This shoulder pulley exerciser train your upper limbs in all directions which can provide with appropriate intensity exercise to accelerate the recovery of mobility, great for rehabilitation training of upper limbs hemiplegic gradual freezing, and people with arthritis, tendonitis, periarthritis, rotator cuff injury, bursitis, or other impact problems. It can also be used for elderly fitness equipment and daily shoulder & back stretching exercises for office workers. How to use: Use your strongerer arm slowly pull handle down while the arm of the impaired limb is passively lifted up from the side. Unless directed by your doctor, do not raise your elbows over your shoulders to avoid pinching soft tissue in your shoulder socket. Note: 1. Please always keep your palm facing you. 2. For rehabilitation purposes, please consult your doctor before performing exercises. 3. Perform exercises slowly and into pain free movements.