Spastic hemiplegic patients are frequently afflicted with painful shoulder contractures. Although most patients will respond to a limited exercise program and mild analgesics, there are some patients who continue to demonstrate increasing localized shoulder pain associated with spasticity of the internal rotator mechanism. These patients can be assisted with surgical release and an immediate postoperative exercise regimen. The results of such a program designed to diminish pain and increase range of asymptomatic motion are presented.