Pendulum and Codman Exercises for Shoulder Rehabilitation

Medically reviewed by Peggy Pletcher, MS, RD, LD, CDE on January 28, 2016Written by Natasha Freutel on January 28, 2016
Pendulum Exercises

The shoulder is a major and important joint of the body. Its complex structure and 360-degree range of motion allows for many dynamic and necessary movements.

Unfortunately, this brings with it a greater chance of injury. One passive shoulder exercise often prescribed during shoulder rehabilitation is called the pendulum or Codman exercise, developed by Edina Codman. It’s used to facilitate passive range of motion of the joint, and doesn’t require a muscle contraction.

Doctors recommend pendulum exercises for many shoulder conditions, including:

  • rotator cuff tears
  • adhesive capsulitis (frozen shoulder)
  • labral tears
  • collarbone fractures
  • shoulder dislocations

The four muscles surrounding the shoulder joint — supraspinatus, infraspinatus, subscapularis, and teres minor — all make up the rotator cuff. They allow for movement and stability to the otherwise loose ball and socket shoulder joint. Injury to these muscles or tendons can cause pain, restriction in movement, and weakness in the shoulder and arm. Surgery is often recommended for serious rotator cuff tears.

A 2010 study recognized that there are many different rehabilitation practices used after rotator cuff surgery. They often include immediate immobilization, like the use of a sling, and passive range of motion exercises. When performed correctly, these exercises help decrease joint stiffness and prevent adhesions and contractures as well as increase circulation and improve healing.

There are multiple ways do pendulum exercises, but it’s best to do them under the direction of your doctor or physical therapist so you can be sure you are doing them the way they prescribe.

Standing Pendulum Exercises

This exercise uses the weight and momentum of your arm to encourage movement at the shoulder joint, while maintaining inactivity of the injured or repaired muscles.

Equipment needed: table

Muscles worked: supraspinatus, infraspinatus, subscapularis, and teres minor

  1. Stand beside a table with the hand of your unaffected shoulder on the table and feet slightly wider than shoulder-width apart.
  2. Bend at the hips approximately 75 to 90 degrees and let your affected arm hang down toward the floor.
  3. Shift your weight side to side, letting your arm swing freely side to side.
  4. Shift your weight forward and backward, letting your arm swing freely front to back.
  5. Once you feel comfortable with these movements, move your body so that your arm swings in a circle, being careful not to use your shoulder muscles to create movement. Keep the circle small, less than 8 inches.
  6. Continue for 30 seconds. Each day, increase the time until you can do 3 to 5 minutes.
  7. Repeat 5 times per day.

Lying Pendulum Exercises

This exercise helps relax the muscles of the shoulder and neck and allows for passive range of motion of the shoulder joint. It’s best for people who have a difficult time with the standing exercise due to balance or back pain.

Equipment needed: bed or table

Muscles worked: supraspinatus, infraspinatus, subscapularis, and teres minor

  1. Lie flat on your stomach close to the edge of the bed. Hang your affected arm over the edge and relax it towards the ground. Let your shoulder blade relax and let go of the tension in your neck.
  2. Breathe in. While you breathe out, gently swing your arm forward and back. Avoid using the muscles of the shoulder to initiate the movement. It’s best to have someone else gently move the arm to begin.
  3. Continue for 30 seconds, moving the arm approximately 15 degrees.
  4. Work up to 3 to 5 minutes at a time, increasing the movement to 30 degrees.
  5. Repeat 5 times per day.

Weighted Pendulum Exercises

This advanced pendulum exercise uses a dumbbell or wrist weight for added pull on the shoulder joint. A 2006 study compared weighted and unweighted pendulum exercises. They concluded that adding 3.3 pounds (1.5 kg) to standing pendulum exercises doesn’t cause an increase in muscle activation when performed correctly, and they can be used during the initial rehabilitation period.

Equipment needed: table, dumbbell, or wrist weight (3 pounds)

Muscles worked: deltoid, infraspinatus, supraspinatus, upper trapezius

  1. Stand beside a table with the hand of your unaffected shoulder resting on the table and feet slightly wider than shoulder-width apart.
  2. Bend at the hips and let your affected arm hang down toward the floor.
  3. Have someone place a dumbbell in the affected hand or wrap a wrist weight around your wrist.
  4. Shift your weight side to side, letting your arm swing freely side to side.
  5. Shift your weight forward and back, letting your arm swing freely, front to back.
  6. Once you feel comfortable with these movements, move your body so your arm swings in a circle, being careful not to use your shoulder muscles to create movement. Keep the circle small, less than 8 inches.
  7. Continue for 30 seconds, increasing to 3 to 5 minutes.
  8. Repeat 5 times per day.

The Takeaway

These exercises mimic the movement of a clock pendulum and are excellent rehabilitation tools after shoulder injury. They use gravity and momentum to create motion rather than muscle strength.

This technique promotes healing and allows for range of motion movement without straining the newly repaired or damaged structures. It’s important to do these exercises correctly since active range of motion exercises, those that use muscle strength, are often contraindicated in early recovery stages.

Always consult your doctor or physical therapist before beginning an exercise program. If these activities cause an increase in pain, stop immediately and seek help. If you have increased swelling or numbness in your hand or arm, stop the exercise and take a break before trying it again. It’s important to allow the shoulder adequate time to heal after injury. Follow all recommendations made by your doctor to prevent reinjury.

Natasha
CMS Id: 97772