Advanced Shoulder Rehabilitation: The “Thread the Needle” Exercise

Recovering from a shoulder injury often involves several stages of rehabilitation. Early treatment may focus on reducing pain and restoring movement, while later stages are aimed at rebuilding strength, stability and confidence with more functional activities. Once pain has improved and basic strength has returned, higher-level rehabilitation exercises can help prepare the shoulder for everyday activities, gym training and sport.

One effective advanced shoulder rehabilitation exercise is called “Thread the Needle.” This movement combines shoulder stability, trunk control and rotational movement, making it a useful progression exercise during the later stages of recovery.

The exercise is commonly performed from a side plank position. From there, the upper arm rotates underneath the body in a controlled twisting movement before returning back to the starting position. The movement challenges the shoulder to remain stable while the body rotates, helping improve control, coordination and strength.

When performing the exercise, it is important to:

• Maintain good shoulder positioning
• Keep the shoulder controlled and stable
• Move slowly and with control
• Focus on maintaining balance throughout the movement

Exercises such as Thread the Needle may help improve:

• Shoulder stability
• Rotational control
• Upper body strength
• Core engagement
• Functional movement patterns
• Confidence returning to activity and sport

Because this is considered a higher-level exercise, it is generally most appropriate once pain has settled and earlier rehabilitation exercises have already been completed successfully. The exercise can also be modified depending on current strength and balance levels.

At Spine & Sports Physiotherapy, our Physiotherapists and Exercise Physiologists can guide shoulder rehabilitation from the early stages of injury recovery right through to advanced strengthening and return-to-sport exercises, helping you recover safely and confidently.