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best kept secrets of the shoulder
Written by October 31, 2011

Michael Harper, MEd

Associate Director of Education
The Cooper Institute

Best kept secrets of the shoulder

One of the “best kept secrets” of the shoulder is the rotator cuff. It helps to allow the shoulder to move in almost any movement pattern. Think of all the ways the shoulder moves when throwing a ball, swimming, reaching in the back seat of the car to lift up a bag, washing your hair, turning over a glass or even taking a bite of food.

The rotator cuff is made up of four muscles and their tendons around the shoulder. Wrapping around the front, back, and top of the shoulder they support movement by stabilizing the shoulder joint. These muscles are not very large in comparison to many of the other muscles in the area. But they still have a very big role that takes adequate strength levels and endurance.

To help make many of these tasks easier or more efficient, over 45 million Americans engage in strength training each year. Yet, a large number of injuries to the shoulder still occur – even within those that strength train. It has been reported that 60% of participants in one study1 had reported shoulder pain within the past year and another study of weight training participants found over 36% of the injuries reported during weight training occur to the shoulder.2

How do you protect these important muscles and tendons?

Just doing resistance training that involves the shoulder may not be the solution. A common trend among studies finds that many of the traditional shoulder exercises strengthen the large muscles around the shoulder, such as the deltoid. Unfortunately the smaller muscles of the rotator cuff are often neglected, causing a muscular imbalance.1,2

Fortunately, research has found that the following exercise is effective at targeting the most “at risk” muscle of the rotator cuff. This is the supraspinatus muscle. While a variety of exercises can improve strength, research by Giannakopoulos showed that isolated exercises may be more beneficial when a strength imbalance has been found.3 Looking at a variety of exercises for the rotator cuff, research by Boettcher found the following exercise to be optimal to strength the supraspinatus along with prone external rotation in the high five position.4

Band or Cable External Rotation

Stand with the feet shoulder width apart, bend the elbow 90 degrees and place the elbow against the side of the body. Grasp the handle of the tubing or cable with the arm opposite the tubing or cable. The forearm should be positioned across the waist with the palm facing in toward the body.

Keep the upper arm next to the side while moving the forearm out away from the waist and externally rotating the shoulder. Then slowly return to the start position and repeat.

Start with a light amount of resistance and then progress gradually and be sure not to move the torso during the movement. The movement should only be in the arm and shoulder.

1Kolber, M., Beezhuizen, K., Cheng, M., & Hellman, M. (2010). Shoulder injuries attributed to resistance training: a brief review. J Strength Cond Res, 24(6), 1696-1704.
2Kolber, M., Beezhuizen, K., Cheng, M., & Hellman, M. (2009). Shoulder joint and muscle characteristics in the recreational weight training population. J Strength Cond Res, 23(1), 148-157.
3Giannakopoulos, K., Beneka, A., Malliou, P., & Godolias, G. (2004). Isolated vs. complex exercises in strengthening the rotator cuff muscle group. J Strength Cond Res, 18(1), 144-148.
4Boettcher, C., Ginn, K., & Cathers, I. (2009). Which is the optimal exercise to strengthen supraspinatus?. Med. Sci. Sports Exerc., 41(11), 1979-1983.

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