A few weeks ago I wrote a blog about your subscapularis and since then I seem to have seen quite a few clients who have had some difficulty in performing the lift off test. Did they have a shoulder problem? Yep. Which came first, the shoulder injury, or the weak/incorrectly firing subscapularis? That’s like the age old question, which came first, the chicken or the egg? It’s anyone’s guess, but if I had to pick one, I would probably say that the subscap was the problem child.
That doesn’t mean that we can’t retrain it to work properly, we just need to know how.
The test that I showed in the previous blog can ALSO be used as a strengthening exercise. This video IMG_5982 shows one of my clients correctly performing the lift off exercise for the inital 3 reps. The last two reps I asked her to perform the exercise incorrectly. If you have difficulty initiating the movement with the injured side, try switching on your “core” muscles (aka the transversus abdominus, pelvic floor, multifidus and gluteus maximus) and then attempting to lift off. If you are still unable to perform the movement, then attempt it with your uninjured arm.
Ideallly, I would like to see someone be able to perform 15-20 good quality repetitions of this movement with the hand starting in the lower lumbar region (as opposed to lower down onto the hip region), prior to progressing the exercise. Extending the shoulder (lifting the arm away from the ball) and straightening the elbow/flexing the wrist are common “cheat” patterns.
If you can’t get your hand behind your back without pain/discomfort at the front of the shoulder or if your scapula “wings” away from your back – you definately need to work on being able to achieve shoulder internal rotation before attempting this exercise…either that or there is something seriously wrong with your shoulder and you need further investigation!