Lateral Raises - Keeping Physical Therapists in Business

I just want to hand my business card out whenever I see this at the gym. These are rotator cuff shredders. Why you ask?



Take your right hand and make a fist. Now take your left hand and wrap your fingers over the fist. Your fist is the head of your humerus, the fingers are the tendons of the rotator cuff (except it only has four tendons, so ignore your thumb). Now twist your right wrist. It puts torsion in your fingers.

When you have your hands in the position as shown in the picture, your shoulder moves into internal rotation and induces that same torsion of the rotator cuff. Right above the rotator cuff is the AC joint. It’s where your collar bone meets with the spine of your scapula. It’s that bony bump on top of your shoulder. With age, like all joints, it degenerates and the joint surface is no longer smooth. As your arm approaches 90 degrees in the lateral raise, the now taut rotator cuff grates against a rough bony surface. In addition to that, you may be one of the unlucky ones with a type 2 or 3 acromion which is even worse (very common). See below:

acromion types.jpg

It’s like taking a rope, making it taught, and and repetitively rubbing against a blade. This is shoulder impingement. Keep doing it and you develop a rotator cuff tear.

What to do? Simple. Just change the position of your hand. You can still do lateral raises, but with the ‘thumbs up’ position.



Note the hand position

The fix: Thumbs up position.

This position keeps the shoulder in the ‘open pack’ position. In other words, there is slack in the rotator cuff. This is way healthier for the shoulder. There is little to no difference in recruitment of the lateral deltoid between these two positions.

Why does it feel easier to do it with the palms turned down as in the traditional method? Because you’ve created torque in the rotator cuff that you are falsely gaining tension from. Don’t do it, having your arm in a sling from a tear is not a good look.