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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Ruben Luijkx

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.

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