23/12/2025
‼️ This is an advanced rehab protocol, proceed with precaution. It’s not for the acute (in most cases), or initial post-op rehab. PS: Always do a good assessment first!
🙋🏻♂️ RATIONALE BEHIND THE CHOSEN EXERCISES?
Saying that MOST people with anterior shoulder pain have weakness of subscap. is irresponsible to say the least! Significant limitation of IR (as well as pain) is frequent when it comes to posterior cuff issues, not much subscap… The “layback” position during throwing is where subscap. is very active! PS: You cannot isolate subscap.! All these exercises activate may other muscles as well… You can activate cuff muscles by: Producing classic conc./ecc. force (rotations, high-elbow rows - beginning of rehab); Static force (ISO vars against wall or w/mini band - beginning of rehab); Quasi-ISO force (rhythmic stability vars - mid. rehab); Ecc.-specific force (engaging posterior cuff when pressing, and anterior when pulling - mid. to later rehab stages). PS: This exercise progression is just 1 example, there are many more out there!
1. Safe and usually pain-free as elbow is down. It engages other big shouder IR muscles, as well as posterior cuff muscles when pushing.
2. Always safe exercise in the beginning of rehab. Make sure to pull in sagittal plane more (elbows down), as lifting elbows more engages posterior cuff more. Shoulder extension tends to translate/subluxate humeral head forward, and subscap. activates in order to prevent it.
3. Press, internally rotate and cross the arms! It activated subscap. more than pressing only - which activates posterior cuff more (opposite of row explanation).
4. Similar explanation as the first exercise, but now the harder progression as we lift elbows up (in sagittal plane though, activating subscap. a bit less than frontal plane).
5. Rowing-like static variation, that engages all the cuff muscles very good (with the main goal of stabilizing ball inside the socket). Lifting elbow up from 60-90deg engages posterior cuff more!
6-7-8. Starting in sagittal plane first, where we don’t provoke subscap. than much (although all the cuff muscles are very active in all 3 positions), and in frontal plane when ready (lifting elbow up in frontal plane engages subscap. significantly - as it wants to prevent superior humeral ball translation, plus stability on top of that = 🔥).
9. At the end of rehab, or even earlier, you are ready for frontal plane (elbow up) IR to fast ecc. stopping (engaging/stressing subscap. A LOT, all the time).
🙋🏻♂️ WHEN TO AVOID SOME OF THESE?
If having 5+ out of 10 pain while performing the specific exercise.
Yours in progress⬆️on,
Luka