Name: Shoulder External Rotator Activation Progression
Uploaded: 2023-04-26T01:02:54.000Z
Duration: 3 min 51 s

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https://stream.mux.com/00Uhql2w01xYOKkv3NrTrOyfD9EaUuLfYb2IDWvEXlP6A.m3u8

Learn how to properly perform shoulder external rotator activation progressions in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on setup, positioning, alignment, and exercise modifications to improve activation of the external rotators of the shoulder (teres minor and infraspinatus) and shoulder stability. Enhance external rotation strength and neuromuscular control while supporting optimal scapular positioning and shoulder mechanics with this targeted activation progression. Perfect for athletes, fitness enthusiasts, and rehabilitation clients seeking to improve shoulder stability, increase strength, and restore optimal movement mechanics while reducing injury risk.

Introduction to External Rotator Activation Progressions

Moving Beyond Neutral Position for Strength Training

Utilizing the Splint for Scapular Stability

Progressing the Exercise with Fit Loops

Alternative Wall Setup for External Rotation

Conclusion and Encouragement for Trainers

Shoulder External Rotator Activation Progression

This is Brent coming at you with progressions for external rotator activation. Now, in a previous video we did this optimal position, right here, this is a wonderful way to get things going. But, the problem becomes, how do I take it up a notch? I have my friend Rob to thank, one of our human movement science geek-outs, we came up with a way of getting us out of this neutral position so we can start working on strength in other ranges. Now, Rob is going to get up on the splint here, it's going to be in quadruped position, but you kind of have to find something to get the arms elevated on, because we are going to have arms bent at 90 degrees. Now the problem with taking him out of this neutral position here, is when I see people do, let's say external rotation at 90 degrees of abduction, usually what I end up seeing is a lot of compensation at the shoulder complex. We get that elevation of the superior angle of the scapula, we get this thing, a lot of anterior tipping, I don't want to see any of that because now, we might be getting good external rotator activation here, but we're contributing to compensation everywhere else. This ingenious little exercise that Rob showed me, gets the shoulder girdle weight-bearing, which means now I can queue scapular depression and protraction, I now know that he is stable, his serratus anterior is nice and active, which is one of our under active muscles, and now all I have to do is have him queue into external rotation. Actually just the friction, you see we even put a towel down to make it slicker, but just the friction of the surface and his body weight is enough to make this really, really, hard. Not to mention, his range of motion is fairly limited because he's working against all of these muscles that are now stretched at 90 degrees of shoulder flexion. If I wanted to progress this exercise, it's actually really simple. I just give him this fit loop, I know you have seen fit loops before, a very, very, useful piece of equipment, very cheap, and now he can go one at a time, using one side as a stable arm. So this is stable, he can go unilateral, or we can progress it a little further and go bilateral, which makes this really, really, really, tough. Rob and I were talking about it a little bit, we're still working through this exercise, finding out, what I like to call, the personality of the exercise. We're not quite sure if it's twice as tough because of how much thoracic mobility it takes, or maybe just working against a lot of your own musculature, or if it's just the fact of double the resistance on the band. Now, if you didn't have all this setup, there is kind of a quick and dirty version of this exercise, which is up against the wall. So if Rob does the same thing against the wall, it's almost like a plank at this point, like if you thought about setting somebody up as in a plank position, against the wall, same nice kinetic chain checkpoints, have them walk their feet back just a little bit, so that they have a little bit of weight into the wall queue them once again into depression, and protraction at the scapula, and then he can do the same external rotation, just using the resistance of the wall initially, he could even walk his feet out a little further and increase that resistance a little bit, and, of course, I could already see that this is really hard, I know you guys can't see his face, but we can always add the band back, and of course you know fit loops come in many different resistances. So, squeeze your glutes for me, tuck under, good, and external rotation. So there you go, a neat little progression on external rotator activation. I hope you guys enjoy this exercise. I hope you see more and more results for your clients, I look forward to talking to you soon!

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Infraspinatus and teres minor (posterior rotator cuff) exercises for improving movement dysfunction, posture, shoulder pain, shoulder impingement, forward head, rotator cuff injury, and sports performance. Great infraspinatus and teres minor activations for the posterior rotator cuff.

Shoulder External Rotator Exercises (Activation)

A comparison of shoulder external rotator (infraspinatus, teres minor, and posterior deltoid) exercises based on EMG activity and percent maximal voluntary isometric contraction. Selection and progression of optimal rotator cuff exercises, loads, and positioning for optimal rotator cuff (SITS) activity, rehabilitation, and recruitment. 

Comparing Shoulder External Rotation Exercises

External Rotation Progression at 90° of Flexion with Scapular Stabilization:

Choose the appropriate body position - Various body positions may be used to increase the resistance against scapular protraction and depression (scapular stabilization), and increase the load on the forearms which may increase friction and resistance to external rotation.

With the elbow bent to 90° and the shoulders flexed to 90°, have your patient/client press the forearms into a wall, table or bench to protract, depress, and stabilize the scapula.

Start with the hands together and while pressing into the wall for added resistance, externally rotate the shoulders without abducting. Note: In this position, the posterior deltoid and 

 are less active, but allowing abduction may contribute to synergistic dominance and reinforce compensatory patterns.

The range of motion of this exercise is fairly small; however, full range of motion should still be the goal.

If not using external resistance, reduce the pressure into the wall, table, or bench and return to the starting position.

A mini-band, resista-band tape, or tubing may be used to add additional resistance, but very little resistance is needed. Start with very light bands and place the resistance closer to the elbows to reduce the moment arm. Even a yellow mini-band at mid-forearm is sufficient resistance for the large, well-conditioned athlete.

Perform 12 – 20 repetitions through full available range of motion, with a 2:4:2 or 4:2:2 tempo, and move on to your next activation exercise. A second set may be performed if you desire and the patient is capable.

Great exercise for anterior shoulder instability:

This exercise has a distinct advantage over the progression above for those individuals with anterior shoulder instability due to the anterior to posterior force aiding in the maintenance of the humeral head posterior on the glenoid fossa.

In a study by Reinold et al., exercises similar to those in progression 1 were shown to result in less posterior deltoid and 

 recruitment, relative to recruitment of the 

 (7 commonly used exercises were compared) (15). Further in a study by Ha et al., external rotation at 90° of flexion was shown to further increase 

 activity and reduce posterior deltoid activity (16).

Before incorporating external resistance using a band, this exercise may be progressed from standing with arms on a wall, to quadruped position on a riser (depicted above), to quasi-plank position. The increase in body weight on the arms results in greater friction and resistance to external rotation.

Shoulder External Rotator Activation Progression

Single Leg Alternating Horizontal Abduction with External Rotation

Combined Deep Cervical Flexor and External Rotator Activation

Infraspinatus and Teres Minor Static Manual Release (Soft Tissue Mobilization)

Shoulder Special Test: Infraspinatus and Internal Rotation Resistance Strength Test (IRRST) Tests

Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population

Shoulder External Rotator Activation Taping

PNF Carry Away

Prone Floor Cobra (after chest-out/thumbs out)

External Rotator Reactive Activation

Shoulder External Rotator Isolated Activation

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