In helper assisted shoulder flexion, you lie on your back while a helper supports your arm at the wrist and elbow and guides it forward and up over your head. You lift gently as well, and the helper carries whatever weight you cannot (active assisted range of motion). Physios use it when a stiff or painful shoulder cannot yet raise the arm forward by itself, and lying down makes it much harder to arch your back to fake extra height.

How to do the helper assisted shoulder flexion

Lie on your back on a firm bed with your legs straight and the arm that needs to move resting by your side.
Your helper stands beside the bed on that side. They hold your forearm just above the wrist with one hand and cup your elbow with the other, firmly but without squeezing.
When the helper gives the cue, start lifting your straight arm forward and up toward the ceiling, slowly and smoothly. The helper guides the arm and takes over the weight you cannot manage.
Carry on past the point where the arm points at the ceiling and on back over your head, as far as stays comfortable. In the video the arm travels back until it is nearly level with the bed above the head.
Pause there for a few seconds and let the shoulder settle, as the voice guide suggests.
The helper then guides the arm back down along the same path, just as slowly, until it rests at your side.

What you should feel

A gentle stretch around the shoulder near the top of the movement. The voice guide puts it at the front of the shoulder, but plenty of people feel it more under the arm. It should not hurt, and the voice guide says so plainly.

Common mistakes

Arching your lower back off the bed as the arm goes over your head.
Shrugging the shoulder up toward your ear to get the arm higher.
The helper jerking the arm, or pushing on after you have asked them to stop.
Keeping quiet when it starts to hurt. Tell your helper straight away.

How often

Many programs use 5 to 10 slow lifts with a pause of a few seconds at the top, 1 to 3 times a day. After surgery, your surgical team sets how high the arm may go. Your physio will adjust this.

Stop and check with your physio if

Sharp or catching pain as the arm rises, or pain that builds with every lift.
Pain, pins and needles or numbness spreading down your arm or into your hand.
Pins and needles in your arm or hand that do not go away after you stop, or part of your arm or hand goes numb. Get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
A sudden pop or tearing feeling in the shoulder that brings sharp pain, new weakness or trouble lifting the arm. Stop and contact your surgical team the same day, or get medical advice the same day if you have not had surgery.
The shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or your hand turns cold, pale or blue. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.
Your wound becomes more red, hot, swollen or painful, or starts to leak. Contact your medical team the same day.

From the clinic

After shoulder surgery, including a rotator cuff repair, or after a shoulder fracture or dislocation, follow your surgeon's or physio's plan, and do only the movements and range they have cleared. Many plans allow only passive movement at first, where the arm is moved for you and its muscles stay relaxed. In this version your own muscles join in with the lift, so it counts as assisted rather than passive movement. If your plan is passive only for now, keep the arm loose and let the helper do all of the moving, as in seated passive shoulder flexion.

Settle on a stop word with your helper before the first lift, and ask your physio to show them the grip and how far to go. After a stroke or a nerve injury, a weak shoulder cannot guard itself, and lifting it too high or too quickly can hurt it, so wait until your helper has been taught. This page explains the general technique, not a stroke rehab program.

If you are pregnant and past the first three months, check with your physio before exercising flat on your back. Once you can lift more of the arm yourself, lying shoulder flexion with a stick lets your other arm take over the helper's job.

Written and checked by the PocketPhysio editorial team. Last updated 2026-09-28.

This page is general education, not a diagnosis or a personal treatment plan. If you have pain, an injury or a health condition, see a physiotherapist or doctor before starting new exercises.

Helper assisted shoulder flexion