Kyle asked the Guru about shoulder rotation…

August 4, 2014

hey Guru

I’ve had a shoulder issue for a couple of years now where I lift it out to the side it feels shaky and unstable.

I saw a physio and they recommended external rotation but this brings pain down the side of my arm but when i do internal rotation the shoulder feels better for a while. I’ m confused now about how to solve this issue.



August 4, 2014

Hi Kyle

Tricky, innit!

Horses of courses, but never internal rotation over external rotation, or vica versa.

It all depends on what you’re doing, for what you’ve got and why.

Probably, from what you’ve said about the shaking and unstableness is that the base you’re trying to start from (the shoulder blade) is most likely doing the wrong thing, at the wrong time, in the wrong place.

The IR and ER muscles move the humerus, which we’re wrongly assuming is the optimal starting position….hence the shoulder blade position.

So before you crack on doing any IR or ER work make sure you’ve put your shoulder blade in the right starting position. This can be really tricky if you’ve got a stiff thoracic spine, as this is one of the major causes of having a poorly functioning scapula.

Without this, any rotator cuff (IR and ER) exercise (no matter how well you perform the actual exercise) will be incorrect as the starting position is incorrect.

When you’re doing any type of rehab work make sure you start with control (scap and cuff) first then add in endurance then finally go for strength.

Get your thoracic spine moving (right place), set your scapula (right time), use all of your cuff (right thing)

Hope this helps.

The Guru

Six Physio

Guru Responded

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