Exercises / Shoulder & scapula
Side-lying external rotation
- Strength
- Shoulder & scapula
- Light dumbbell, Towel roll
The rotator cuff exercise with the highest infraspinatus and teres minor EMG in fine-wire studies. Also keeps upper trapezius quiet.
Also called side-lying ER, sidelying shoulder external rotation.
Where you stand
No published distribution for this exercise yet. We add one only from a peer-reviewed study.
Muscles worked
Filled: primary. Outlined: secondary.
How much
Typical strength dose: 2-3 sets of 8-12 repetitions at a load that is hard by the last repetition, 2-3 days per week (ACSM novice guideline). Adjust to symptoms.
Start: Side-lying on the uninvolved side
Steps
- Lie on the unaffected side with a small towel roll between the elbow and trunk.
- Bend the elbow to 90° with the forearm resting across the abdomen.
- Keeping the elbow on the towel, rotate the forearm up toward the ceiling.
- Lower slowly over 2-3 seconds.
Cues
- Keep the elbow pinned to the towel
- Move only through a pain-free range
- Keep the shoulder blade gently set back
Common mistakes
- Rolling the trunk backward to gain range
- Lifting the elbow away from the side (substitutes deltoid)
Used for
- Rotator cuff related shoulder pain
- Rotator cuff tendinopathy
- Post-operative rotator cuff (later phase)
- Shoulder instability
Take care (1)
- Respect post-operative loading timelines after rotator cuff repair.
Evidence (2)
Easier
Harder
References (2)
- Reinold MM, Wilk KE, Fleisig GS, et al. J Orthop Sports Phys Ther. 2004;34(7):385-394. Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises
- Cools AM, Dewitte V, Lanszweert F, et al. Am J Sports Med. 2007;35(10):1744-1751. Rehabilitation of scapular muscle balance: which exercises to prescribe?