Throwers Shoulder Home Exercise Program (Thrower's Ten)

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

A home exercise program from Dr. Shayne Kelly, fellowship-trained sports medicine surgeon.

Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team’s directions. In an emergency, call 911.

How much pain is OK?

Published rehab research (the Silbernagel pain-monitoring model) uses this rule of thumb: pain up to about 5 out of 10 during exercise is acceptable — as long as it settles back to your usual level by the next morning and isn't trending worse week over week. If pain runs higher, is worse the next day, or keeps climbing, ease back on the weight or repetitions.

Thrower's Ten

The throwers ten exercise program has been designed to exercise the major muscles necessary to return to throwing. The program's goal is to be an organized and precise exercise program specific to the thrower to improve strength, power, and endurance of the shoulder musculature.

1a. PNF D2 Extension Typically 2-3 sets of 10, daily

Affix tubing overhead, pull tubing down and across your body to the opposite side of leg. During the motion, lead with your thumb.

1b. PNF D2 Flexion Typically 2-3 sets of 10, daily

Affix tubing to door or stand on with opposite foot, start with palm facing behind you. Pull arm out, up, and across body. Rotate arm as you move so palm continues to face behind you.

2a. External Rotation at 0° Abduction Typically 2-3 sets of 10, daily

Stand with your uninvolved side next to a closed door, tubing attached to the doorknob. With elbow at 90° and at your side, pull out to side, hold 5 sec.

2b. Internal Rotation at 0° Abduction Typically 2-3 sets of 10, daily

Stand with your involved side next to a closed door, tubing attached to the doorknob. With elbow at 90° and at your side, pull across your body, slowly return to starting position.

2c. External Rotation at 90° Abduction Typically 2-3 sets of 10, daily

Standing with shoulder abducted at 90° and elbow flexed at 90°. Grip tubing with affixed end straight ahead slightly lower than shoulder. With shoulder abducted, rotate shoulder back keeping elbow at 90°. Return tubing and hand to starting position.

2d. Internal Rotation at 90° Abduction Typically 2-3 sets of 10, daily

Stand with shoulder abducted at 90° and elbow flexed to 90°. Grip tubing with affixed end straight ahead and slightly lower than shoulder. With shoulder abducted, rotate shoulder forward keeping elbow at 90°. Return tubing and hand to starting position.

3. Shoulder Abduction to 90° Typically 2-3 sets of 10, daily

Stand with arm at side, elbow straight, and palm against side. Raise arm to the side, palm down, until arm reaches 90° (shoulder level). Hold 2 sec.

4. Scaption (Full Can) Typically 2-3 sets of 10, daily

Standing with elbow straight and thumb up. Raise arm to shoulder level at 45° angle in front of body. Do not go above shoulder height. Hold for 2 seconds and then lower slowly.

5a. Prone Horizontal Abduction (Neutral) Typically 2-3 sets of 10, daily

Lie on table, face down, with involved arm hanging straight to floor, palm facing down. Raise arm to the side, parallel to the ground.

5b. Prone Horizontal Abduction (Full) Typically 2-3 sets of 10, daily

Lie on table, face down, with involved arm hanging straight to floor, palm facing down. Raise arm out to the side slightly in front of shoulder, parallel to the floor.

6. Press-Ups Typically 2-3 sets of 10, daily

Seated on a chair or table, place both hands firmly on the sides of the chair or table, palm down and fingers pointed outward. Hands should be placed equal with shoulders. Slowly push downward through the hands to elevate the body.

7. Prone Rowing Typically 2-3 sets of 10, daily

Lying on your stomach, with your involved arm hanging over the side of the table, dumbbell in hand and elbow straight. Slowly raise arm, bending elbow and bring dumbbell as high as possible. Hold at the top for 2 seconds, then slowly lower.

8. Push-Ups Typically 2-3 sets of 10, daily

Start in the down position with arms in a comfortable position. Place hands shoulder width apart. Push up as high as possible, rolling shoulders forward after elbows are straight. Start with a push-up on the wall, progress to table top and gradually progress to the floor as tolerable.

9a. Elbow Flexion Typically 2-3 sets of 10, daily

Standing with arm against side and palm facing inward, bend elbow upward turning palm up as you progress. Hold 2 seconds and lower slowly.

9b. Elbow Extension Typically 2-3 sets of 10, daily

Raise involved arm overhead. Provide support at the elbow from uninvolved hand. Straighten arm overhead. Hold 2 sec and lower slowly.

10a. Wrist Extension Typically 2-3 sets of 10, daily

Supporting the forearm and with palm facing down, raise the weight in hand as far as possible. Hold 2 seconds and lower slowly.

10b. Wrist Flexion Typically 2-3 sets of 10, daily

Supporting the forearm and with palm facing up, lower the weight in hand as far as possible and then curl up as far as possible. Hold for 2 seconds and return to start.

10c. Supination Typically 2-3 sets of 10, daily

Forearm supported on table with wrist in neutral position. Using a weight or hammer, roll wrist taking palm up. Hold 2 seconds and return to starting position.

10d. Pronation Typically 2-3 sets of 10, daily

Forearm should be supported on a table with wrist in neutral position. Using a weight or hammer, roll wrist taking palm down. Return to starting position.

When to call

Call Dr. Kelly’s office at (509) 460-5588 for fever over 101°F, increasing redness or drainage at incisions, pain that is worsening instead of improving, or new numbness or tingling. For chest pain or trouble breathing, call 911.

Questions about your recovery?

Dr. Kelly sees patients at Tri-City Orthopedics in Kennewick.

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