Four Quadrant Stretching

The 4 quadrant stretching program is a tried-and-true technique to help with many types of shoulder pain. 

It can help with pain from capsulitis, frozen shoulder, rotator cuff tears, arthritis, bursitis, labral tears, impingement syndrome, biceps problems, fractures and others. It is used in an effort to avoid surgery and, if surgery is needed, after surgery as well.

The 4 quadrant stretching program is made to stretch all parts of the shoulder. These parts include: 1) the front part by the arm pit (anterior inferior) 2) the back part by the arm pit (posterior inferior) 3) the upper part in the back (posterior superior) and 4) the upper part in the front (anterior superior).

The basic program uses 5 stretches. Four of the stretches are made to address each of the shoulder’s four quadrants and one is designed to address all of them at once. A persons therapist will determine which stretch will best help. Sometimes the therapist will remove certain stretches. Other times the therapist will add more stretches.

When doing a stretching session, each stretch should be held for 30 seconds. Each stretch should be done 5 times in a session. That means 25 stretches in each session. The person should do 5 session a day. This means 125 stretches per day.

Stretching of the shoulder should cause pain. If a person is stretching and causing no pain then they are not stretching correctly. With this said, the pain from the stretch should not last longer than 15 minutes. If the pain does last longer than 15 minutes then the person has stretches either too hard or wrong.

This program requires a lot of time. If a person is stretching wrong then they are wasting a lot time. As such it is important that a person be under the guidance of a qualified therapist.


Forward elevation: anterior/inferior capsule

Press hand on wall as high as you can reach.  Keep hand on wall and step away from all.  Slowly bend at the waist for stretch.

Abduction/extension: anterior capsule: anterior/inferior capsule

Place hand on wall at shoulder level.  Gently rotate away from wall.

Abduction/flexion: posterior capsule

Cradle stiff arm in opposite elbow.  Gently pull stiff arm toward your body.

Abduction/internal rotation: posterior/inferior capsule

Lay on affected shoulder.  Extend arm straight out from body.  Gently push affected hand toward floor.

Abduction/internal rotation: posterior/superior capsule

Place affected hand behind back.  Grab stick or towel held by unaffected hand.  Gently extend unaffected hand upwards.

External Rotation 

Hold the stick, palms upward and about shoulder width apart.  Keep the elbows against the body, and push the stick towards the affected side.