00:04 - 00:06This is Brent president of the Brookbush Institute bringing
00:06 - 00:08you guys a technique that you may not
00:08 - 00:10use as often as some of the other
00:10 - 00:11techniques we've demonstrated in
00:11 - 00:13previous videos, and that's because we're
00:13 - 00:15going to demonstrate internal rotator
00:15 - 00:18activation. Now why you wouldn't use
00:18 - 00:19internal rotator activation is because
00:19 - 00:20most individuals have a propensity
00:20 - 00:23towards excessive glenohumeral or
00:23 - 00:25shoulder internal rotation during both
00:25 - 00:28static and dynamic postures, however
00:28 - 00:30there is also a group of individuals who
00:30 - 00:33are affected by shoulder hypermobility
00:33 - 00:37or glenohumeral laxity. Now
00:37 - 00:39in those individuals we have a
00:39 - 00:42propensity towards excessive anterior
00:42 - 00:46glide, and now we see where the
00:46 - 00:49subscapularis lying in front of the
00:49 - 00:52humerus, if it increases in activity may
00:52 - 00:57actually have a good fiber arrangement
00:57 - 01:01to help block excessive anterior glide.
01:01 - 01:02So I'm going to have my friend Melissa
01:02 - 01:04come out, she's going to help me
01:04 - 01:06demonstrate this exercise that actually
01:06 - 01:08took me quite a while to come up with
01:08 - 01:11because we have this problem when we try
01:11 - 01:13to do internal rotator activation. I'm
01:13 - 01:15sure some of you have seen internal
01:15 - 01:17rotator activation this way which is a
01:17 - 01:19good general idea it is internal
01:19 - 01:23rotation, other than we have two or three
01:23 - 01:27larger internal
01:27 - 01:30rotators being our pectoralis major,
01:30 - 01:33latissimus dorsi and teres
01:33 - 01:36major. So now the question becomes well
01:36 - 01:39how do I target my subscapularis because
01:39 - 01:41chances are my pectoralis major, my
01:41 - 01:43latissimus dorsi and my teres major
01:43 - 01:46aren't going to help me with this
01:46 - 01:49anterior shoulder laxity. So Melissa I'm
01:49 - 01:53going to have you take the band and do
01:53 - 01:56this, so it's across your back and
01:56 - 01:58you're going to put it right underneath
01:58 - 02:00the border of your deltoid so that it's
02:00 - 02:04literally wrapped around you.
02:04 - 02:06Alright so as she does that I know some of
02:06 - 02:09you guys are already thinking well he
02:09 - 02:12said he wants to hit the subscapularis and we basically
02:12 - 02:15have pectoralis major and latissimus dorsi
02:15 - 02:17that I need to reciprocally inhibit,
02:17 - 02:18If you are thinking toward some of
02:18 - 02:20the other activation videos we did. And
02:20 - 02:22pectoralis major I could
02:22 - 02:25probably reciprocally inhibit using
02:25 - 02:28horizontal abduction, and then my
02:28 - 02:30latissimus dorsi I probably can inhibit
02:30 - 02:33using flexion. So what would it look like
02:33 - 02:36to do horizontal abduction, flexion and
02:36 - 02:38internal rotation all at the same time,
02:38 - 02:41and how do I resist that. Now you know
02:41 - 02:42why this took me a few months to come up
02:42 - 02:44with. What you're going to
02:44 - 02:45do Melissa is go ahead and lie on your
02:45 - 02:50side. Now since the band is wrapped
02:50 - 02:53around her back
02:53 - 02:56I already have internal rotation
02:56 - 02:59resisted on this bottom arm. Just if
02:59 - 03:01she goes, so just take this out away for
03:01 - 03:05a second. If she goes like this, the band
03:05 - 03:08gets stretched around her arm, that'll
03:08 - 03:11resist my internal rotation. Now to
03:11 - 03:13inhibit my pectoralis major with
03:13 - 03:16horizontal abduction all I have to do
03:16 - 03:19is cue Melissa to take the shoulder and
03:19 - 03:22press it back into the wall. So we're
03:22 - 03:24using a plyo box just for video purposes, but
03:24 - 03:25you could just do this against
03:25 - 03:30any blank wall. Now to get the latissimus
03:30 - 03:33dorsi out I'm going to go ahead and use
03:33 - 03:34a little shoulder flexion, and the way
03:34 - 03:36I'm going to do that is i'm going to
03:36 - 03:38have Melissa take this hand and put it
03:38 - 03:41on top of the bicep. Alright so now she's
03:41 - 03:43she's getting pretty close to to what's
03:43 - 03:45going to end up being this kind of cross
03:45 - 03:47arm pose which is our goal. The only
03:47 - 03:49difference is I'm going to actually have
03:49 - 03:50her kind of cue this chicken wing
03:50 - 03:52maneuver where I have her think about
03:52 - 03:56going elbow up and hand down so that our
03:56 - 03:59hand just passes this elbow. So she's kind
03:59 - 04:01of grinding her elbow into the turf here
04:01 - 04:04going this way, while bringing her hand
04:04 - 04:09down this way, good and back up. So she
04:09 - 04:12started with her elbow kind of low, you
04:12 - 04:14guys don't have to be at 90 degrees of
04:14 - 04:16flexion necessarily. It may be more
04:16 - 04:17comfortable for somebody
04:17 - 04:19to come down to like 45 degrees of
04:19 - 04:22flexion, if she wanted to she could
04:22 - 04:28definitely go higher. Lets see can
04:28 - 04:32you go all the way up. Let's try this,
04:33 - 04:37how does that feel? A little tougher up there
04:37 - 04:39which you'll find unfortunately is
04:39 - 04:41although it's tougher to do it 90
04:41 - 04:43degrees of flexion, some individuals who
04:43 - 04:45have some shoulder pain already, they're
04:45 - 04:47already showing symptoms of inflammation,
04:47 - 04:51they may not like doing internal
04:51 - 04:53rotation at 90 degrees it just doesn't
04:53 - 04:57feel comfortable for them. Alright you
04:57 - 04:59just have them like I said keep trying to
04:59 - 05:02get this hand past this elbow. If you
05:02 - 05:04know how much internal rotation
05:04 - 05:06somebody is supposed to have in this
05:06 - 05:08position it should be between 50 and 70
05:08 - 05:11degrees, they should actually be able to
05:11 - 05:13get their fingertips
05:13 - 05:16pretty close to the floor, assuming
05:16 - 05:17they're going to do a little wrist
05:17 - 05:19flexion too. We can see Melissa is
05:19 - 05:21missing a few degrees there. Under
05:21 - 05:23normal circumstances we would have done
05:23 - 05:26some mobility techniques first. Alright Melissa
05:26 - 05:27do you want to try the other side see
05:27 - 05:30if you can get set up on your own. Good
05:30 - 05:32thing to work through with people is
05:32 - 05:34usually I'll show them one side and then
05:34 - 05:35I'll see how far they can get on their
05:35 - 05:37own without any cueing to set up the
05:37 - 05:40other side, just to make sure they're
05:40 - 05:41going to be able to do this in a home
05:41 - 05:46exercise program without my supervision.
05:47 - 05:49Make sure you're leaning back into the
05:49 - 06:00wall, there i go cueing again. Alright
06:05 - 06:08good how does that feel. A lot of people
06:08 - 06:10won't feel much, if they do feel
06:10 - 06:12something they might feel it deep in
06:12 - 06:13their armpit. If they start feeling a
06:13 - 06:15burn in their pectoralis major you know
06:15 - 06:16you're going to have to work a little
06:16 - 06:18harder to try to get them to inhibit
06:18 - 06:21their pectoralis major, and that might be
06:21 - 06:23leaning back into the wall a little bit
06:23 - 06:26harder, or messing around with how much
06:26 - 06:28flexion they had in the arm that they're
06:28 - 06:31working. From an assessment standpoint
06:31 - 06:32guys you're probably going to see
06:32 - 06:35something like excessive external
06:35 - 06:37rotation, maybe a hundred degrees of
06:37 - 06:40external rotation before implementing
06:40 - 06:44this technique; and oddly when compared
06:44 - 06:47to some of our other case studies that
06:47 - 06:50you might have gone through before, we're
06:50 - 06:52actually looking for a decrease in
06:52 - 06:55mobility after this technique has been
06:55 - 06:59performed like I said if we're using it
06:59 - 07:01for anterior shoulder laxity. Now I know
07:01 - 07:02some of you guys are going to use this
07:02 - 07:05potentially for individuals who have a
07:05 - 07:07decreased internal rotation range of
07:07 - 07:10motion which is okay. I might not use it
07:10 - 07:12for that based on some of the
07:12 - 07:14arthrokinematic dysfunction that's happening
07:14 - 07:15around that, but if that were the case
07:15 - 07:17then you would use internal rotation
07:17 - 07:20goniometry and actually expect an
07:20 - 07:23increase in internal rotation range of
07:23 - 07:26motion after doing this technique. So
07:26 - 07:29there you guys have it we have monster
07:29 - 07:31band resisted internal rotation,
07:31 - 07:34resistance is coming from the band being
07:34 - 07:37wrapped around their arm. So it's not
07:37 - 07:39like they're pulling on the band, the
07:39 - 07:41band is getting stretched around their
07:41 - 07:43arm as they're rotating inward. You're
07:43 - 07:46reciprocally inhibiting the
07:46 - 07:49pectoralis major through horizontal
07:49 - 07:51abduction, and you're resisting the
07:51 - 07:54latissimus dorsi be a little shoulder
07:54 - 07:58flexion. Ideal number of reps for all of
07:58 - 08:00our activation techniques is 12 to 20
08:00 - 08:02repetitions. Our tempo for something
08:02 - 08:04like this although I haven;t cued Melissa
08:04 - 08:06too harshly as you're just trying to get
08:06 - 08:08this set up, would be something like a
08:08 - 08:112-4-2, where I have her hold for four
08:11 - 08:12second at the bottom if I really want to
08:12 - 08:15work on that range of motion. Or a 4-2-2,
08:16 - 08:19where she would go through, hold and then
08:19 - 08:22back nice and slow working on eccentric
08:22 - 08:26control, and all we need is one, maybe two
08:26 - 08:29sets of these activation techniques
08:29 - 08:32before we start moving into our other
08:32 - 08:34more complicated resistance training
08:34 - 08:36based movement patterns. I look forward
08:36 - 08:38to hearing your questions and i hope you
08:38 - 08:40enjoyed this video, and enjoy using this
08:40 - 08:43exercise in your programs.