The effects of poor posture and modern living gets a lot of air time these days. Central to this often is mention of rounded, internally rotated shoulders and the effect that this has on everything from breathing to Olympic lifting performances. I recently completed the Yoga Tune Up® Hips Immersion with Trina Altman. One of the take-aways from the immersion was that strengthening of the external (or lateral) rotators of the shoulder joints has now become a regular feature in my own training and in the classes I teach.

The shoulder, which is in fact made up of four joints, is a complex joint. This blog will focus on external rotation of the glenohumeral joint. This includes not only the muscles, bones and ligaments but all of the myofascia and nervous system tissue that is interconnected to the rest of the body. When the body moves, it moves as a whole – our nervous system didn’t name each muscle, tendon, nerve and ligament. Every movement is a whole body movement. Therefore, building awareness and strength in one area has an effect on the entire body. I am not going to wander too far down the rabbit hole that is the movement of the body but it’s safe to say that there is much more to learn.

The prime muscle groups that externally rotate the glenohumeral joint are the posterior deltoid, infraspinatus, and teres minor. The antangonists to this direction of movement include the anterior deltoid, latissimus dorsi, teres major, subscapularis (the only one of the rotator cuff group that internally rotates the shoulder joint) and the pectoralis major. It is clear that the size and number of internal rotators exceeds the external rotators. Couple that with the fact that the external rotators of the glenohumeral joint are out of direct line of vision as they are located on the posterior aspect of the body and you can see how there may be some amnesia about these important workers. According to Davis’ Law1, soft tissue responds to stress by laying down more tissue and becoming shortened and more adhesions between the various layers. In simple terms that can result in shortening of the internal rotators and weakening over time of the shoulder external rotation muscles. This leads to a dysfunctional shoulder, a grumpy nervous system and  frustration in  treating pain in a specific area without dealing with the cause.

gray's illustration of the rotator cuff
The shoulder…it’s complicated.

So, what can we do to initiate change and get to a “new normal?”  In part one of this post, we will outline myofascial work using the Yoga Tune Up® Therapy Balls. Then to follow up, the second part of the post will describe a simple sequence using Yoga Tune Up® poses that can be integrated to daily practices to strengthen the shoulder joints and external rotator shoulder muscles.

Posterior Deltoids

We begin by seeking out some blind spots in the posterior deltoids. To do this, use a toted pair of original therapy balls at the wall. Place them in a vertical position on the back of the shoulder and adjust your body weight to the desired effect by moving your legs away from the wall. Once a trigger point is located, apply sustained compression for 60 seconds, before bending and straightening your knees to strip the muscle fibres. Then move left to right to crossfiber the tissues and tease apart any adhesions. Perform all of these techniques mindfully and enhance everything that you are doing by using the most powerful technique at your disposal – your breath. See also Sequence 12: Shoulder to Elbow in The Roll Model book by Jill Miller for more details on “Shoulder Shrink-Wrap” and pay specific attention to the posterior aspect of the deltoids.

Infraspinatus and Teres Minor

Staying at the wall, remove one therapy ball from the tote. Place it between your right shoulder blade and the wall. Again, sink your weight against the ball and allow yourself to feel the tissues of the infraspinatus and Teres minor. The infraspinatus, as the name suggests originates from the infraspinatus fossa of the scapula, and the teres minor from the upper two-thirds of the lateral border of the scapula. Both insert in to the greater tubercle of the humerus. These are two of the four rotator cuff muscles whose main function is to stabilize the glenohumeral joint. You use these muscles also when pulling the cord to start a lawnmower. They should be strongly engaged when performing Downward Facing Dog for example, but this often is not the case. Using the therapy balls is a great way to educate movers and Down Dog aficionados about optimal muscle engagement towards a safer and more effective pose.

By physically locating this dynamic muscle duo with the Yoga Tune Up therapy balls, you bring your awareness to the area. You enhance your proprioception and increase the number of proprioceptors that are active. Your nervous system and your shoulders will thank you. Repeat the three techniques that you applied for the posterior deltoid in the same manner – sustained compression for 60 seconds, then stripping and lastly crossfibring. Repeat on the left side, noticing any difference between left and right. If you have been using the therapy balls for a while, try and really slow down the movements and allow your breath and your nervous system to guide you to the spots that require attention at a given moment. Change how you look at things, and the things that you look at change.

1 Tissue Provocation Therapies: Can healing be forced? The Laws of tissue adaptation and therapies like prolotherapy and Graston Technique. First published 2012, updated January 10 2017; Paul Ingraham;

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