Prone Shoulder External Rotations are an early-phase rehabilitation Strength ening exercise for GH Joint - External Rotation . The prone position heightens the effect of gravity on External Rotation. A study recording the relative activity of associated muscles reported the following (SOURCE-1):
Infraspinatus - achieved 50±23% of Maximum Voluntary Isometric Contraction (MVIC)
Teres Minor - 48±27% MVIC
Supraspinatus - 68±33% MVIC
Lateral Deltoid - 49±15% MVIC
Posterior Deltoid - 79±31% MVIC
Starting Position:
Lying prone with arm in 90º GH Joint - Abduction and Elbow - Flexion
From this position the exercise is then performed with the addition of GH Joint - External Rotation , maintaining the upper arm in 90º GH Joint - Abduction .
The Standing Shoulder External Rotations have multiple variations which alter activity of the involved muscles (SOURCE-1):
Exercise Ball- can be performed on an exercise ball for an additional challenge of the stabilisers/ kinetic chains
Y-Raise - with this variation the arm is straight with 100º of GH Joint - Abduction . Greater emphasis on the Supraspinatus (82±37% MVIC), Lateral Deltoid (82±32% MVIC), Posterior Deltoid (88±33% MVIC)
The following exercises can be used as a regression if Prone Shoulder External Rotations exceed the capacity of the patient:
(unweighted) Side-Lying Shoulder External Rotations - utilises gravity alone to resist movement with arm in GH Joint - Adduction
Rotator Cuff Pendulums - oscillatory motion that afford a distracting glide to the Humeral Head
Band Pull-Apart - basic isotonic exercise for Scapular Retractors
Rotator Cuff Banded Rotations - light low range isotonic rotation exercises
The following exercises can be used as a progression to Prone Shoulder External Rotations once exercise proficiency is achieved:
Standing Shoulder External Rotations - incorporates upright torso posture
Upright Row - weighted isotonic vertical pull exercise that emphasises Upper Trapezius , Deltoid and External Rotation
Face Pulls - bilateral isonotic horizontal pull exercise that emphasises GH Joint - External Rotation
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
Escamilla, R. F., Yamashiro, K., Paulos, L., & Andrews, J. R. (2009). Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Medicine, 39(8), 663–685.