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Ruben Luijkx, Master of Science and co-owner of Fysio Fitaal, specialises in sports-related complaints, ultrasound diagnostics and manual therapy. Writing on physiofitaal.nl, he introduces you to the expertise and professionalism of Fysio Fitaal in Tilburg.
Anteflexion unloaded with cane
The anteflexion shoulder exercise with stick is a mobility and rehabilitation exercise where you use a cane to mobilise the anteflexion direction of the shoulder. "Anteflexion" means lifting the arm forward/upward. This exercise is unloaded, meaning you no resistance or extra weight used - it is purely about regaining freedom of movement.
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Purpose of the exercise
The main objective is the Active-assisted recovery of shoulder mobility. This allows you to move further and more controlled than you could on your own, without overloading your shoulder. The unilateral execution (one arm at a time) gives you maximum control and focus on the affected shoulder.
Why this exercise for shoulder problems
- Active-assisted motion - conducts active mobilising exercise
- Unilateral focus - Full attention to affected shoulder
- Gradual mobility building - you determine the distance
- Better proprioception - you better feel what your shoulder is doing
- Transition to daily functioning - standing is more ADL related
- Safe and controlled - stick gives support
- Capsular stretch - helps with stiff shoulder
When to use this exercise
This exercise is ideal for the early to mid rehabilitation phase when active movement is still painful. Perfect for frozen shoulder (capsulitis), after shoulder surgery when you are allowed to mobilise, for movement restriction, or as a progression after supine mobilisation exercises. This is a logical next step after supine anteflexion or if you want to start functional mobilisation straight away.
Difficulty
Accessible to moderate. Heavier than lying version due to gravity, but lighter than fully active anteflexion without assistance. Requires basic balance to stand.
Equipment
- Stick, broom, or PVC pipe (about 1-1.2 metres long)
Starting position
- Stand upright with feet hip-width apart
- Weight evenly distributed on both feet
- Knees slightly bent (not hyperextended)
- Back neutral, shoulders relaxed
- Grasp the stick with both hands
- Affected arm: Hold stick at the end (negotiated grip)
- Healthy arm: Hold stick in the middle (upper hand grip)
- Stick hangs vertically or diagonally in front of your body
- Start with stick at the level of your thighs/pelvis
Downward movement(anteflexion)
- The stick stays on the ground
- Affected arm continues to hold the stick and be carried away
- Elbow of affected arm remains extended or slightly flexed
- Go as deep as comfortable as possible - stop at pain
- Ideal: stick completely above your head (vertical)
- Don't go beyond your pain threshold - this is mobility, not competition
- Keep your torso stable - no bending or twisting
Holding final position
- Hold the bottom position for a few seconds if necessary
- Feel the stretch in your shoulder, no sharp pain
- Keep breathing calmly
- Shoulders stay low, do not raise to your ears
Movement back
- Gently force into the ground with the stick
- Straighten your torso again and come upright
- Back to starting position (stick in front of your body)
Note
- Stop at sharp pain - slight stretch/strain is OK, pain is not
- Shoulder of affected arm not raised to ear
- No compensatory movements: torso remains stable, no bending/turning
- Movement should be fluid, no jerking
- Start with small movement distance
- Keep your core stable and activated
- When you get dizzy focus your gaze on a fixed point
Trained/mobilised structures
Note: This is primarily a mobility exercise, but requires some muscle activation!
Active (minimal) at affected arm:
- Lattisimus dorsi, triceps brachii
- Serrated muscle (serratus anterior) - scapula stabilisation
- Rotator cuff - stabilisation and movement
Mobilised structures (affected arm):
- Shoulder joint (glenohumeral joint) - extension of motion
- Shoulder caps - especially anterior and inferior
- Rotator cuff tendons - gentle stretch and mobilisation
- Biceps tendon (long head) - stretch
- Chest muscles (pectoralis) - stretch at full anteflexion
- Latissimus dorsi - stretch
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