The ‘Go-To’ Physio Blog – Week 14 – The Importance Of The Fingertips To Rotator Cuff Exercises

The ‘Go-To’ Physio Blog – Week 14 – The Importance Of The Fingertips To Rotator Cuff Exercises


So Today, what I want to talk about is using open chain shoulder exercises now, if you’re in my mentorship group You’ll know I’m not a massive fan of these exercises, I do a whole lot of stuff where we’re linking the fingertips the elbow joint and the shoulder, the rib cage all working together rather than trying to isolate muscles but, if you are someone who uses the open chain version, that’s fine and I respect that okay but what I want to do today is to give you a tip to, in my opinion, get you a more coordinated focus where we can still get a lot of rotator cuff so with the sidelying external rotation I’ve used this in the past, hands-down it’s helped, you know it’s getting a lot of posterior delt it’s not a bad exercise In this day and age I’ve started to look more at the physiology and looking at muscle function and stuff I’m going to change my approach slightly as i’ve moved on in my career Ok, so if you are doing this exercise, there is one tip that I think that makes a massive difference as Shane does this exercise what you’re going to see a lot of patients do is, they’ll extend the wrist Okay, So they’ll lead with the wrist, that’s one kind of cheat they will do or the other one they will do is theyll retract their shoulder blade so they’ll get a lot of rhomboid doing this, rugby league plays in particular have a big, kind of, a tendency to use their rhomboids instead, okay. whereas when we look at tasks and real-life tasks one of the first things I want to do when I grab or pick something up to get that rotator cuff functioning coordinatively with the rest of the limb my fingertips are going to be very important we know from the research that when we grip something that the rotator cuff is going to fire, Okay we know that, So… what I want to do is, I want to take that research and try get the best out of this exercise, so what I want Shane to do is I want Shane’s intentions to start from the fingertips So as Shane Grips, and I haven’t told Shane what I want him to do yet so this is live here, in terms of coaching, hold it here Shane, these fingertips that are gripping, I want you to lead the movement with those fingertips okay? you can see here now, it’s going to feel very very different to Shane okay, can you feel the difference? what do you feel different? Shane: It’s a bit harder to do, I’m getting a bit of a shake okay, so we’re taking away a lot of the cheats but the intention here is getting the flexors coordinating with the deltoids and a lot of other tissues so it’s a nice one when the intention happens from the fingertips we’re using the grip to the max of our capabilities a lot of people when they are doing these exercises the grip is passive, if you do it again for me, go back to doing it the old way for me that’s going to feel very easy to Shane he’s going to use a lot of wrist extensors with a lot of variation happening at the scap whereas when he does it like that we’re actually going to limit a lot of the cheats he’s going to use okay, its a very simple change but form my cinical experience it makes a big difference into actually recruiting around here whether you put an EMG on it, and you look at the difference, i’ll let someone else take care of that but clinically I think using the intention of the fingertips it takes away a lot of the cheats you’re going to see and hopefully, it will give you more clinical success like it did for me, if I ever do feel like I need to use something like this I’m very very conscious of what’s happening at the fingertips Now, in my mentorship, as I said I’ll use a lot of exercises where we’re doing a lot with the hands and hand pressures, integrating the hand, co-contractions the elbow and the shoulder. Really making sure everything is doing it’s job not just the rotator cuff and I think the vast majority of times when we get everything else right, the rotator cuff isn’t actually a major major issue, I think a lot of times the rotator cuffs getting bashed up as it’s trying to do a whole lot of work for a lot bigger muscles, and there is a lot of force transmission issues that are happening before we even have to worry about the rotator cuff so give that a tweak or give that tweak a go, see how you feel, I’m happy to answer any questions, let me know your thoughts after you give it a try

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