Positioning To Increase Shoulder Range Of Motion (ROM)
Positioning to increase or maintain the shoulder range of motion gained through therapy is important as well. Maintaining shoulder ER/ABD can be accomplished with minor modifications. Forearm pronation/supination positioning should be based on the needs of each individual patient. Positioning in bed should prioritize shoulder external rotation and forearm pronation. This can be a difficult combination to achieve. Positioning the forearm in pronation can facilitate shoulder Internal rotation if the patient does not have sufficient motion at both joints. If shoulder ER and forearm pronation cannot be achieved simultaneously, shoulder ER should be prioritized.
Bed Positioning - Shoulder ER with Shoulder Flexion slightly below 90
Alternative Bed Positioning to Facilitate Shoulder ABD and ER
The most effective position for challenging the rotator cuff, serratus anterior and other scapular stabilizers is the prone position. The following exercises were found in various studies to produce the highest activation levels for the muscles of the rotator cuff. (3,4)