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External Rotation in Shoulder Impingement

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    Posted: Jul 10 2015 at 5:10pm
Our user asked: "I have shoulder impingement and I want to devise a physical therapy program that includes exercises that involve external rotation. However, I am already doing rear delt exercises on a combination peck-deck rear-delt machine. I don't do these as therapy, but in my regular weight training workouts. My concern is, that I don't want to mimic any external rotation movement that I may be doing already on the rear delt machine. Below are some web links of trainees doing the same rear delt movements I am referring to. So my question is, are these weight trainees accomplishing external rotation with their rear delt machine exercises? Are these rear delt machine good for external rotation? http://www.bodybuilding.com/exercises/detail/view/name/reverse-machine-flyes https://www.youtube.com/watch?v=9Gx2LF48rRA"
 
Ask a PT Response: "Shoulder impingement can be attributed to a number of factors: ie. anatomical/structural (acromion shape), weakness, instability, imbalance, hypermobility, postural, mechanics, etc. One would have to determine the cause of the impingement to determine a plan of care.

The Posterior Deltoid assists with ER but is not considered its main function (primary function is shoulder extension). If you are looking to focus on strengthening external rotators, why not work on strengthening that motion ie. arm at the side and bringing forearm out or in a throwing position bringing arm back with weights or tubing, etc. So to answer your question, if you want to strengthen external rotators the posterior deltoid machine would not be my first choice. For individuals who experience impingement great care should be taken especially with overhead exercises so as to prevent further injury (ie. rotator cuff tear)

Here is a link to some useful info on shoulder impingement syndrome: http://www2.massgeneral.org/sports/pdf/injury%20prevention/tennis%20tips/impingement%20-%20rtc,%20bursitis.pdf "

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