I promised I’d reveal the secret for shoulder magic. Here it is.
During Lyme disease, I had radiating nerve pain 7-10 on my left side. A year later I had partial paralysis in my left arm from physical therapy. MRI showed some cervical spine abnormalities. Lots of hypotheses.
Then, a live ultrasound found that I had a 75% tear in my left supraspinatus (part of the rotator cuff) from who knows how long ago (it was old accumulated damage). The avulsion had pulled a fleck of bone off the greater tubercle of the humerus and it was grinding around on the nerves.
How is it that I can rep out at least 100lb dumbbells in overhead press now without any irritation?
I answered that partially in the first shoulder tips article.
Another piece is this prone strict external rotation:
• Lateral abduction begins to shorten supraspinatus (this is orienting the elbow at the same “forward” coordinate as the shoulder)
• Horizontal abduction shortens a little more (further orienting elbow at same objective height as shoulder)
• The end (top of the movement) of external rotation pulls everything into its shortest position EVEN for someone like me with this injury (that is, in the top position, you cannot make out even a full tear in the supraspinatus on imaging - indicating we create an opportunity for your body to close the fissure)
• Many coaches have argued this force production should be at least 10% of your max press to ensure balance at the shoulder girdle
• This exercise is not at odds with hypertrophy or max strength, although it is a magnificent measure of mobility and assessment of a common deficit in all three
• Though biopsy studies show disproportionate Type I muscle fiber cross-sections here, I increasingly lean toward heavy loading as the client can maintain form and bracing
The standing version of this loads the stretch position greatest and doesn’t load the shortened position much. That can actually worsen should instability. A standing variation with bands or cables where the anchor point is in front of or slightly above the end hand position is analogous to the prone variant here.
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