Rehab to Return: Shoulder and Elbow Injury Protocols
Restore joint health, rebuild strength, and safely progress back to throwing with evidence-based rehab sequences and preventive exercises for long-term arm resilience.
Why Structured Rehab Matters
An organized rehab plan prevents setbacks, rebalances muscle imbalances, and rebuilds throwing tolerance. Rushing phases increases re-injury risk; following evidence-based progressions ensures a safe timeline from pain relief to full competition.
Phase 1: Acute – Pain Control & Mobility
| Exercise | Description | Sets/Reps |
|---|---|---|
| Pendulum Swings | Lean forward, let arm sway in small circles | 2Ă—1 minute each dir |
| Passive Shoulder ER/IR Stretch | Lying supine, use rod to gently rotate | 3Ă—30 seconds each |
| Elbow Range-of-Motion (Supine) | Bend and straighten elbow with towel support | 3Ă—10 slow reps |
| Scapular Retractions (Prone) | Lying face down, squeeze shoulder blades | 3Ă—12 |
Focus on pain-free movement. Ice after sessions and avoid overhead stress until full passive range is achieved.
Phase 2: Subacute – Activation & Stability
| Exercise | Targeted Muscle | Sets/Reps |
|---|---|---|
| Isometric ER/IR at 0° Abduction | Rotator cuff activation | 4×10-second holds |
| Scapular Wall Slides | Serratus anterior and lower trap engagement | 3Ă—15 |
| Banded Elbow Flexion/Extension | Biceps/triceps light activation | 3Ă—12 each |
| Closed-Chain Punches (Wall) | Shoulder stability under load | 3Ă—15 per arm |
Begin light resistance once passive mobility is pain-free. Emphasize control and avoid compensatory trunk movement.
Phase 3: Strength & Endurance
| Exercise | Description | Sets/Reps |
|---|---|---|
| Dumbbell External Rotation (Side) | Lying on side, elbow bent at 90° | 4×12–15 each |
| Prone Y, T, W Raises | Shoulder and scapular endurance | 3×10–12 each |
| Hammer Curls & Reverse Curls | Elbow flexor and extensor balance | 3Ă—10 each |
| Farmer’s Carry (Neutral Grip) | Grip, shoulder, and core stability | 3×30 seconds walk |
| Light Medicine-Ball Throws | Low-impact rotational power | 3Ă—8 per side |
Load up gradually. Stop if sharp pain arises. Aim for muscular fatigue without joint soreness.
Phase 4: Throwing Prep & Return to Sport
| Drill | Purpose | Volume |
|---|---|---|
| Long Toss Progression | Build throwing distance tolerance | 20→40→60→80 ft |
| Flat-Ground Programmed Tosses | Controlled arm speed and mechanics | 30–40 total throws |
| Interval Throwing (Mound) | Simulate game effort in increasing increments | 10, 20, 30, 40 pitches |
| Plyo-Ball Overload/Underload Tosses | Arm speed reinforcement | 3Ă—8 reps each |
Advance only if previous distance and volume are pain-free and mechanics remain sound.
Prevention & Maintenance Exercises
- Internal/External Rotation with Band: 2×15 each at 20° abduction
- Scapular Clock: 3×8 reps each “hour” on wall, slow and controlled
- Wrist Flexor/Extensor Stretch: 2Ă—30 seconds each side
- Thrower’s Ten Sequence: Comprehensive rotator cuff and scapular series, 2×10 each
Incorporate these into warm-ups and cool-downs to preserve balanced strength and joint integrity.
Weekly Rehab Schedule Template
| Day | Focus | Exercises |
|---|---|---|
| Monday | Phase 2 Activation | Isometrics, wall slides, banded elbow drills |
| Tuesday | Phase 3 Strength | External rotations, prone Y/T/W, hammer curls |
| Wednesday | Mobility & Recovery | Pendulums, passive ROM, light massage/foam roll |
| Thursday | Phase 3 Strength | Farmer’s carry, reverse curls, med-ball throws |
| Friday | Throwing Prep | Long toss progression or flat-ground throws |
| Saturday | Phase 4 Mound Work | Interval mound throwing and plyo-ball packet |
| Sunday | Rest & Preventive Routine | Scapular clock, wrist stretches, light band work |
Adjust based on pain levels and coach or therapist feedback. Rest days are critical for tissue adaptation.
Monitoring & Return Criteria
- Full pain-free passive and active range of motion
- Strength ≥90% contralateral side on manual muscle tests
- No soreness 24 hours post-throwing session
- Consistent mechanics under camera analysis
- Clearance benchmarks met (e.g., 50 pitches at 75% effort without pain)
Use video review to compare early and current mechanics, ensuring no compensations emerge as volume rises.
Elevate your comeback with expert-guided rehab progressions, detailed video feedback, and personalized prevention plans through Next Swing Baseball’s virtual training analysis programs. Partner with our sports rehabilitation specialists to rebuild arm health and return stronger than ever.
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https://nextswingbaseball.com/virtual-training