The Safer, Better Alternative To Shoulder (Codman's) Pendulums | Modern Manual Therapy Blog

The Safer, Better Alternative To Shoulder (Codman's) Pendulums

Two weeks ago, I wrote a post about getting rid of the shoulder pulley exercise (read it here) and while I was writing, I realized that a lot of the same issues I have with the pulleys I also have with shoulder (or Codman’s) pendulums.

Pendulums seem to be a staple in post-operative shoulder rehab programs/protocols.  And, just like I mentioned with the pulleys, I don’t know how or why pendulums have developed such a firm position in shoulder rehab.  Below are my issues with pendulums and an alternative exercise to have your patients perform instead.

First, the vast majority perform pendulums incorrectly (I’m thinking at least 90% & that’s probably low).  And if barely anyone can perform an exercise correctly, then why would you prescribe it to someone.  Even the picture above (which probably came from a HEP card), provides an incorrect depiction of the exercise.

The typical way in which patients perform pendulums is they just bend over and “stir the pot” with their arm.  This completely goes against the whole premise of the exercise being passive and instead it’s actively firing the rotator cuff muscles – something you don’t want in those early days after surgery.  This study showed that when you perform pendulums incorrectly there is a significant increase in supraspinatus activity.  

Another issue I have with pendulums is why patients are even doing them in the clinic!?  To me, the pendulum exercise is something you show patients for their HEP, not part of your in-clinic treatment.  Instead of watching someone do pendulums incorrectly, go do some grade I/II gleno-humeral and scapula mobilizations.  I'll bet you that your patients will appreciate that more than you telling them to swing their arm around in circles.

The safer and more effective exercise to use instead of Codman's pendulums is the "Rock the Baby" exercise - I can't remember if that's the exact name of the exercise, but that's what I tell to patients.  I came across this exercise probably 7-8 years ago and still use it to this day (I forgot where I saw it, so I apologize to whoever invented the exercise for not giving them due credit).  Below is a video of the exercise:

This alternative is much more likely to be performed correctly because it’s easier to replicate and it gives patients more control of their operated shoulder.  As you know, many patients are very anxious to move their arm after shoulder surgery and have increased muscle tone in the surrounding musculature.  By allowing them to control their operated shoulder with their good arm, you decrease their anxiety level which will make them more likely to perform the exercise while also making it more effective. When patients perform this regularly during those first few days after surgery, I find that those patients are less anxious about me moving their shoulder during their PT session - a win-win for all.

Let me know what your thoughts are on pendulums and what other alternatives you like to use.

Dr. Dennis Treubig, DPT - Modern Sports PT

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

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