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;

Miriam Rigney

Miriam has been teaching Hatha yoga since 2009 having completed her teacher training with the Yoga Therapy and Training Centre (Y.T.C.C.) in Cork, Ireland. Miriam initially came to yoga for injury prevention reasons, but soon discovered the numerous other aspects of yoga practice. Since then, she has explored many types and systems of yoga. She first came upon Yoga Tune Up ™ in 2014 and has not looked back since. She completed the Level 1 Yoga Tune Up ™ teacher training in May 2015 and finds herself learning more all the time.

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Kristi Ablett

The idea of using therapy balls to propriocept areas of the body that may have been “forgotten” is an interesting concept. I like the idea that there is this kind of amnesia that develops when we can’t physically see an area of our body and therefore disconnect from it. The roll out is simple and quick to bring these areas back into awareness!

Primavera G

This article really makes me curious about the natural imbalance of external versus internal rotators. Are we always meant to be stronger with internal versus external rotation. Is it from crawling on all 4’s? Or pulling ourselves up into the trees? Thank you for the therapy ball tips, couldn’t we also use it on our internal rotators to loosen them up or is that counter productive?

Rachel Lando

Thank you for breaking down external rotation of the shoulder as well as why pain develops over time. These practices have been a huge resource in alleviating tension and pain along the rotator cuff!

Nadia Vachon

Very useful to gain shoulder mobility and reduce pain in this area.


Merci pour ce texte qui valorise l’épaule comme partie importante du tout qu’est le corps. Les exercices sont faciles à appliquer et bienfaisants pour des épaules en santé…

Ann Donachey

Great article- as someone who holds a lot of tension in my shoulders- this is personally very useful and the examples provided give so much context to the motion!

Suzanne Lemay

Great techniques. I will use it on the wall to keep in good health my shoulders. When you say that every movement move the whole body, it is important to remember it in every day life.


Je me souviens très bien en 2007 lorsque j’ai commencé à donner des cours, je répétait continuellement aux nouvelle mamans l’importance d’une bonne posture et la conscientisation de bien étirer la colonne. De cette façon mon cerveau assimilait continuellement cette information et ma posture c’est grandement amélioré. Un matin à mon travail, un client régulier m’a demandé si j’avais eu une perte de poids considérable…. mais non, c’était uniquement la façon de tenir mon corps qui donnait cet impression. Mes douleurs aux épaules et au cou ont diminué considérablement et mon énergie restait stable toute la journée.

Stephanie Aldrich

“Every movement is a whole body movement.” Brilliant! It’s easy to fall into the trap of thinking about muscles, or even muscle groups, in isolation, but this post helps explain why disfunction in any one body area can impact other areas of the body. Thanks for the great information and the ball rolling suggestions!


My shoulders need so much self care. I noticed when we were in YTU training and l could not do shoulder flossing. Am going to spend time on my shoulders and get them moving well without pain.

suzanne Muro

I am currently in the Yoga Tune Up training and we spent time on the shoulder today. I just wrote about the relationship between slumping shoulders and the effects not only physically on weak posterior shoulder muscles but also on our feelings of confidence and empowerment. Spending time exploring the shoulder joint with balls and strengthening exercises like matador circles, or epaulet arms circles is not only freeing for our shoulders so they can support us, but improves our posture, and helps us find the confidence to stand up to to the challenge of being who we are and believing… Read more »


Thanks for all the detail in the article. Seems like a wonderful way to get to learn on your own anatomy to be able to better teach it to students as the shoulder is so involved with so many moving parts and muscles.