The First 3 Exercises to Start Rebuilding Your Shoulder - Lewis Physical Therapy & Sports Rehab

What You’ll Learn in This Blog

• Why isometrics calm shoulder pain

• The 3 isometric exercises we use on Day 1 of rehab

• How these movements restore rotator cuff stability

• Why long-duration holds matter more than reps

• How this approach helps pitchers & overhead athletes return faster

🎥 Watch the Full Shoulder Pain Breakdown on YouTube

Don’t miss the full demonstration of all three isometrics, positioning cues, and programming details.
▶️ Watch Now on YouTube:

Understanding Why Shoulder Pain Happens

Shoulder pain is one of the most common issues we see at Lewis Physical Therapy & Sports Rehab — in both pitchers and active adults who lift overhead. The shoulder is a highly mobile joint, and when the rotator cuff, scapular stabilizers, or tendons become irritated, the body quickly becomes sensitive to movement.

More importantly, most people immediately jump into stretching, massage, or random exercises without addressing one core problem first: the shoulder has lost the ability to tolerate load.
This is exactly why long-duration isometrics play such a powerful role in early rehab.

Why Long-Duration Isometrics Are the First Step

Isometrics create muscle tension without joint movement. For an irritated shoulder, this provides controlled loading that decreases pain, improves tendon tolerance, and restores neuromuscular control.

Unlike the outdated “10 reps of 10 seconds” approach, we use 30–60+ second holds, which research shows are far more effective for:
✔ Pain modulation
✔ Restoring stability
✔ Improving tendon stiffness
✔ Preparing the shoulder to handle dynamic loading again

This is why almost every athlete we treat starts here — pitchers, CrossFit athletes, and recreational lifters alike.

Exercise 1: External Rotation Isometric

The external rotation isometric is the cornerstone of early shoulder rehab. The posterior rotator cuff (specifically the infraspinatus and teres minor) helps center the humeral head and control stability during throwing and overhead lifting.

But most athletes feel this exercise in the front or side of the shoulder — both signs of poor cuff recruitment.

The correct setup ensures you feel it:

• Deep in the back of the shoulder

• With the elbow tucked

• Without the shoulder rolling forward

• With the scapula slightly set down and back

This position helps restore the stability you need before returning to high-velocity or overhead work.

Exercise 2: Internal Rotation Isometric

The internal rotation isometric targets the subscapularis, a critical stabilizer often neglected in rehab.

The goal is to feel the effort:

• Deep in the armpit

• Along the front of the shoulder

• Without elbow-dominant pulling

Balanced cuff activation between ER and IR is essential to restoring shoulder control and preventing front-of-shoulder pinching during pressing or throwing.

Exercise 3: Scaption Isometric

The scaption isometric is the transition between basic cuff activation and controlled overhead mechanics. When performed correctly (thumb up, slight lift angle, neck relaxed), it engages:

• Rotator cuff

• Lower trapezius

• Serratus anterior

This reduces pinching, improves upward rotation, and helps the shoulder tolerate overhead loading.

It’s one of the most important exercises for athletes who struggle with:

• Pressing pain

• Kipping

• Snatching

• Overhead stability

• Late-cocking phase shoulder symptoms

Putting It All Together

These 3 isometrics form the foundation of shoulder pain rehab. They reduce symptoms, restore control, and prepare the shoulder for progressive loading. Once an athlete can complete these comfortably, we then introduce:

• Light dynamic cuff work

• Scapular strengthening

• Plyometrics (for throwers)

• Overhead strength progressions

A full evaluation is always the best next step — but this is the safest, most effective starting point for most shoulder pain cases.

🎙 Listen to This Episode on The Lewis Physical Therapy & Sports Rehab Podcast

Catch the full breakdown of early-phase shoulder rehab, isometrics, and cuff stability concepts.
🎧 Listen on Spotify: https://open.spotify.com/show/4A6iBs0CzkAwSu9rUVPfGX?si=lrea2AaWQSy5USIT90KXhQ

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