You’re working with a throwing athlete who’s

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Introduction: As a medical professor, it is important to design appropriate exercise routines for athletes who have undergone surgical procedures. In this scenario, a throwing athlete has had rotator cuff surgery, and the aim is to gradually strengthen and stretch the shoulder over three months. In this answer, I will provide ROM exercises, modified strength exercises, and a routine for this athlete, citing examples from the literature of at least two programs for athletes following a published training format.

ROM exercises:
– Pendulum swings: this exercise involves the athlete standing and bending forward, using the unaffected arm to support their weight. The affected arm hangs down towards the floor, and the athlete swings it gently in circles, forwards and backwards, and side to side.
– Wall walking: this exercise involves the athlete standing facing a wall, with their fingertips resting on the wall. The athlete walks their fingers up the wall as high as possible, then back down again.

Modified strength exercises:
– Scaption with external rotation: this exercise involves the athlete holding a light dumbbell in each hand and raising their arms diagonally forwards and upwards to shoulder height. The palms should be facing downwards, and as the athlete reaches shoulder height, they should rotate their palms to face forwards.
– Isometric external rotation: this exercise involves the athlete sitting with their affected arm bent at 90 degrees and the elbow resting on a pillow. The athlete holds a towel or resistance band at chest height with both hands and tries to rotate their affected arm outwards against the resistance of the towel or band.

Routine:
– Week 1-4: Pendulum swings, wall walking, scaption with external rotation (2 sets of 10 reps), isometric external rotation (2 sets of 10 reps), 3 times per week.
– Week 5-8: Pendulum swings, wall walking, scaption with external rotation (3 sets of 10 reps), isometric external rotation (3 sets of 10 reps), light dumbbell rows (2 sets of 10 reps), 3 times per week.
– Week 9-12: Pendulum swings, wall walking, scaption with external rotation (3 sets of 15 reps), isometric external rotation (3 sets of 15 reps), light dumbbell rows (2 sets of 15 reps), resistance band rotations (2 sets of 10 reps), 3 times per week.

Example programs:
1. The “Thrower’s 10” program, developed by Dr. Kevin Wilk and colleagues, is a published training format for baseball players. It includes 10 exercises specifically designed to address shoulder strength and mobility, including a variety of rotator cuff exercises and scapular stabilization exercises.
2. The “SHoulder IMplementation Protects Pitchers (SHIPP) Program,” developed by Dr. Elizabeth Matzkin and colleagues, is a published training program designed to reduce the risk of shoulder and elbow injuries in youth baseball players. It includes a variety of exercises for shoulder strength and mobility, including exercises with resistance bands and light dumbbells.

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