Shoulder Rehab: Hughston Exercises

The shoulder is a very complex joint, where many people develop different problems such as tears, tendonitis, frozen shoulder, impingement, etc. Some times we can wake up with a sudden pain and it goes away, and sometimes it lingers, needing medical attention. One way to combat these issues is performing exercises to increase strength and stabilization around the joint.

Hughston exercises are specific exercises that strengthen your rotator cuff muscles. Rotator cuff muscles help stabilize the shoulder and rotate the arm. There are a total of 4: supraspinatus, infraspinatus, teres minor, and subscapularis. Not only is it beneficial to strengthen these muscles when pain is present, but it also helps improves performance and prevent future injuries.

What makes Hughston exercises different than other shoulder exercises, is that each exercise begins in the same start position - laying in prone (face down), with arms handing off the table. Each exercises is performed 3 sets of 10 reps, holding the end (top) position for roughly 2-3 seconds. All movements should be slow and controlled, especially when lowering arms back towards floor. It is adequate to do 2x/ week, giving a minimum of a day in between rest. Pay special attention to end range squeeze, but remember to keep it at low intensity. There are roughly 7 different exercises. These exercises are very similar, so take note on thumb placement, which makes all the different. Depending on whether thumb is down or up can determine which muscle group is being primarily activated. Below is a list of those exercises:

*All positions are face down with pillow under stomach for support, and rolled towel at forehead for neck support. Each exercise will begin with the first exercise as the scapula will be squeeze and "set" in place.

1. Prone Retraction - While attempting to keep arm hanging, move shoulder blade toward spine.

2. Prone Shoulder Extension with External Rotation - Face palm toward floor. Bring arm away from floor to your side. Hold. Return hand toward floor.

3. Shoulder Row -Bring hand away from floor as you bend elbow. Emphasis is on bringing shoulder blade toward spine. Hold. Return hand toward floor.

4. Horizontal Abduction (thumb up) - Point thumb toward ceiling. Lift arm out to side at eye level. Hold. Return hand toward floor.

5. Prone External Rotation (6-step exercise) - Raise elbow straight out to the side, to just below table level, letting elbow bend to 90 degrees.Rotate shoulder by moving back of hand upward toward ceiling. Hold. Lower elbow toward floor.

6. Prone scaption (Ys) - Begin with arm hanging off table, turn thumb toward ceiling. Raise arm forward to position below level of table. Hold. Return hand toward floor.

7. Prone Pivot Prone - Lie on stomach with pillow support., maintaining a neutral head position. Bring elbows toward back pocket with elbows bent, wrist bent leading with little finger. Hold. Return hand toward floor.