Face Pulls

Face Pulls are a mid-phase isotonic Horizontal Pull exercise that emphasises GH Joint - External Rotation . As external rotation deficits are a common predisposing and maintaining factor for pathology of The Shoulder Girdle , Face Pulls may be relevant for the for an array of conditions such as Subacromial Impingement , Rotator Cuff Tear or Tendinopathy , Glenohumeral Instability and Adhesive Capsulitis .

Muscles Involved

• Posterior Deltoid

• Rhomboids

• Middle and Lower Trapezius

• Rotator Cuff - particularly Infraspinatus and Teres Minor

• Biceps Brachii

• Serratus Anterior

Procedure

Starting Position:

• Patient is standing or seated facing a cable machine with cable pulley typically around chest height

• The cable attachment (most often a rope) is grasped with a pronated grip so that the Thumbs are closest to the torso and pinky Fingers furthest away

• Upright “good” posture of the torso is maintained and The Elbows are kept naturally flexed

Once slack from the cable is removed by engaging the weight, the Face Pull is performed primarily through Scapulothoracic Joint - Retraction and GH Joint - External Rotation although the cable is pulled in a non-linear/ convex fashion so that the hands approach either side of the head, near the ears. The patient may also be instructed to “pull the hands apart” to emphasise retraction of the Scapula and adequate clearance of the Humerus in the subacromial space.

Cluster

Regressions

The following exercises can be used as a regression if Face Pulls exceed the capacity of the patient:

• Prone Shoulder External Rotations - adds gravity or light load to Apprehension Test position

• Rotator Cuff Banded Rotations - light low range isotonic rotation exercises

• Side-Lying Shoulder External Rotations - maximises effect of gravity against External Rotation with upper arm fixed against torso

• Standing Shoulder External Rotations - incorporates upright torso posture

• Upright Row - weighted isotonic vertical pull exercise that emphasises Upper Trapezius and Deltoid

Progressions

The following exercises can be used as a progression to Face Pulls once exercise proficiency is achieved:

• DB Hang Clean - unilateral upright row progression, often performed explosively

• Bottoms-Up Kettlebell Walk - typically isometric exercise for entire arm musculature with perturbation from walking

• Push Press - explosive overhead movement with large range that incorporates entire body

• Rope Climb - pull-up variation with entire load bestowed on alternating arm

• Split Stance Landmine Press - unilateral total-body overhead pressing movement, typically performed explosively

References