Simplifying Performance Rehab Part 6: Shoulder Instability

Presented by Phil Plisky and Nate Denning

Video Runtime: 55 Minutes; Learning Assessment Time: 38 Minutes

This course is part of a series designed to be taken sequentially. It is recommended that learners view the series in the following course order:

Simplifying Performance Rehab Part 1: A Case-Based Series
Simplifying Performance Rehab Part 2: Movement, Strength, and Power
Simplifying Performance Rehab Part 3: Speed, Agility, and Metabolic Training
Simplifying Performance Rehab Part 4: Managing Workload (Webinar)
Simplifying Performance Rehab Part 5: UCL Reconstruction
Simplifying Performance Rehab Part 6: Shoulder Instability
Simplifying Performance Rehab Part 7: Sport-Specific Progressions (Webinar)
Simplifying Performance Rehab Part 8: ACL Reconstruction
Simplifying Performance Rehab Part 9: Ankle Sprain
Simplifying Performance Rehab Part 10: Putting It All Together (Webinar)

An acute shoulder injury doesn’t have to mean months of lost training, but many clinicians feel unsure about how to keep an athlete with shoulder instability developing—especially explosive, overhead power—without jeopardizing the healing tissue. This course applies performance programming to a real nonsurgical case: a 13-year-old volleyball and track athlete with shoulder instability. It defines the clinical goals and progression criteria for each phase of healing and builds a full training regimen around them, with particular emphasis on power. Learners see how to establish the strength, muscular endurance, and end-range stability that must precede power work, then how to progress from early power (concentric-focused and closed-chain to open-chain) through late power that adds eccentric demand, greater force production, and complexity toward a return to sport. Speed, agility, and metabolic conditioning are layered in by phase, with metabolic work replacing missed practice load. Throughout, structured training runs alongside continued local shoulder rehabilitation. Physical therapists, athletic trainers, and other clinicians managing upper body injuries will be able to safely progress a complete, power-focused program from acute injury to full return to sport.

Learning Outcomes

Plan phase-specific clinical goals and progression criteria based on the physiological stages of healing for an upper body injury
Implement core rehabilitation essentials necessary to protect and support adequate upper body tissue healing
Apply power training and rate-of-force-development variables safely across all phases of upper body tissue recovery
Modify strength training progressions throughout the healing timeline to safely optimize an athlete’s return-to-sport readiness
Prioritize speed, agility, and metabolic conditioning pathways across the phases of healing to prepare the athlete for full sport return

Meet your instructors

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Phil Plisky

Dr. Phil Plisky is a professor in the University of Evansville’s Doctor of Physical Therapy and PhD in Health Professions Education programs. He is the host of the Medbridge Rehab and Performance Lab podcast and founder of the Coaches Club at

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Nate Denning

Dr. Nathan Denning is the founder of Integrated Performance and a partner at Athlete Development Solutions. His mission is to revolutionize human performance and rehabilitation through the integration of physical, mental, and educational support. Nate believes that peak performance—whether for an athlete or a clinician—is the…

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Chapters & learning objectives

1. Shoulder Instability: The Essentials

This chapter introduces the recurring case—a 13-year-old volleyball and track athlete with nonsurgical shoulder instability—and establishes the rehabilitation essentials that continue throughout the rehabilitation process: restoring shoulder range of motion and local strength, managing pain and swelling, and maintaining modalities such as e-stim and blood flow restriction. It defines phase 1 goals and the progression criteria for each phase, then lays the foundation in strength, including movement readiness, strength, and muscular endurance (built through carries and holds) required before power training. Anchoring the program to a phase-based roadmap ensures power work is later built on protected, healing tissue.

2. Early Power: Shoulder Instability

This chapter covers early-phase power progressions from phase 2 to phase 3, whose goals are to establish strength at end range and to create dynamic stability at the end range of power production. It presents concentric-focused exercises, such as the unilateral-hold RDL, quadruped ball catches, and Heiden hop and stick, along with the key cues and landmarks for each phase. Introducing power this way lets the athlete keep developing while still symptomatic and playing, building the concentric foundation and stability that higher-demand power work later requires.

3. Late Power: Shoulder Instability

This chapter covers late-phase power progressions from phase 4 through return to sport, where the goals shift to increasing force production, complexity, and movement speed while adding the eccentric phase and the eccentric-to-concentric transition. Exercises such as the barbell jump shrug, half-kneeling decel catches, and hang clean develop higher-velocity, higher-force capacity. Because these demands are significant, the course advances an athlete to late-stage power only after early-stage competency has been achieved, ensuring a safe path toward a competitive return.

4. Speed, Agility, and Metabolic Training

This chapter modifies speed, agility, and metabolic conditioning across the phases of healing, with phase-specific examples for each quality, and explains how metabolic training substitutes for the practice and game load an athlete misses while restricted. Because these largely lower body qualities can begin immediately after an upper body injury, progressing them by phase keeps the athlete conditioned and sport-ready while the shoulder heals.

More courses in this series

Simplifying Performance Rehab Part 1: A Case-Based Series

Nate Denning and Phil Plisky

Simplifying Performance Rehab Part 2: Movement, Strength, and Power

Nate Denning and Phil Plisky

Simplifying Performance Rehab Part 3: Speed, Agility, and Metabolic Training

Nate Denning and Phil Plisky

Simplifying Performance Rehab Part 5: UCL Reconstruction

Nate Denning and Phil Plisky