Upper Limb Exercise

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Upper limb exercise

This exercise leaflet has been designed to help improve the strength and function of your arm.

Only perform the exercises that your therapist has instructed you to do.

Stop any exercise that is causing you pain and report it to your therapist next time you see them.

If you experience any sudden shortness of breath, chest pain, angina or dizziness STOP exercising and contact your doctor or consider dialling 111 or 999 as appropriate.

UPPER ARM EXERCISES

 Exercise 1

Scapula setting
This should be your starting position for all the following exercises.

Lying on your back.  Squeeze your shoulder blades together and down.  Hold for at least 5 seconds.

A diagram of an individual squeezing their shoulder blades together. Arrows indicate the movement.

Lift your shoulders in a shrugging action, hold for 5 seconds- relax.

A diagram of an individual squeezing their shoulders up towards their ears. Arrows indicate the movement.

Roll your shoulders clockwise, then anticlockwise.

A diagram of an individual rolling shoulders.

Exercise progressions/options:

  • Complete the same exercises in sitting
  • Complete the same exercises in standing

Shoulder movements

Flexion

Lying on your back raise your arm as far as possible. Initially you could use your other arm to assist you. The goal is to increase your range of movement

A diagram of an individual laying on the floor squeezing their hands together and stretching arms straight out above head (parallel to floor).

Exercise progressions/options:

  • Complete the above exercise in sitting.
  • Complete the above exercise in standing.
  • Hold a small weight to increase the strength as well as range of movement

Once you can lift your arm in a controlled manner, lift and hold at 90 degrees then slowly take your hand to your head and then back to starting position.    

A diagram of an individual laying on the floor holding outstretched arm to sky then bending elbow to touch hand to head

Abduction/ Adduction

Lying on your back, start with your arm down by your side, palm facing your body. Slowly move your arm away from your body, aim for at least 90 degrees and return to your side. Complete with your thumb pointing forward and palm down and then with your thumb pointing up and your palm out.

Exercise Progression

  • Raise past 90 degrees.
  • Repeat in sitting/ standing.
  • Add a small weight.
A diagram of an individual sitting on a chair lifting straight arm out to side to shoulder height

Rotation

Lying on your side with a towel tucked in between your arm and torso. 

Starting with your arm bent across your body, maintaining your upper arm at your side, bring your forearm out to the side until your hand is pointing up to the ceiling.  Hold for 3 seconds and slowly return to the starting position.

Next, bring the forearm of the arm you are lying on across your body and then back out to the bed.

Diagram of an individual lay on their side with 90 degree bent arm resting on a folded towel. The arrow indicates arm being raised. A second image show the same but arrow indicates arm being lowered. The elbow stays supported.

Exercise progressions/options:

  • Hold a small weight
  • Complete in sitting, ensuring that you keep your elbow close to your body throughout
Diagram of an individual lay on their side with 90 degree bent arm resting on a folded towel holding a small weight. The weight is lifted and lowered whilst elbow stays supported.
  • Position yourself next to a wall, with your elbow bent to 90 degrees and tucked in at your side as before. Push out against the wall with your forearm and the back of your hand and hold for 3-5 seconds then repeat
A diagram of an individual standing side on to a wall using a 90 degree bent forearm to press against a pillow

Shoulder stability

Lying on your back raise your arm to 90°, keeping your elbow straight and leading with your thumb (You may need someone to help you move your arm into position or you can use your other arm to place your affected arm into position).

Once your arm is in position (release the assistance if used) and try to maintain your arm position independently.

A diagram of an individual laying on bed straightening arm from the shoulder and stretching hand up to the ceiling

Exercise Progressions/options:

  • To progress this exercise, move your arm to 90° with the help of a carer or using your other arm as needed, maintain this position whilst moving your arm up, down, left and right a few degrees in each direction.
  • Complete the above exercises in sitting.
  • Complete the above exercises in standing.
  • In sitting raise your arm as far as it will go (180° rather than 90°) and then complete the above exercise.
  • In standing raise your arm as far as it will go (180° rather than 90°) and then complete the above exercises.
  • Use a duster or tissue under your hand and move it around on a table or against the wall in front of you at different heights according to your comfort and ability. Progress this to holding a small ball (football sized) on a table in front of you or against the wall and controlling its movement up/down or in circles. The heavier the ball the harder the exercise will be so a light beach ball type may be easier initially.
A diagram of an individual facing a wall with hand on a cloth. They are sliding the cloth up and down the wall

Elbow Movements

Flexion/extension

Sit on a chair with your elbow extended and supported out to the edge on a table (palm facing upwards). Use a folded towel under the elbow. Keep your spine effortlessly elongated and maintain width across your collar bones.

Bend and extend your elbow using full range of motion.

An image of an individual straightening forearm from elbow and then bending elbow to bring hand to shoulder height

Exercise Progressions/options

  • Complete in standing
  • Complete using a weight or resistance band (as advised by your therapist)

Supination/pronation Sit on a chair of a stool with your arms by your side and elbows at a right angle. Keep your spine effortlessly elongated.

Turn your palms up and down.

An image of a hands out in front of them elbows bent at 90 degrees with the thumb and fingers straight, Palms are turning up and down

Exercise progressions/options:

  • Complete using a hand weight or resistance band (as advised by your therapist)

Weightbearing exercises

In sitting. Keep palm flat on surface and your body still. Bend and straighten elbow slowly. The movement is small and should just come from your arm

Exercise progressions/options:

Complete this in standing, leaning onto a table or with your hands in front of you against a wall and complete a small press up action, try to control the movement and fully straighten the elbows when pushing away

An diagram of an individual bearing weight onto a straight arm and hand flat on a surface they are sat on

HAND MOVEMENTS

At the beginning of each exercise squeeze your shoulder blades together and down to ensure correct starting posture.
(Ref to Exercise 1 – Scapula stability)

  • Sitting with your forearm on a table and your hand over the edge of the table, lift the hand upwards keeping the forearm still.
  • Progression: hold a small weight.
An diagram of a forearm resting on a table the wrist on the edge and the hand dangling over the side. The hand is moving up and down from the wrist
  • Sitting with your forearm and hand supported on a table move your hand from   side to side, keeping your forearm still.
  • Progression: hold a small weight.
A diagram of a hand being held up and moved from side to side as if waving at someone
  • In sitting with your forearm and hand supported on a table.  Turn your palm up and down keeping your elbow still and bent at 90 degrees.
  • Progression: hold a small weight.
A diagram of a hand being turned palm up and palm down
  • Place your hand on a table. Keeping your fingers straight and fingertips touching the table, lift your knuckles up making a bridge.  Slowly slide back to your starting position.
A diagram of a hand alternately placed flat on a surface then the knuckles are raised to tent the hand
  • Touch your thumb to the tip of each finger in turn.  Try to complete faster and in both directions.
A diagram of a thumb touching each individual finger
  • Reach forwards and pick up a large ball with both hands.
  • Progression: move it towards and away from your body in a controlled manner and then hold it and move it from side to side across your body, maintain your hand in a good position, with full contact on the ball throughout
  • Reach for a cup of water, bring the cup to your mouth and then put it back down on the table.

ADVANCED HAND ACTIVITIES

  • Functional activities to practice:
    • Turning pages in a newspaper/book.
    • Brushing your hair/teeth.
    • Taking your glasses on and off.
    • Rubbing cream on your face.
    • Folding towels or laundry with both hands.
    • Using a knife and fork to eat.
    • Writing practice.
    • Pressing buttons on your mobile phone/television remote.
    • Picking grapes from a bunch, peeling an orange, other cooking preparation.

Feedback for Inpatient Therapies

Please scan the QR code or follow the link below: 

If you have been seen by a Physiotherapist or Occupational Therapist during your admission, please leave us some feedback by scanning the QR code or following the link and filling in the short survey.

QR code

https://apps.worcsacute.nhs.uk/PublicSurvey/AHPFeedback

Ward admitted to:__________________________________ Therapy team who treated you: _______________________

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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