Anderson, Hall, and Martin (2000) list a systematic process of rehabilitation and management for an impingement like SS (listed below), which also includes elements listed in other works. These steps can be used to rehabilitate from SS:
- Initially, use cryotherapy (Chang, 2002; Costill, Maglischo, & Richardson, 1992; Koehler & Thorson, 1996; Loosli & Quick, 1996; Mayo Clinic, 2000; Pollard & Croker, 1999; Richardson, Jobe, & Collins, 1980; Tuffey, 2000; Otis & Goldingay, 2000).
- Later change to contrasting treatments of moist heat and cryotherapy twice per day (Chang, 2002; Counsilman & McAllister, 1986).
- Pain management may be facilitated through electronic stimulation (Chang, 2002; Costill, Maglischo, & Richardson, 1992; Pollard & Croker, 1999).
- Ultrasound treatments and nonsteroidal anti-inflammatory medication can be used to reduce inflammation (Chang, 2002; Costill, Maglischo, & Richardson, 1992; Koehler & Thorson, 1996; Loosli & Quick, 1996; Mayo Clinic, 2000; Pollard & Croker, 1999; Richardson, Jobe, & Collins, 1980; Tuffey, 2000; Otis & Goldingay, 2000; Weldon & Richardson, 2001).
- Attempt to eliminate movements that cause pain for 4-6 weeks and avoid abduction above 90º (Chang, 2002; Costill, Maglischo, & Richardson, 1992; Koehler & Thorson, 1996; Loosli & Quick, 1996; Pollard & Croker, 1999; Richardson, Jobe, & Collins, 1980; Otis & Goldingay, 2000; Weisenthal, 2001).
- Correct technique flaws that produce shoulder stress (Bak, 1997; Bak & Fauno, 1997; Costill, Maglischo, & Richardson, 1992; Johnson, Gauvin, & Fredericson, 2003; Koehler & Thorson, 1996; Loosli & Quick, 1996; Maglischo, 2003; Mayo Clinic, 2000; Pink & Jobe, 1996; Pollard & Croker, 1999; Tuffey, 2000; Otis & Goldingay, 2000; Weldon & Richardson, 2001).
- Stop using hand paddles, stop partner-assisted stretching, and stop overhead training (Costill, Maglischo, & Richardson, 1992; Koehler & Thorson, 1996; Pollard, 2001; Pollard & Croker, 1999).
- Use wand, T-bar, or other stretching exercises to improve mobility (but not hypermobility) (Pink & Jobe, 1996).
- Employ pain-free isometric and elastic cord exercises with low resistance and a high number of repetitions two to three times daily to maintain muscle tone (Baum, 1994; Bak & Fauno, 1997; Chang, 2002; Loosli & Quick, 1996).
- Control humeral head superior displacement by strengthening the infraspinatus and teres minor (Bak, 1997; Chang, 2002; Loosli & Quick, 1996; Pink & Jobe, 1996; Weisenthal, 2001).
- Add high-speed isokinetic exercises and diagonal pattern elastic band exercises after 4-6 weeks (Baum, 1994).
- Allow a gradual return to full activity if symptoms are absent and do not reoccur (Chang, 2002; Loosli & Quick, 1996; Pink & Jobe, 1996; Weisenthal, 2001).
