• Tendinopathy with painful AS impingement
• Capsulitis
• Calcifications + painful impingement
• increasing flexibility of the shoulder
• strengthening the muscles which stabilise the humeral head (teres major, latissimus dorsi, pectoralis major, subscapularis, teres minor and infraspinatus)
• full passive mobilisation in all directions; stretching
• active mobilisation and flexibility
• no work against resistance
• no exercises with pulleys
• cool the shoulder at the end of each session
• patient education as to home exercises

HANDS-ON PHYSIOTHERAPY WITH THE PATIENT FOR ABOUT 30 MINS

1st period (0 to 15 days):
- Sling for pain relief
- Active mobilisation of hand and elbow
- Shoulder massage. Ice. TENS to reduce pain
- Full, pain-free passive mobilisation in all directions of joint movement
- Pendulum movements to increase flexibility

2nd period (15th to 45th day):
- Full, pain-free assisted active mobilisation (if full passive movement has been achieved)
- Active elliptical exercises
- Isometric exercises against resistance for the external rotators.

HANDS ON PHYSIOTHERAPY FOR ABOUT 30 MINUTES

- Active mobilisation of the hand and elbow with protection of the ulnar nerve at the elbow
- Full, pain-free mobilisation of the shoulder while resting on an abduction cushion
- Pendulum movements for flexibility
- Re-learning washing and dressing
- Ice and TENS to reduce pain
- Full passive rotation
- strengthening the muscles which stabilise the humeral head and centralising the humeral head
- Swimming may begin after the 15th day

- gradual reduction in abduction of the arm
- Begin active assisted physiotherapy while seated, using the other arm, once full, pain-free passive movement has been achieved
- Isometric exercises working to full power and progressing to elliptical movements

- Discard the abduction cushion
- Active assisted shoulder exercises
- Progressive isometric exercises for the external rotators
- Exercise against resistance does not begin till after the 3rd month

- Sling holding the arm to the body for going out (the arm is left free at home)
- Immediate, active mobilisation of hand and elbow
- Ice, TENS to reduce pain

- Stop immobilising the arm
- Full, pain-free passive mobilisation of the shoulder Immediate pain-free active mobilisation, except for external rotation. Pain-free assisted active exercises as soon as full passive movement has been achieved. External rotation must not go beyond NEUTRAL position.
Swimming is allowed after the 15th day.

- Active exercises, begin external rotation

- Begin active exercises against resistance
- Neuromuscular re-education, with closed then open restraint
- Restart non-contact sports using the arm after 3 months; contact sports after 6 months.

- immediate active mobilisation of the hand and elbow
- Ice & TENS to reduce pain
- Full passive pain free mobilisation of the shoulder
- No external rotation (the subscapularis has been divided and repaired)
- Pendulum exercises
- Strengthening of the humeral head stabilisers
- Shoulder and neck massage (to reduce contractures)

- Active assisted mobilisation one full pain-free passive movement of the shoulder has been achieved
- Mobilisation by swimming

- Active isometric exercise of the external rotators against resistance

- Active mobilisation of the elbow and hand while protecting the ulnar nerve at the elbow
- Full, pain free mobilisation of the shoulder while supported
- Pendulum exercises for flexibility
- Learning to wash & dress
- Ice & TENS to reduce pain
- Rotations from rest to maximum
- Strengthening the humeral head stabilisers and re-centralising the humeral head
- Swimming is allowed after the 15th day

- Begin active assisted exercises while sitting, using the other arm, once full pain-free passive shoulder movement has been achieved
- Tighten muscles from rest to the maximum contracture, working the arm progressively outwards 

- Active assisted shoulder exercises
- Progressive isometric exercises for the external rotators
- No exercise against resistance until after the 3rd month