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Exercise of the Month: Shoulder Internal and External Rotation

March 2010

These are very common exercises in shoulder rehabilitation and a regular part of the workout of any athlete who needs to perform overhead motions with their arms. These exercises target deep stabilizing muscles.

Start Position: Start in a standing position with your feet lined up under your hips, your pelvis centered over your feet, your rib cage stacked directly over the pelvis, and your head centered between your shoulders—that is, with your joints lined up in your best neutral position. Contract your deep abdominals first, and then set the shoulder blade in that neutral position. Keep your upper arm down to your side with the elbow bent to 90 degrees so your forearm is facing forward. The head of your humerus (the bone of your upper arm) should be in the center of the shoulder socket with your upper arm perpendicular to the ground. Keep your wrist in a neutral position.

Mechanics

Internal Rotation: It is best to perform internal rotation first to assist in setting the ball in the socket—or the head of your humerus in the shoulder joint.

• Exhale: Holding on to a resisted band or pulley, rotate your upper arm toward your body without moving your elbow forward or backward. Think of that upper arm spinning as if it is on a rotisserie.
• Inhale: Return to the start position.


Start	End

External Rotation: These muscles are small and generally can tolerate less weight than those that perform internal rotation.

• Exhale: Holding on to a resisted band or pulley, rotate your upper arm away from your body without moving your elbow forward or backward. Again, imagine your arm is on a rotisserie.
• Inhale: Return to the start position.


Start	End

Alternative positions: Tuck a towel or pad under your arm to assist in maintaining correct alignment of the shoulder in the socket. As you become better able to stabilize your shoulder blade and increase strength in the rotator cuff muscles, moving your arm away from your body (abduction) lets you work toward having the arm in a more functional position (for example, allowing you to participate in sports that require raising your arms over your head).

Common Form Mistakes:
•    Poor alignment to start the exercise: If the shoulder blade or arm is not in the correct position to start, you might be working the wrong muscles.
•    Shoulder blade initiates the movement by retracting toward the spine: The shoulder blade should stay set so there is no tension in your neck and the correct muscles are being stabilized.
•    Gripping at your armpit: Holding your arm too tight to the body can again cause the wrong muscles to work.
•    Shoulder lifts up toward the ear during exercise: This is caused by too much gripping or working of the upper trapezius. This causes stress at the neck and poor positioning of the shoulder in the socket.

STOTT PILATES. Essential Reformer. 2nd ed. Toronto: Merrithew Corporation, 2003. 58-59. Print.

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