To get started on the shoulder CPM, make sure your sitting on the edge of the chair with the armrest in between your body and your arm. Carefully sit back and rest your arm in the armrest. You will now secure the two straps. To use the controller, hit the menu button at the top. The far left button controls shoulder elevation with plus or minus. The far right button controls shoulder rotation with plus or minus. Once your numbers are set, hit start, and the machine will move your arm for you.