Common problems
1. Rotator cuff strength – most common
2. Limited rotation
3. Limited flexion
Usually people have all 3
Progression
Rotator cuff strength
1. Banded side pulls with rotation
2. Crossover Symmetry
3. Seated DB External Rotation
Limited rotation
1. Passive stretch – front rack = external, behind back = internal
2. PNF stretching
3. Loaded rotation
Limited flexion
1. Passive stretch – bar hang
2. Standing shoulder flexion PAILs/RAILs
3. Prone shoulder flexion PAILs/RAILs - progress to loaded w/ light DB, dowel
Pushing
0. No ROM, no tension – standing pec ISOs, light static stretching
1. Some ROM, micro tension – light floor press
2. Full ROM, mini tension – standing arm flies/bench
3. Full ROM, low tension – supine arm flies/bench
4. Full ROM, moderate tension - assisted dip, assisted pushup, empty bar bench
5. Full ROM, high tension – dips, bench, weighted pushup, MU
Pulling
0. No ROM, no tension – lat ISOs, light static stretching
1. Some ROM, micro tension – scap only row/pulldown
2. Full ROM, mini tension – full range row/pulldown
3. Full ROM, low tension – full range row/pulldown
4. Full ROM, moderate tension - assisted pullup, light full ROM rows, pulldowns
5. Full ROM, high tension – pullup, pulldown, row, MU
Common mistakes
1. Avoidance – avoiding using the knee altogether
2. Assuming it will heal completely with rest. 0 to 60 – “I just need to rest it.” Going from complete rest to full ROM, high tension.
3. Not enough frequency – micro and mini tension needs to be daily
4. Stopping movement prep/accessories altogether once the shoulder feels good. Keep 1 step down from wherever you are in the progression in your program if you’ve experienced pain in the past.
