NAME CLINIC/HOSPITAL

ADDRESS CITY, STATE/PROVINCE, COUNTRY ZIP

Sample
Prepared by:Dan Dutton Phone: 999-999-9999 Date: 05-20-2011 Page: 1
Physiotec 1996-2011. All right reserved.

Bob Ward www.physiotec.ca (User: dufrucra Pswd: se9wGypr)

Client:

Notes:

Use a 5 pound weight for the first one and a red elastic for the others.Don't forget to activate your abdominals during all the exercises and keep a good lower back posture.Ice your shoulder for 15 minutes after the exercises.

1. Stabilization Flex/Abd
Stand with weight in both hands. Lift your arms forward to 90 degrees thumbs facing up. Open arms to side, turn your hands (palm facing down) and slowly lower to initial position.

Sets: 2 Repetition: 10
2. Strengthening Ext/retraction

Hold: 10 sec.

Tie elastic in front of you at waist level. Hold tightly both ends of elastic in both hands. Your elbows are slightly flexed. Keeping the elbows locked, shoulders down and torso stable, pull elastic backwards as far as possible by joining shoulder blades together and arms back Slowly return to initial position and repeat.

Sets: 2 Repetition: 10

Hold: 10 sec.

NAME CLINIC/HOSPITAL
ADDRESS CITY, STATE/PROVINCE, COUNTRY ZIP

Sample
Prepared by:Dan Dutton Phone: 999-999-9999 Date: 05-20-2011 Page: 2
Physiotec 1996-2011. All right reserved.

Bob Ward www.physiotec.ca (User: dufrucra Pswd: se9wGypr)

Client:

Notes:

Use a 5 pound weight for the first one and a red elastic for the others.Don't forget to activate your abdominals during all the exercises and keep a good lower back posture.Ice your shoulder for 15 minutes after the exercises.

3. Strengthening Horiz ABD/ER

Tie elastic in front of you at waist level. Hold tightly both ends of elastic in both hands. Your elbows are slightly flexed. Pull elastic backwards as far as possible by joining shoulder blades together, bending elbows 90 degrees and keeping arms horizontal. Keep shoulders back and torso stable during the exercise. Slowly return to initial position and repeat.

Sets: 2 Repetition: 10
4. Strengthening PNF

Hold: 10 sec.

Tie elastic down on one side to a door. Kneel down on the knee closest to door, having the other leg up at a 90 degree angle. Hold elastic tightly with both hands wide apart with shoulders back. Tighten up the gluts and abdominals and pull elastic up with a quick rotation movement while keeping your body upright. Come back slowly to initial position and repeat.

Sets: 2 Repetition: 10

Hold: 10 sec.

NAME CLINIC/HOSPITAL
ADDRESS CITY, STATE/PROVINCE, COUNTRY ZIP

Sample
Prepared by:Dan Dutton Phone: 999-999-9999 Date: 05-20-2011 Page: 3
Physiotec 1996-2011. All right reserved.

Bob Ward www.physiotec.ca (User: dufrucra Pswd: se9wGypr)

Client:

Notes:

Use a 5 pound weight for the first one and a red elastic for the others.Don't forget to activate your abdominals during all the exercises and keep a good lower back posture.Ice your shoulder for 15 minutes after the exercises.

5. Stretching Lat. Dorsi

Lie on your back, knees bent, hands together on stomach. Move slowly your arms up towards the head and bring the forearms together. Keeping the forearms and hands together, reach over the head until your fingers touch the floor. You then open up the forearms and slide down your arms on each side keeping them along the floor and return to initial position.

Sets: 2 Repetition: 10

Hold: 10 sec.

NAME CLINIC/HOSPITAL ADDRESS CITY, STATE/PROVINCE, COUNTRY ZIP , 999-999-9999

dates Exercises
Repetition Tempo Sets Weight Repetition Tempo Sets Weight Repetition Tempo Sets Weight Repetition Tempo Sets Weight Repetition Tempo Sets Weight

www.physiotec.ca ( User: : dufrucra Pswd: : se9wGypr)

Client : Bob Ward

Objective

Conditions

Sample dates dates dates dates dates dates dates dates dates

Prepared by: Dan Dutton dates dates