National Physical Therapy Examination (NPTE) Practice Exam

Which exercise should be implemented for a musculoskeletal shoulder injury in the early stages of care?

1. Strengthening of the rotator cuff muscles

2. Strengthening of the rhomboids and lower trapezius

3. Pendulum exercise

4. Active range of motion exercises focused on abduction

The correct answer is: Pendulum exercise

In the early stages of care for a musculoskeletal shoulder injury, the focus is typically on allowing healing while maintaining as much range of motion as possible without causing further damage. The pendulum exercise is particularly beneficial during this phase because it promotes gentle mobility of the shoulder joint. This exercise involves the patient bending at the waist and allowing the arm to swing freely, which helps to encourage circulation, decrease stiffness, and gently mobilize the shoulder without putting undue stress on injured tissues. Strengthening exercises, such as those targeting the rotator cuff or the rhomboids and lower trapezius, are generally more appropriate during later stages of rehabilitation once the shoulder has started to heal, and an adequate range of motion has been restored. Active range of motion exercises, especially focused on abduction, may also be too aggressive in the early stages, wherein passive or assisted movements are more suitable to prevent exacerbation of the injury. Thus, the pendulum exercise stands out as an ideal option during the initial recovery phase.