It’s very important to work with your care team to make sure your bed, wheelchair, car and home are set up in a healthy way for your shoulders. Talk with your team about this to make sure to set yourself up for success.

It’s important to remember that you should be careful with all of the exercises in this booklet – if they are causing you more pain, stop and talk to your physiotherapist. Mild discomfort with stretching is okay, but pain with any exercise is not.

How often should you do these exercises?

• Daily: morning and night for stretching, once daily for strengthening (can be at the same time).

• Each stretch should be held for at least 30 seconds• Work up to 30 seconds if unable in the beginning• Strengthening: 10 repetitions, 1-3 sets

Part 1: Posture and Neck Stretching/Strengthening

Posture: What would we like to see?• Chin down and in• Shoulders down and back• Less rounding in upper back (depends on spine mobility / level of injury / age)• Got abdominals? Use them!

Rotator Cuff

Humeral Head

HumerusScapula(shoulder blade)

Clavicle(collarbone)

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Posture in BedSleeping on your back: when you are sleeping on your back, bring your arm out to the side (approximately 75 degrees) and the other arm out to 90 degrees. The elbow of the arm that is out at 90 degrees should also be bent to 90 degrees. Place pillows under both your arms to distribute pressure evenly.

Neck Posture Muscle Strengthening• In lying, place a rolled hand towel under the middle of your neck. • Place your fingertips on the muscles at the front of the neck. They should feel RELAXED• Keeping your head in contact with the bed, tuck your chin (nod your head). Do not allow

your chin to poke forward. • Hold 5 seconds

Neck Stretches1. Set up your posture by tucking chin in

2. Curl chin to chest

3. Tilt head to shoulder

4. Tuck chin in – turn head to look over each shoulder

© Vancouver Coastal Health

Relax these muscles© Vancouver Coastal Health



1 2

3 4

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Pillow too high Pillow too low Pillow correct height

Part 2: Shoulder Stretching Exercises

Hold 30 seconds each.

Posterior Shoulder Capsule Stretch• Lay on your back in order to stabilize the shoulder blade.• Gently pull the arm across the body with the opposite arm

without letting the shoulder blade move.

Upper Trapezius Stretch• While maintaining good sitting posture, use one arm to

stabilize the trunk and the other arm to gently bend the head to one side.

• Avoid rotating the head during the stretch.

Pectoral Muscle Stretch• Start with good posture.• With arm abducted and externally rotated (as if about to

throw a ball).• Place the forearm against a doorjamb.• Keep the shoulder slightly lower than 90° abduction.• Rotate your chair slowly away until a stretch is felt in

your chest.

Alternate for Pectoral Muscle Stretch: Lying• Grab a towel or use theraband

around wrists• Raise arms above head and

pull shoulder blades down your back until you feel a stretch in front of the chest

• If you are unable to raise arms above the head, lie with your arms in a ‘cactus’ position

• Breathe deeply

Biceps Long Head• Start with good posture.• Position the wheelchair in the doorway with the arm

slightly abducted (pulled away from body)• Place the forearm on the doorjamb.• Slowly rotate the chair away from the doorjamb keeping

the elbow straight.






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Part 3: Strengthening exercises

Do 3 sets of 10 repetitions.

Serratus Anterior Strengthening• In lying, extend your arm straight up in the air. Straighten the elbow if you are able.• Push your shoulder and arm straight up in the air in a slow punching motion. You should

feel the shoulder blade moving across your ribs.

Shoulder External Rotator Strengthening• Place a towel roll between the trunk and each arm. • While keeping elbows bent to 90°, grasp the

resistance band.• Pinch shoulder blades down and together, and then

slowly pull hands apart.

Seated Row (Rhomboid/Trapezius Strengthening)• Wrap a band around a table leg or tie a knot in the middle

and place it on the other side of a closed door. • Pull back on the band with your elbows bent as if rowing.

Keep your elbows close to your body, and squeeze the shoulder blades together.

Alternate for Seated Row: Lower Trapezius Strengthening in Bed

• Lie on your back with arms at approximately 45°of abduction.

• Squeeze shoulder blades down and together.• Extend the arms against the mat and feel the

shoulder blades push against the rib cage.• Hold for 5 seconds.

© Vancouver Coastal Health© Vancouver Coastal Health





This is a SHOULDER BLADE exercise, not an ARM exercise. Squeeze those shoulder blades down and together!

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For more copies, go online at http://vch.eduhealth.ca oremail [email protected] and quote Catalogue No. FB.817.T35

© Vancouver Coastal Health, January 2017

The information in this document is intended solely for theperson to whom it was given by the health care team.

www.vch.ca

Documents

Taking Care of Your Shoulders After a Spinal Cord Injury ... · Posterior Shoulder Capsule Stretch • Lay on your back in order to stabilize the shoulder blade. • Gently pull the