Standing Shoulder External Rotations are an early-phase rehabilitation Strength ening exercise for GH Joint - External Rotation . A study recording the relative activity of associated muscles reported the following (SOURCE-1):
Infraspinatus - achieved 40±14% ofMaximum Voluntary Isometric Contraction (MVIC)
Teres Minor - 34±13% MVIC
Supraspinatus - 41±38% MVIC
Lateral Deltoid - 11±7% MVIC
Posterior Deltoid - 27±27% MVIC
Starting Position:
Standing with symptomatic Elbow tucked to their side in ~ 90º Elbow - Flexion and very slight GH Joint - Flexion
A band/ cable attachment is fixed on the contralateral side at roughly Elbow height and grasped by the ipsilateral hand so that the cable/ band is drawn across the front of the torso
The patient then oscillates through ~50% of available GH Joint - External Rotation , keeping their elbow fixed to their side and avoiding compensation from structures such as the Posterior Deltoid . As these exercises serve as an activation, 2-3 sets of 12-15 repetitions is adequate.
The Standing Shoulder External Rotations have multiple variations which alter activity of the involved muscles (SOURCE-1):
Scapular Plane- Standing with 45º GH Joint - Abduction and 30º Horizontal GH Joint - Adduction . Greatest recruitment of the Infraspinatus (53±25% MVIC) and Teres Minor (55±30% MVIC)
90º GH Joint - Abduction - External Rotation is performed from a starting position of 90º Abduction. Greatest recruitment of the Supraspinatus (57±32% MVIC), Lateral Deltoid (55±23% MVIC) and Posterior Deltoid (59±33% MVIC)
Towel- A towel or similar object is wedged between The Hip and The Elbow , placing the patient in roughly 15º of GH Joint - Abduction . Prevents compensatory motion at The Elbow and better recruitment of the Infraspinatus and Teres Minor compared to without a towel
The following exercises can be used as a regression if Standing Shoulder External Rotations exceed the capacity of the patient:
Rotator Cuff Pendulums - oscillatory motion that afford a distracting glide to the Humeral Head
Band Pull-Apart - basic isotonic exercise for Scapular Retractors
Prone Shoulder External Rotations - adds gravity or light load to Apprehension Test position
Rotator Cuff Banded Rotations - light low range isotonic rotation exercises
Side-Lying Shoulder External Rotations - maximises effect of gravity against External Rotation with upper arm fixed against torso
The following exercises can be used as a progression to Standing Shoulder External Rotations once exercise proficiency is achieved:
Upright Row - weighted isotonic vertical pull exercise that emphasises Upper Trapezius and Deltoid
Bottoms-Up Kettlebell Walk - typically isometric exercise for entire arm musculature with perturbation from walking
Push Press - explosive overhead movement with large range that incorporates entire body
Rope Climb - pull-up variation with entire load bestowed on alternating arm
Split Stance Landmine Press - unilateral total-body overhead pressing movement, typically performed explosively
Escamilla, R. F., Yamashiro, K., Paulos, L., & Andrews, J. R. (2009). Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Medicine, 39(8), 663–685.