Two Exercises You Need in Every Program

That’s right I just said that, you need these two exercises in EVERY program!  OK, maybe not every program, but I think there are two critical movements that should be included in almost everyone’s program – shoulder external rotation and hip external rotation.

Why do I think these two movements are so critical that you should include them in every program?

I have 2 main reasons for this:

  1. We are an extremely sagittal plane population – so much of what we do occurs right in front of us, which leads to weakness in the frontal and transverse planes.  Unfortunately, weakness in in these other planes can cause injuries while performing sagittal plane activities.  Basically we need to be stable in the frontal and transverse planes when performing sagittal plane movements.  We’ve talked at length on how hip strength impacts patellofemoral pain and other injuries.
  2. I am a believe of “activating” muscle groups by working them, or “turning them on” prior to performing larger multi-joint movements.  For this specific example, I would perform shoulder external rotation prior to upper body movements and hip external rotation prior to lower body movements.

Unfortunately, these types of exercises aren’t very sexy, they aren’t going to get you beach muscles, and they are kind of boring.  But staying healthy and minimizing the chance of creating a problems is always a good thing.

There are many ways to skin a cat and to perform shoulder external rotation and hip external rotation, but below are the 2 exercises I recommend you start with – the Shoulder W External Rotation exercise and the Hip Clam Shell exercise

 

The W Shoulder External Rotation Exercise

If you’ve heard me speak any time in the last several years, I’ve been saying that the shoulder “W” exercise is my new favorite exercise.  I’ve been saying that for a while now, so I guess it’s not new anymore, but it’s still a favorite of mine.

The exercise combines shoulder external rotation with scapular retraction and posterior tilt, definitely a great combo and advantageous for many people as it recruits the posterior rotator cuff (infraspinatus and teres minor) and the lower trapezius.

Plus, it’s performed bilaterally, which helps with posture and shoulder stability, and you can work both arms at the same time.  So more bang for your buck.

Shoulder External Rotation W Exercise W Exercise - Shoulder External Rotation

UPDATE: I have posted another article and technique video with more detail on the shoulder W exercise.

 

Hip Clam Shells

Clam shells are a quick and easy way to strength the external rotators of the hip.  It’s simple to perform with just a loop or similar resistance band but can be very effective.  Plus, because the resistance band is around both knees, you are working both sides simultaneously, the bottom leg has to stabilize using the hip external rotators to perform the exercise.

Of course it’s all in the technique.  As you can see below, I prefer to use my lower arm to keep my head aligned in neutral and the other hand placed on my hip.  This helps me make sure I am not compensating with my lower back.

Hip clam shell exercise hip ER exercise

UPDATE: I have posted another article and technique video with more detail on the hip clamshell exercise

 

What do you think?  Do you try to incorporate targeted exercises like this in your rehabilitation and training programs?  What else do you consider essential? I’m am always trying to help facilitate functional movements and I really think that incorporating more shoulder external rotation and hip external rotation into all of our programs can really make a difference.

Of course, there are a ton of other exercises that you can perform to work on shoulder external rotation and hip external rotation, but I really like the the shoulder external rotation W exercise and hip clam shells for their simplicity and effectiveness.

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  • martin

    mike learnt the w exercise aka no money drill (no resistance band) from your shoulder dvd. great exercise give it to lots of my patients shoulder patints c and t spine patients. You get lower trap, rotator cuff activity, postural cervical retraction. you can do it standing or supine.
    Clam exercise easy to give not very active patients. Glute medius activity very poor in many patients. Can progress to hip bridge with band around kneess. Hip abduction with band around feet in sidelying.
    The simplest exercise is to get people standing on 1 foot. Focus on glute contraction. Can stand next to a wall for some support.

    • http://mikereinold.com Mike Reinold

      Martin, all good thoughts, agree on all and good progressions.

  • Randy

    Performing the W exercise on the corner of a wall to help facilitate scapular retraction and neutral spinal alignment is a good addition. I also like to add some band perturbations to the W to facilitate some dynamic RC strengthening

    Performing the clam with a bolster under the lumbar spine to maintain normal spinal alignment and limit side-bending is essential.

    Two great exercises and both my patients with UE and LE pathology get some form of Gluteal and Scpaular Retraction exercise.

    • http://mikereinold.com Mike Reinold

      I like it Randy, thanks.

  • john

    Hi Mike,
    For the more advanced client, I use a power cord or theraband incorporating UE external rotation, trunk rotation and hip external rotation in the standing position progressing to standing on one leg ….. giving functional resistance to both groups Great for strengthening both groups and great for balance etc.
    John

    • http://mikereinold.com Mike Reinold

      That is a good thought, do you have a video of that you could share?

  • Joe

    Very good exercises. I often have pt’s perform abdominal draw-in when performing clam shell, good way to concentrate on TA with hip movement which also has a functional component. Another good movement I have used with W’s, is performing a W, then with one arm, perform serratus punch, or scaption raise to get more of a dynamic movement. This allows pt to feel lower trap kicking in throughout the movement….also functional.

    • http://mikereinold.com Mike Reinold

      Joe good additions, great way to enhance the exercises, for sure.

  • http://minimalistfitness.wordpress.com charlie

    Mike, what are your thoughts on loaded external rotations starting from an internally rotated hip position? Here’s an example from Sue Falsone: http://www.youtube.com/watch?v=qP4eqnahpSQ

    • http://mikereinold.com Mike Reinold

      Charlie, I do like those and perform those as well. Great demo in that video, the person’s left leg stabilization is outstanding! Great exercise, but if I had to pick on basic core exercise to include it would be clam, but love those as well.

      I don’t love the shoulder exercises as much on that video, though…

  • Brent Van Gemert

    As Martin mentioned glut med is very poor in many patients. I see it in my professional athletes as well as my recreational older or middle aged patients. I think it’s a must especially in relation to any knee or lower body pathology and is often over looked or not assessed just because hip abduction seems strong. Take a close look and you’ll find much better ckc exercise alignment when addressed, leading to more efficient and effective functional movements. Plus it can range
    from clam shells to single leg RDL’S, so it can be addressed at all levels.

  • Ravi

    Regarding clams: I find the glut med is often inhibited in my more deconditioned patients and long-term compensation strategies have developed. Occasionally I’ll use NMES to help patients “find” the muscle (often together with glut max). I also have pts isometrically contract glut max with glut med which intensifies the workout.

  • http://www.chrisjohnsonpt.com Christopher Johnson

    Mike,

    Good to see you training! Good post and gonna throw a variation of the shoulder external rotation exercise at ya that I think you’d enjoy though you have probably already done something along these lines. Helps to cue scap depression in people who need to get “their shoulders out of their ears.”
    I also think that when performed properly, single leg stance is one of the most important exercises though my experience is that the vast majority of people including elite athletes lack stability in single leg stance. I am amazed at people losing frontal and transverse plane control with this exercise. Please check out my post on endurance corner on this topic as I think it will trigger a few different light bulbs (http://www.endurancecorner.com/Chris_Johnson/single_leg_stance). I also recently wrote a post about the wobbly runner (http://chrisjohnsonpt.com/the-wobbly-runner-and-recurrent-injury/) and recurrent injury on my blog that you and your readers will enjoy. Keep up the great work and reach out when you come to NY to play the Yankees. Wishing you HAPPY, HEALTHY, and STRONG Training!!!

  • http://www.chrisjohnsonpt.com Christopher Johnson

    Sorry…forgot to include the link to the shoulder ER variation. This is good for initial cueing

  • Betsy Estacio, PT

    Love these exercises Mike, use them all the time with my young athletes and deconditioned 70, 80 year olds. Keeping hand on hip to monitor pelvic position is so important. After attending a Shirley Sahrman class last year I became very nitpicky with my patients about how they are doing their exercises to avoid compensation. So many people will rotate their lumbar spines with hip rotation and are not able to independently move the hip while keeping the spine stable. Keying patients into what their bodies are doing via hand on the hip is a great way to do neuromuscular re-ed. Other essential exercise with patients: Hip abduction sidelying without hip hiking using quadratus lumborum or like sidestep with theraband too. I agree we need more lateral stabilization most people are very sagittal plane ie. runners, bikers, walkers. Thanks for your posts, enjoy them.

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  • andrea

    Hi Mike

    will this exercise be ok if you have overactive rhomboids

  • http://www.chriskolba.wordpress.com chris kolba

    great article. I too feel the the hip and shld rotators are important for everyone. I also feel that the hip flexors often need stretched and contribute to inhibition of the glut.
    Thanks

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  • Stephen

    Mike, I have extremely poor ROM when doing the hip clams, can only just get a fist in between my knees at the top of the movement. I feel the tightness in my groin, so would you reccommend a lot of adductor mobility? Maybe something like MWOD groin openers?

    Many thanks

    Stephen

    • http://www.mikereinold.com Mike Reinold

      Stephen, that sounds unusually tight, you may either be doing it wrong or should get checked out by someone.