Protect Your Weak Arm
and Shoulder after Stroke
After having a stroke, it is common to have weakness on one side of the body,
called hemiparesis. Learn how to prevent injuries by protecting your arm and
shoulder on your weak side.
About the shoulder joint
The shoulder joint is made up of
3 bones:
• Clavicle at the front
• Scapula or shoulder blade at the back
• Humerus in your upper arm
The ball shaped end of the humerus is held
in the shallow socket of the scapula by
muscles and tendons, called the rotator cuff.
The scapula and humerus work together to
allow your arm to rise up.
When you have weakness on one side, the
muscles of the arm and shoulder are not
able to work as well.
You need to limit some motions to prevent
injuries.
Common shoulder injuries and how to prevent them
Muscle Pinch (Impingement)
You may not have the strength to raise your
weak arm without help. If you or someone raises
your elbow on your weak side above your
shoulder, the humerus gets pushed into the
scapula socket.
The muscle can get pinched between the
scapula and humerus. This injury is called
impingement. Pain and long term damage can
occur in the joint.
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To protect your shoulder joint from this type of injury:
Ì Do not raise your weak arm above the level of your
shoulder with your other hand.
Ì Do not let anyone else lift it higher than your shoulder.
Ì Do not pull on or twist your arm at the shoulder.
Ball Slips Out of Socket (Subluxation)
If your rotator cuff muscles get weak and lose tone, the
humerus in your upper arm may slip down out of the scapula
socket. This is called subluxation.
Exercises can help keep these muscles strong and prevent this
injury. Strong shoulder muscles can pull the humerus back into
the socket.
Treatment to protect your arm and shoulder
Hemiparesis of the arm is treated with:
• Good posture and balance when sitting
• Exercises to strengthen the shoulder and arm
Using an arm sling does not help a shoulder with hemiparesis. The sling may actually keep the
arm in poor position and cause more pain and swelling. Your therapist can work with you to find
ways to support your shoulder, such as using a lap tray on your wheelchair to keep your arm in a
neutral position.
Use Good Posture
Your posture impacts how well the shoulder joint
works.
To improve your shoulder movement, sit up tall as
often as you can to keep your shoulder blades in
the correct position.
Do Not Lean or Slouch
If you sit in a slouched or leaning position,
your shoulder blade, called scapula, is not Scapula
able to move as well and can prevent your (shoulder blade)
upper arm from moving, causing injury.
Using good posture can help prevent this
injury.
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Use Rolled Towel When Sitting
When you sit in a chair, place a rolled towel or pad in the curve of
your lower back. This helps you sit upright and keeps your back
comfortable, keeping your shoulders over your hips.
Exercises
Shoulder Raise (Elevation)
• Raise your shoulders up toward your ears, keeping your
neck straight. Relax your shoulders back down and
repeat.
• If you are not able to do this by yourself:
Ì Have another person help you by placing the palm
of his or her hand on the front of your affected
shoulder and the other hand on the bottom of your
shoulder blade on the same side.
Ì Lean toward your helper, so that your shoulder and
shoulder blade raise up.
Shoulder Squeeze (Retraction)
• Pull your shoulders back and squeeze your shoulder
blades together. Relax and repeat.
• If you are not able to do this by yourself:
Ì Have another person help you by placing the palm
of his or her hand on the front of your affected
shoulder and the other hand cupping your
shoulder blade on the same side.
Ì Turn your body away from your helper, so that your
shoulder blade pulls inward.
Backward Shoulder Roll
• Roll your shoulder backward in a circle. Relax and
repeat.
• Do not roll your shoulder forward.
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Rocking the Baby
• Cross your arms in front of you. Your affected arm is on top, with your elbow supported by
the hand of your other arm.
• Rotate your body from side to side while supporting the affected arm.
• Repeat this 10 times each hour.
Outside Shoulder Stretch (External Rotation)
Do not try this stretch until your therapist has
shown you how to do it properly.
• Lie on your back with your arm at a 45 degree
angle to your side.
• Gently rotate your hand back, supporting your
lower arm on a pillow.
• Leave your arm in this position for ____
minutes for a long stretch.
As you gain more strength and movement in your arm, your therapist will give you exercises to
increase coordination between your arms.
Talk to your doctor or health care team if you have any questions about your care.
For more health information, contact the Library for Health Information at 614-293-3707 or
e-mail [email protected].
© 2012 - January 25, 2018, The Ohio State University Wexner Medical Center.
