Shoulder Pain Rehabilitation: How to Progress Exercises For Shoulder Pain in Athletes Part 1: Closed Chain

I’ve been working with a lot of students lately in my clinical practice as a physical therapist lately. In my experience most students tend to have pretty good clinical decision making skills, a fairly sound evidence based approach as well as some solid evaluation and treatment ideas.

When it comes time for program directors to visit their students at our clinic they usually ask about ways to improve their physical therapy curriculum. Far and away the biggest comment I give is the lack of experience with exercise selection.

I also feel that as a profession overall we lack a bit in this area. We do a good job of finding evidence based EMG exercises for specific conditions but sometimes drop the ball when it comes to finding great exercises that are specific to getting back to sport. Those basic exercises are of extreme importance but what do we do once our athletes reach their maximum benefit from these exercises and aren’t yet back to their activities. I work with a decent number of weightlifters and crossfit athletes. Besides a lack of knowledge of their sport, the second biggest reason for failed previous treatment is a lack of specific exercise progression to get them back to their activities. Getting someone back to their ADLs pain free and getting them back to high level performance are two different things.

I wanted to put together a series of exercises I use with my athletes to get them back to their sport. These exercises are specific to strengthening and conditioning an athlete along their rehab/physical therapy process. The first example will be a series of closed chain exercises. Populations that would benefit from these exercises would be a gymnast or crossfit athlete that wants to return to handstands, handstand walking or any other closed chain pressing …read more

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