Sidelying External Rotation Cues

Sidelying external rotation is a great exercise for individuals with shoulder pathology. The exercise has been shown to have excellent EMG activity of the posterior shoulder girdle. Additionally shoulder external rotation has been shown to engage the lower trapezius muscle, which is often weak in individuals with shoulder impingement syndrome. Many therapists prescribe sidelying external rotation as an exercise in shoulder rehabilitation, but are we prescribing this exercise appropriately? In this post, I will break down Eric Cressey's sidelying ER video and add my own personal cues.

Cues by Eric Cressey:
1) Put a towel under the armpit to place the glenohumeral joint in the proper position. A small towel decreases the stretch placed across the supraspinatus tendon. Additionally, the neutral position allows for better blood flow and healing across the glenohumeral joint optimizing your success with conservative management. 
2) Place the scapula in a neutral posture to take stress off the Latissimus dorsi and other shoulder internal rotators. Often times, the glenohumeral joint will rest in downward rotation and depression, inhibiting the rotator cuff muscles. Before strengthening the posterior shoulder, make sure the scapula is in neutral. 
3) Manually reposition the shoulder into slight posterior tilt to allow for better muscle activation of the posterior cuff. As I have discussed in previous posts, the serratus anterior and lower trapezius are both posterior tilt muscles of the shoulder girdle. Contrarily the pectoralis minor anteriorly tilts the shoulder blade. Before strengthening the rotator cuff make sure the shoulder is in a slight posterior tilt.

​-Jim